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Pallidal and thalamic oscillations are associated with tic severity in patients with Tourette syndrome

WJ. Neumann, J. Huebl, C. Brücke, R. Lofredi, A. Saryyeva, K. Müller-Vahl, J. Krauss, A. Kühn (Berlin, Germany)

Meeting: 2018 International Congress

Abstract Number: 211

Keywords: Pallidum, Thalamus, Tics(also see Gilles de la Tourette syndrome): Pathophysiology

Session Information

Date: Saturday, October 6, 2018

Session Title: Neurophysiology (Non-PD)

Session Time: 1:45pm-3:15pm

Location: Hall 3FG

Objective: The present study aimed at elucidating the pathophysiological role of pallidal and thalamic oscillatory local field potential (LFP) dynamics in patients with Tourette Syndrome.

Background: Aberrant oscillatory activity has been hypothesized to play a role in the pathophysiology of Tourette syndrome. Deep brain stimulation in Tourette Syndrome has so far shown promising, but inconsistent clinical results with varying structures being targeted. Modulation of symptom specific oscillatory signatures of circuit disorders may underlie the mechanism of action of deep brain stimulation and could be used for innovative adaptive neuromodulation to improve therapeutic efficacy.

Methods: Nine severely affected patients with medication refractory Tourette Syndrome were included in the study. Intracerebral local field potentials were recorded simultaneously from bilateral pallidal and thalamic deep brain stimulation electrodes. Dynamics of pallidal and thalamic oscillatory activity was characterized in the time and frequency domain. Wavelet time frequency decomposition was utilized to investigate theta (3 – 12 Hz) and beta (13 – 35 Hz) power and coherence. Correlations with preoperative Yale Global Tic Severity Scale (YGTSS) scores were used to investigate potential associations with symptom severity.

Results: Peaks of activity in the theta (3 – 12 Hz) and beta (13 – 35 Hz) were present in pallidal and thalamic recordings from all patients (3 women/6 men; mean age: 29.8 years) and coupled through coherence across targets. Theta coupling was significantly higher, when compared to beta coupling and phase shuffled surrogate data. Presence of prolonged theta bursts in both targets were most predictive of motor tic severity. Total YGTSS scores (mean: 38.1) could be predicted from pallidal and thalamic LFP activity using multivariable linear regression (R² = 0.96, p = 0.02).

Conclusions: Our findings suggest that pallido-thalamic oscillatory activity may be implicated in the pathophysiology of TS and can serve as a promising biomarker for tic severity to inform adaptive closed loop stimulation algorithms to improve the clinical success of DBS for patients with TS.

To cite this abstract in AMA style:

WJ. Neumann, J. Huebl, C. Brücke, R. Lofredi, A. Saryyeva, K. Müller-Vahl, J. Krauss, A. Kühn. Pallidal and thalamic oscillations are associated with tic severity in patients with Tourette syndrome [abstract]. Mov Disord. 2018; 33 (suppl 2). https://www.mdsabstracts.org/abstract/pallidal-and-thalamic-oscillations-are-associated-with-tic-severity-in-patients-with-tourette-syndrome/. Accessed May 14, 2025.
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