title: Thalamocortical network activity enables chronic tic detection in humans with Tourette syndrome.
abstract: Tourette syndrome (TS) is a neuropsychiatric disorder characterized by multiple motor and vocal tics. Deep brain stimulation (DBS) is an emerging therapy for severe cases of TS. We studied two patients with TS implanted with bilateral Medtronic Activa PC + S DBS devices, capable of chronic recordings, with depth leads in the thalamic centromedian-parafascicular complex (CM-PF) and subdural strips over the precentral gyrus. Low-frequency (1-10 Hz) CM-PF activity was observed during tics, as well as modulations in beta rhythms over the motor cortex. Tics were divided into three categories: long complex, complex, and simple. Long complex tics, tics involving multiple body regions and lasting longer than 5 s, were concurrent with a highly detectable thalamocortical signature (average recall [sensitivity] 88.6%, average precision 96.3%). Complex tics were detected with an average recall of 63.9% and precision of 36.6% and simple tics an average recall of 39.3% and precision of 37.9%. The detections were determined using data from both patients.
authors.affiliation: J. Crayton Pruitt Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611, USA; Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL 32611, USA.
authors.forename: Jonathan B
authors.initials: JB
authors.lastname: Shute
authors.affiliation: Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL 32611, USA; Department of Neurology, University of Florida, Gainesville, FL 32611, USA; Department of Neurosurgery, University of Florida, Gainesville, FL 32611, USA.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Okun
authors.affiliation: J. Crayton Pruitt Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611, USA; Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL 32611, USA.
authors.forename: Enrico
authors.initials: E
authors.lastname: Opri
authors.affiliation: J. Crayton Pruitt Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611, USA; Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL 32611, USA.
authors.forename: Rene
authors.initials: R
authors.lastname: Molina
authors.affiliation: Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL 32611, USA.
authors.forename: P Justin
authors.initials: PJ
authors.lastname: Rossi
authors.affiliation: Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL 32611, USA; Department of Neurology, University of Florida, Gainesville, FL 32611, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Martinez-Ramirez
authors.affiliation: Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL 32611, USA; Department of Neurosurgery, University of Florida, Gainesville, FL 32611, USA.
authors.forename: Kelly D
authors.initials: KD
authors.lastname: Foote
authors.affiliation: J. Crayton Pruitt Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611, USA; Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL 32611, USA; Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL 32611, USA.
authors.forename: Aysegul
authors.initials: A
authors.lastname: Gunduz
mesh_terms: D000328:Adult; D001611:Beta Rhythm; D046690:Deep Brain Stimulation; D005260:Female; D006801:Humans; D020646:Intralaminar Thalamic Nuclei / Q000503:physiopathology*; D009044:Motor Cortex / Q000503:physiopathology*; D009434:Neural Pathways / Q000503:physiopathology; D020323:Tics / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D005879:Tourette Syndrome / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D055815:Young Adult
keywords: Centromedian thalamus; Deep brain stimulation; Motor cortex; Tourette syndrome