Marano Massimo, Migliore Simone, Squitieri Ferdinando, Insola Angelo, Scarnati Eugenio, Mazzone Paolo
Unit of Neurology, Neurophysiology and Neurobiology, Department of Medicine, Campus Bio-Medico of Rome University, Via Alvaro del Portillo, 21, 00128 Rome, Italy.
Huntington and Rare Diseases Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, Viale Cappuccini, 1, 71013 San Giovanni Rotondo, Italy.
J Clin Neurosci. 2019 Apr;62:269-272. doi: 10.1016/j.jocn.2018.12.029. Epub 2019 Jan 3.
Tourette syndrome is a rare neuropsychiatric disorder affecting the cortico-striato-thalamo-cortical system. The disease manifests in childhood with tics and various psychiatric comorbidities. Cases of refractory Tourette syndrome are valuable candidates for functional neurosurgery. The thalamic centromedian-parafascicular complex is an experimental target that shows a promising role in Tourette syndrome deep brain stimulation, due to pathophysiologic evidences. We have shown on a long term follow-up, that thalamic deep brain stimulation, targeted on the centromedian-parafascicular complex, could modulate motor (i.e. tics) symptoms and owns a putative effect on various psychiatric aspects. Non-responding psychiatric symptoms could be due to the aberrant developmental environment of young Tourette patients more than disease itself. Centromedian-parafascicular complex is intriguingly embedded in motor, associative and limbic pathways and should be further investigated in his role for neuromodulation of human movement and behavior.
抽动秽语综合征是一种罕见的神经精神疾病，影响皮质-纹状体-丘脑-皮质系统。该疾病在儿童期表现为抽动和各种精神共病。难治性抽动秽语综合征病例是功能性神经外科手术的重要候选对象。丘脑中央中-束旁复合体是一个实验靶点，由于病理生理学证据，其在抽动秽语综合征的深部脑刺激中显示出有前景的作用。我们通过长期随访表明，针对中央中-束旁复合体的丘脑深部脑刺激可以调节运动（即抽动）症状，并对各种精神方面有假定作用。无反应的精神症状可能更多是由于年轻抽动秽语患者异常的发育环境，而非疾病本身。中央中-束旁复合体有趣地嵌入运动、联合和边缘通路，其在人类运动和行为神经调节中的作用应进一步研究。
