Bour L J, Ackermans L, Foncke E M J, Cath D, van der Linden C, Visser Vandewalle V, Tijssen M A
Department of Neurology and Clinical Neurophysiology of the Academic Medical Center, University of Amsterdam, The Netherlands.
Department of Neurosurgery, Maastricht University Medical Center, The Netherlands; MIND (Maastricht Institute for Neuromodulative Development), The Netherlands.
Clin Neurophysiol. 2015 Aug;126(8):1578-88. doi: 10.1016/j.clinph.2014.10.217. Epub 2014 Nov 13.
Three patients with intractable Tourette syndrome (TS) underwent thalamic deep brain stimulation (DBS). To investigate the role of thalamic electrical activity in tic generation, local field potentials (LFP), EEG and EMG simultaneously were recorded.
Event related potentials and event related spectral perturbations of EEG and LFP, event related cross-coherences between EEG/LFP and LFP/LFP were analyzed. As time locking events, the tic onsets were used. Spontaneous tics were compared to voluntary tic mimicking. The effect of tic suppression and DBS on thalamic LFPs was evaluated.
All three patients showed time-locked and prior to onset of spontaneous motor tics thalamic synchronization and thalamo-cortical cross-coherence. Also in three patients, not time-locked to motor tics, increased intra-thalamic coherences in the 1-8Hz frequency band were found. In one patient it was demonstrated that voluntary mimicked tics were preceded by premotor cortical and thalamic potentials. In this patient unilateral thalamic DBS contralaterally decreased the background thalamic activity.
The present study in three cases with TS shows that spontaneous tics in TS are preceded by repetitive coherent thalamo-cortical discharges, indicating that preceding a tic the basal ganglia circuits are "charged up", ultimately leading to a motor tic.
Thalamic LFP recording may lead to more insight in underlying pathophysiological mechanisms in TS.
三名患有难治性抽动秽语综合征（TS）的患者接受了丘脑深部脑刺激（DBS）。为了研究丘脑电活动在抽动产生中的作用，同时记录了局部场电位（LFP）、脑电图（EEG）和肌电图（EMG）。
分析了脑电图和局部场电位的事件相关电位和事件相关频谱扰动，脑电图/局部场电位与局部场电位/局部场电位之间的事件相关交叉相干性。以抽动发作作为时间锁定事件。将自发抽动与自愿模仿抽动进行比较。评估了抽动抑制和深部脑刺激对丘脑局部场电位的影响。
所有三名患者在自发运动性抽动发作前均出现丘脑同步和丘脑 - 皮质交叉相干性，且与抽动发作时间锁定。同样在三名患者中，发现了在1 - 8Hz频段内与运动性抽动无时间锁定的丘脑内相干性增加。在一名患者中证实，自愿模仿抽动之前有运动前皮质和丘脑电位。在该患者中，单侧丘脑深部脑刺激对侧降低了丘脑背景活动。
本研究对三名抽动秽语综合征患者的研究表明，抽动秽语综合征中的自发抽动之前存在重复性相干丘脑 - 皮质放电，表明在抽动之前基底神经节回路被“充电”，最终导致运动性抽动。
丘脑局部场电位记录可能有助于更深入了解抽动秽语综合征潜在的病理生理机制。
