Heiden Petra, Hoevels Mauritius, Bayram Dilruba, Baldermann Juan C, Schüller Thomas, Huys Daniel, Visser-Vandewalle Veerle, Andrade Pablo
Department of Stereotactic and Functional Neurosurgery, University Hospital of Cologne, 50937 Cologne, Germany.
Department of Neurosurgery, University Hospital of Cologne, 50937 Cologne, Germany.
Brain Sci. 2021 Jan 11;11(1):87. doi: 10.3390/brainsci11010087.
Since 1999, several targets for deep brain stimulation (DBS) in Gilles de la Tourette syndrome (GTS) have emerged showing similar success rates. Studies using different tractography techniques have identified connectivity profiles associated with a better outcome for individual targets. However, GTS patients might need individualized therapy. The objective of this study is to analyze the connectivity profile of different DBS targets for GTS. We identified standard target coordinates for the centromedian nucleus/nucleus ventro-oralis internus (CM/Voi), the CM/parafascicular (CM-Pf) complex, the anteromedial globus pallidus internus (amGPi), the posteroventral GPi (pvGPi), the ventral anterior/ventrolateral thalamus (VA/VL), and the nucleus accumbens/anterior limb of the internal capsule (Nacc/ALIC). Probabilistic tractography was performed from the targets to different limbic and motor areas based on patient-specific imaging and a normative connectome (HCP). Our analysis showed significant differences between the connectivity profiles of standard DBS targets ( < 0.05). Among all targets, the pvGPi showed the strongest connection to the sensorimotor cortex, while the amGPi showed the strongest connection to the prefrontal cortex in patient-specific imaging. Differences were observed between the connectivity profiles when using probabilistic tractography based on patient data and HCP. Our findings showed that the connectivity profiles of different DBS targets to major motor and limbic areas differ significantly. In the future, these differences may be considered when planning DBS for GTS patients employing an individualized approach. There were compelling differences in connectivity profiles when using different tractography techniques.
自1999年以来，抽动秽语综合征（GTS）的几种脑深部电刺激（DBS）靶点相继出现，成功率相似。使用不同纤维束成像技术的研究已经确定了与各个靶点更好疗效相关的连接图谱。然而，GTS患者可能需要个体化治疗。本研究的目的是分析GTS不同DBS靶点的连接图谱。我们确定了中央中核/腹口内侧核（CM/Voi）、中央中核/束旁核（CM-Pf）复合体、内侧苍白球内部（amGPi）、苍白球腹后部（pvGPi）、腹前/腹外侧丘脑（VA/VL）以及伏隔核/内囊前肢（Nacc/ALIC）的标准靶点坐标。基于患者特异性成像和标准连接组（人类连接组计划，HCP），从这些靶点向不同的边缘和运动区域进行了概率性纤维束成像。我们的分析显示标准DBS靶点的连接图谱之间存在显著差异（<0.05）。在所有靶点中，在患者特异性成像中，pvGPi与感觉运动皮层的连接最强，而amGPi与前额叶皮层的连接最强。基于患者数据和HCP进行概率性纤维束成像时，连接图谱存在差异。我们的研究结果表明，不同DBS靶点与主要运动和边缘区域的连接图谱存在显著差异。未来，在为GTS患者制定个体化DBS治疗方案时，可能需要考虑这些差异。使用不同的纤维束成像技术时，连接图谱存在明显差异。
