Low‐Frequency Oscillations at The Limbic Globus Pallidus Internus Seem to Be Associated With Premonitory Urges in Tourette's Syndrome

Tourette's syndrome (TS) is a childhood neuropsychiatric disorder characterized by multiple involuntary motor and vocal tics. It is commonly associated with other behavioral disorders including attention-deficit/hyperactivity disorder, obsessive-compulsive disorder, anxiety, depression, and self-injurious behaviors. Tourette's syndrome can be effectively managed with psychobehavioral and pharmacological treatments, and many patients experience an improvement in tics in adulthood. However, symptoms may persist and cause severe impairment in a small subset of patients despite available therapies. In recent years, deep brain stimulation (DBS) has been shown to be a promising treatment option for such patients. Since the advent of its use in 1999, multiple targets have been identified in DBS for TS, including the medial thalamus, globus pallidus internus, globus pallidus externus, anterior limb of the internal capsule/nucleus accumbens, and subthalamic nucleus. While the medial thalamus is the most commonly reported trajectory, the optimal surgical target for TS is still a topic of much debate. This paper provides a review of the available literature regarding the use of DBS for TS.

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Behavioral and Motor Improvement After Deep Brain Stimulation of the Globus Pallidus Externus in a Case of Tourette's Syndrome

Neuromodulation Technology at the Neural Interface ◽

10.1111/j.1525-1403.2012.00526.x ◽

2012 ◽

Vol 16 (1) ◽

pp. 55-58 ◽

Cited By ~ 32

Author(s):

Fabián Piedimonte ◽

Juan Carlos M. Andreani ◽

Leandro Piedimonte ◽

Pablo Graff ◽

Valeria Bacaro ◽

...

Keyword(s):

Deep Brain Stimulation ◽

Globus Pallidus ◽

Brain Stimulation ◽

Tourette's Syndrome ◽

Tourette’S Syndrome ◽

Motor Improvement ◽

Globus Pallidus Externus ◽

Deep Brain ◽

Stimulation Of

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Low-Frequency Stimulation of Globus Pallidus Internus for Axial Motor Symptoms of Parkinson's Disease

Movement Disorders Clinical Practice ◽

10.1002/mdc3.12215 ◽

2015 ◽

Vol 2 (4) ◽

pp. 445-446 ◽

Cited By ~ 2

Author(s):

Maurizio Zibetti ◽

Andres M. Lozano ◽

Marina Picillo ◽

Renato P. Munhoz ◽

Alfonso Fasano

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Globus Pallidus ◽

Low Frequency ◽

Globus Pallidus Internus ◽

Motor Symptoms ◽

Low Frequency Stimulation ◽

Frequency Stimulation ◽

Stimulation Of

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Functional Neural Changes after Low-Frequency Bilateral Globus Pallidus Internus Deep Brain Stimulation for Post-Hypoxic Cortical Myoclonus: Voxel-Based Subtraction Analysis of Serial Positron Emission

Brain Sciences ◽

10.3390/brainsci10100730 ◽

2020 ◽

Vol 10 (10) ◽

pp. 730

Author(s):

Myung Ji Kim ◽

So Hee Park ◽

Kyoung Heo ◽

Jin Woo Chang ◽

Joong Il Kim ◽

...

Keyword(s):

Deep Brain Stimulation ◽

Globus Pallidus ◽

Brain Stimulation ◽

Statistical Parametric Mapping ◽

Low Frequency ◽

Globus Pallidus Internus ◽

Hypoxic Event ◽

Positron Emission ◽

Study Results ◽

Deep Brain

Post-hypoxic myoclonus (PHM) and Lance–Adams syndrome (LAS) are rare conditions following cardiopulmonary resuscitation. The aim of this study was to identify functional activity in the cerebral cortex after a hypoxic event and to investigate alterations that could be modulated by deep brain stimulation (DBS). A voxel-based subtraction analysis of serial positron emission tomography (PET) scans was performed in a 34-year-old woman with chronic medically refractory PHM that improved with bilateral globus pallidus internus (Gpi) DBS implanted three years after the hypoxic event. The patient required low-frequency stimulation to show myoclonus improvement. Using voxel-based statistical parametric mapping, we identified a decrease in glucose metabolism in the prefrontal lobe including the dorsolateral, orbito-, and inferior prefrontal cortex, which was suspected to be the origin of the myoclonus from postoperative PET/magnetic resonance imaging (MRI) after DBS. Based on the present study results, voxel-based subtraction of PET appears to be a useful approach for monitoring patients with PHM treated with DBS. Further investigation and continuous follow-up on the use of PET analysis and DBS treatment for patients with PHM are necessary to help understanding the pathophysiology of PHM, or LAS.

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