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dc.contributor.authorJo, Hang Joon
dc.contributor.authorMcCairn, Kevin W.
dc.contributor.authorGibson, William S.
dc.contributor.authorTestini, Paola
dc.contributor.authorZhao, Cong Zhi
dc.contributor.authorGorny, Krzysztof R.
dc.contributor.authorFelmlee, Joel P.
dc.contributor.authorWelker, Kirk M.
dc.contributor.authorBlaha, Charles D.
dc.contributor.authorKlassen, Bryan T.
dc.contributor.authorMin, Hoon-Ki
dc.contributor.authorLee, Kendall H.
dc.date.accessioned2018-08-21T01:02:13Z-
dc.date.available2018-08-21T01:02:13Z-
dc.date.issued2018
dc.identifier.issn2213-1582
dc.identifier.urihttp://hdl.handle.net/2433/233924-
dc.description.abstractBackground and objectives: Deep brain stimulation (DBS) of the thalamus is a promising therapeutic alternative for treating medically refractory Tourette syndrome (TS). However, few human studies have examined its mechanism of action. Therefore, the networks that mediate the therapeutic effects of thalamic DBS remain poorly understood.
dc.description.abstractMethods: Five participants diagnosed with severe medically refractory TS underwent bilateral thalamic DBS stereotactic surgery. Intraoperative fMRI characterized the blood oxygen level-dependent (BOLD) response evoked by thalamic DBS and determined whether the therapeutic effectiveness of thalamic DBS, as assessed using the Modified Rush Video Rating Scale test, would correlate with evoked BOLD responses in motor and limbic cortical and subcortical regions.
dc.description.abstractResults: Our results reveal that thalamic stimulation in TS participants has wide-ranging effects that impact the frontostriatal, limbic, and motor networks. Thalamic stimulation induced suppression of motor and insula networks correlated with motor tic reduction, while suppression of frontal and parietal networks correlated with vocal tic reduction. These regions mapped closely to major regions of interest (ROI) identified in a nonhuman primate model of TS.
dc.description.abstractConclusions: Overall, these findings suggest that a critical factor in TS treatment should involve modulation of both frontostriatal and motor networks, rather than be treated as a focal disorder of the brain. Using the novel combination of DBS-evoked tic reduction and fMRI in human subjects, we provide new insights into the basal ganglia-cerebellar-thalamo-cortical network-level mechanisms that influence the effects of thalamic DBS. Future translational research should identify whether these network changes are cause or effect of TS symptoms.
dc.format.mimetypeapplication/pdf
dc.language.isoeng
dc.publisherElsevier BV
dc.rights© 2018 Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/BY-NC-ND/4.0/).
dc.subjectNeurological disorders
dc.subjectDeep brain stimulation
dc.subjectFunctional magnetic resonance imaging
dc.subjectBasal ganglia-cerebellar-thalamo-cortical networks
dc.subjectVocal/motor tics
dc.titleGlobal network modulation during thalamic stimulation for Tourette syndrome
dc.type.niitypeJournal Article
dc.identifier.jtitleNeuroImage: Clinical
dc.identifier.volume18
dc.identifier.spage502
dc.identifier.epage509
dc.relation.doi10.1016/j.nicl.2018.02.018
dc.textversionpublisher
dc.addressDepartment of Neurologic Surgery, Mayo Clinic・Department of Neurology, Mayo Clinic
dc.addressSystems Neuroscience Section, Primate Research Institute, Kyoto University
dc.addressDepartment of Neurologic Surgery, Mayo Clinic
dc.addressDepartment of Neurologic Surgery, Mayo Clinic
dc.addressDepartment of Neurology, Mayo Clinic
dc.addressDepartment of Radiology, Mayo Clinic
dc.addressDepartment of Radiology, Mayo Clinic
dc.addressDepartment of Radiology, Mayo Clinic
dc.addressDepartment of Neurologic Surgery, Mayo Clinic
dc.addressDepartment of Neurology, Mayo Clinic
dc.addressDepartment of Neurologic Surgery, Mayo Clinic・Department of Radiology, Mayo Clinic・Department of Physiology and Biomedical Engineering, Mayo Clinic
dc.addressDepartment of Neurologic Surgery, Mayo Clinic・Department of Physiology and Biomedical Engineering, Mayo Clinic
dc.identifier.pmid29560306
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