Wehmeyer Laura, Baldermann Juan Carlos, Pogosyan Alek, Rodriguez Plazas Fernando, Loehrer Philipp A, Bonetti Leonardo, Yassine Sahar, Zur Mühlen Katharina, Schüller Thomas, Kuhn Jens, Visser-Vandewalle Veerle, Tan Huiling, Andrade Pablo
MRC Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
Department of Stereotactic and Functional Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Mol Psychiatry. 2025 Sep 13. doi: 10.1038/s41380-025-03220-9.
Thalamic deep brain stimulation (DBS) has shown clinical improvement for patients with treatment-refractory Tourette Syndrome (TS). Advancing DBS for TS requires identifying reliable electrophysiological markers. Recognising TS as a network disorder, we investigated thalamo-cortical oscillatory connectivity by combining local field potential (LFP) recordings from the DBS thalamic target region using the Percept PC neurostimulator with high-density EEG in eight male TS patients (aged 27-38) while stimulation was off. We identified a spatially and spectrally distinct oscillatory network connecting the medial thalamus and frontal regions in the alpha band (8-12 Hz), with functional connectivity strength negatively correlated with TS symptom severity. Moreover, reduced thalamo-frontal alpha functional connectivity before tic onset, localised in sensorimotor regions and the inferior parietal cortex, suggests its direct role in tic generation. Importantly, associations with symptoms and pre-tic dynamics were specific to functional connectivity patterns and not evident in the pure power spectra. These findings underscore the importance of investigating electrophysiological oscillatory connectivity to characterise pathological network connections in TS, potentially guiding stimulation-based interventions and future research on closed-loop DBS for TS.
丘脑深部脑刺激（DBS）已显示出对难治性抽动秽语综合征（TS）患者有临床改善作用。推进TS的DBS治疗需要识别可靠的电生理标志物。鉴于认识到TS是一种网络障碍，我们在8名男性TS患者（年龄27 - 38岁）中，在刺激关闭时，使用Percept PC神经刺激器结合来自DBS丘脑靶点区域的局部场电位（LFP）记录与高密度脑电图，研究了丘脑 - 皮质振荡连接性。我们在α波段（8 - 12赫兹）识别出一个在空间和频谱上都不同的振荡网络，连接内侧丘脑和额叶区域，其功能连接强度与TS症状严重程度呈负相关。此外，在抽动发作前，丘脑 - 额叶α功能连接性降低，位于感觉运动区域和顶下小叶，提示其在抽动产生中起直接作用。重要的是，与症状和抽动前动态的关联特定于功能连接模式，在纯功率谱中并不明显。这些发现强调了研究电生理振荡连接性以表征TS中病理网络连接的重要性，可能为基于刺激的干预措施以及未来TS的闭环DBS研究提供指导。
