Baldermann Juan Carlos, Petry-Schmelzer Jan Niklas, Schüller Thomas, Mahfoud Lin, Brandt Gregor A, Dembek Till A, van der Linden Christina, Krauss Joachim K, Szejko Natalia, Müller-Vahl Kirsten R, Ganos Christos, Al-Fatly Bassam, Heiden Petra, Servello Domenico, Galbiati Tommaso, Johnson Kara A, Butson Christopher R, Okun Michael S, Andrade Pablo, Domschke Katharina, Fink Gereon R, Fox Michael D, Horn Andreas, Kuhn Jens, Visser-Vandewalle Veerle, Barbe Michael T
Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Nat Commun. 2024 Dec 16;15(1):10687. doi: 10.1038/s41467-024-55242-6.
Gilles de la Tourette Syndrome (GTS) is a chronic tic disorder, characterized by unwanted motor actions and vocalizations. While brain stimulation techniques show promise in reducing tic severity, optimal target networks are not well-defined. Here, we leverage datasets from two independent deep brain stimulation (DBS) cohorts and a cohort of tic-inducing lesions to infer critical networks for treatment and occurrence of tics by mapping stimulation sites and lesions to a functional connectome derived from 1,000 healthy participants. We find that greater tic reduction is linked to higher connectivity of DBS sites (N = 37) with action-related functional resting-state networks, i.e., the cingulo-opercular (r = 0.62; p < 0.001) and somato-cognitive action networks (r = 0.47; p = 0.002). Regions of the cingulo-opercular network best match the optimal connectivity profiles of thalamic DBS. We replicate the significance of targeting cingulo-opercular and somato-cognitive action network connectivity in an independent DBS cohort (N = 10). Finally, we demonstrate that tic-inducing brain lesions (N = 22) exhibit similar connectivity to these networks. Collectively, these results suggest a critical role for these action-related networks in the pathophysiology and treatment of GTS.
Gilles de la Tourette综合征（GTS）是一种慢性抽动障碍，其特征为不自主的运动行为和发声。虽然脑刺激技术在降低抽动严重程度方面显示出前景，但最佳目标网络尚未明确界定。在此，我们利用来自两个独立的深部脑刺激（DBS）队列以及一个抽动诱发病变队列的数据集，通过将刺激部位和病变映射到源自1000名健康参与者的功能连接组，来推断抽动治疗和发生的关键网络。我们发现，抽动减少程度越大，与DBS位点（N = 37）与动作相关的功能静息态网络，即扣带回 - 脑岛网络（r = 0.62；p < 0.001）和躯体 - 认知动作网络（r = 0.47；p = 0.002）的更高连接性相关。扣带回 - 脑岛网络区域与丘脑DBS的最佳连接性图谱最为匹配。我们在一个独立的DBS队列（N = 10）中重复了靶向扣带回 - 脑岛和躯体 - 认知动作网络连接性的重要性。最后，我们证明抽动诱发脑病变（N = 22）与这些网络表现出相似的连接性。总体而言，这些结果表明这些动作相关网络在GTS的病理生理学和治疗中起关键作用。
