Deep Brain Stimulation of the H Fields of Forel Alleviates Tics in Tourette Syndrome
نویسندگان
چکیده
The current rationale for target selection in Tourette syndrome revolves around the notion of cortico-basal ganglia circuit involvement in the pathophysiology of the disease. However, despite extensive research, the ideal target for deep brain stimulation (DBS) is still under debate, with many structures being neglected and underexplored. Based on clinical observations and taking into account the prevailing hypotheses of network processing in Tourette syndrome, we chose the fields of Forel, namely field H1, as a target for DBS. The fields of Forel constitute the main link between the striatopallidal system and the thalamocortical network, relaying pallidothalamic projections from core anatomical structures to the thalamic ventral nuclear group. In a retrospective study we investigated two patients suffering from chronic, medically intractable Tourette syndrome who underwent bilateral lead implantation in field H1 of Forel. Clinical scales revealed significant alleviation of tics and comorbid symptoms, namely depression and anxiety, in the postoperative course in both patients.
منابع مشابه
Deep Brain Stimulation for Tourette Syndrome
Tourette syndrome (TS) is a chronic neurodevelopmental disorder characterised by motor and vocal tics. Tics often present early in childhood at 6-8 years old, commonly following a waxing and waning course before reaching a peak in severity at around 12 years of age [1]. Although symptoms can subside by early adulthood, a significant number of patients continue to experience severe tics across t...
متن کاملHigh-frequency pallidal stimulation eliminates tic-related neuronal activity in a nonhuman primate model of Tourette syndrome.
High-frequency deep brain stimulation targeting the output nucleus of the basal ganglia, the globus pallidus internus, has been suggested as a treatment modality for intractable Tourette syndrome and basal-ganglia-mediated motor tics. Recent studies on the modeling of motor tics induced by focal injections of bicuculline to the striatum, a putative model of Tourette syndrome, have shown that ti...
متن کاملTourette syndrome deep brain stimulation: a review and updated recommendations.
Deep brain stimulation (DBS) may improve disabling tics in severely affected medication and behaviorally resistant Tourette syndrome (TS). Here we review all reported cases of TS DBS and provide updated recommendations for selection, assessment, and management of potential TS DBS cases based on the literature and implantation experience. Candidates should have a Diagnostic and Statistical Manua...
متن کاملHemi tics and deep brain stimulation.
Deep brain stimulation of targets in both thalamus1 and globus pallidus interna (GPi)2 has been used successfully to control tics in severe cases of Tourette syndrome. Following placement of bilateral GPi stimulators, this 26-year-old-right handed man with a history of medically refractory motor and vocal tics experienced disappearance of vocal tics and marked improvement in neck movements. Mon...
متن کاملChasing Tics in the Human Brain: Development of Open, Scheduled and Closed Loop Responsive Approaches to Deep Brain Stimulation for Tourette Syndrome
Tourette syndrome is a childhood-onset disorder characterized by a combination of motor and vocal tics, often associated with psychiatric comorbidities including attention deficit and hyperactivity disorder and obsessive-compulsive disorder. Despite an onset early in life, half of patients may present symptoms in adulthood, with variable degrees of severity. In select cases, the syndrome may le...
متن کامل