Globus Pallidus Interna in Tourette Syndrome: Decreased Local Activity and Disrupted Functional Connectivtiy

Abstract

Globus pallidus interna (GPi) is an effective deep brain stimulation site for the treatment of Tourette syndrome (TS), and plays a crucial role in the pathophysiology of TS. To investigate the functional network feature of GPi in TS patients, we retrospectively studied 24 boys with ‘pure’ TS and 32 age-/education-matched healthy boys by resting state functional magnetic resonance images. Amplitude of low-frequency fluctuation (ALFF) and functional connectivity were used to estimate the local activity in GPi and its functional coordinate with the whole brain regions, respectively. We found decreased ALFF in patients’ bilateral GPi, which was also negatively correlated with clinical symptoms. Functional connectivity analysis indicated abnormal regions within motor and motor-control networks in patients (inferior part of sensorimotor area, cerebellum, prefrontal cortex, cingulate gyrus, caudate nucleus, and brain stem). Transcranial magnetic stimulation sites defined by previous studies (“hand knob” area, premotor area, and supplementary motor area) did not show significantly different functional connectivity with GPi between groups. In summary, this study characterized the disrupted functional network of GPi and provided potential regions-of-interest for further basic and clinical studies on TS.

Functional Connectivity of the Corticobasal Ganglia–Thalamocortical Network in Parkinson Disease: A Systematic Review and Meta-Analysis with Cross-Validation

“…The CBTC network is a fundamental circuit for motor ability and critically related to the clinical symptoms of PD. A recently proposed theory (10,11) postulates that seed-based FC in the CBTC network may provide important information for precise targeting of repetitive transcranial magnetic stimulation treatment for PD. By using software (Effect Size-Signed Differential Mapping version 4.31 for Windows; www.…”

Deep brain stimulation modulates pallidal and subthalamic neural oscillations in Tourette's syndrome

“…Low-frequency (4-12 Hz) and high-frequency (>150 Hz) phaseamplitude couplings in the GPi were seen at rest (Ji et al, 2016). So, combining the evidence above, the low-frequency oscillation is pathological because it related to the clinical scores.…”

“…Alternatively, in the globus pallidus interna (GPi), attenuated beta oscillation and elevated gamma and high‐frequency oscillations were seen along with frequent tics (Jimenez‐Shahed, Telkes, Viswanathan, & Ince, ). Low‐frequency (4–12 Hz) and high‐frequency (>150 Hz) phase–amplitude couplings in the GPi were seen at rest (Ji et al, ). So, combining the evidence above, the low‐frequency oscillation is pathological because it related to the clinical scores.…”

Deep brain stimulation for Tourette’s syndrome

“…The globus pallidus (GP) is a promising DBS target for managing severe and refractory TS [63]. As alluded to earlier, the GP is an element of the basal gangliathalamocortical circuit that is believed to play a crucial role in the control of motor function.…”

“…Some experts have hypothesized that the GP modulates the excitability of the thalamus and influences the input from thalamus to cortex [64]. A recent restingstate functional magnetic resonance imaging (fMRI) study indicates that the GP could be involved in TS pathophysiology [63],owever, the putative role of the GP in TS remains to be clearly defined.…”