CM-Pf deep brain stimulation and the long term management of motor and psychiatric symptoms in a case of Tourette syndrome. (April 2019)

• Record Type: Journal Article
• Authors: Marano, Massimo; Migliore, Simone; Squitieri, Ferdinando; Insola, Angelo; Scarnati, Eugenio; Mazzone, Paolo
• Is Part Of: Journal of clinical neuroscience. Volume 62(2019)
• Page Start: 269
• Page End: 272
• Publication Date: 2019-04
• Subjects: Tic -- Obsessive compulsive disorder -- ADHD -- Centromedian-parafascicular complex -- Depression -- Thalamus -- Neuromodulation; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2018.12.029
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Tourette syndrome is a rare neuropsychiatric disorder featured by chronic tics. Tourette is enriched of psychiatric comorbidities and could be refractory to medications. The thalamic CM-Pf complex is a promising deep brain stimulation target in Tourette. The CM-Pf is embedded in a network involving motor, associative and limbic structures. Patients receiving CM-Pf DBS should be studied also for psychiatric outcomes. Abstract: 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.