title: Deep Brain Stimulation for Tourette's Syndrome: The Case for Targeting the Thalamic Centromedian-Parafascicular Complex.
abstract: Tourette's syndrome (TS) is a neurologic condition characterized by both motor and phonic tics and is typically associated with psychiatric comorbidities, including obsessive-compulsive disorder/behavior and attention-deficit hyperactivity disorder, and can be psychologically and socially debilitating. It is considered a disorder of the cortico-striato-thalamo-cortical circuitry, as suggested by pathophysiology studies and therapeutic options. Among these, deep brain stimulation (DBS) of the centromedian-parafascicular nucleus (CM-Pf) of the thalamus is emerging as a valuable treatment modality for patients affected by severe, treatment-resistant TS. Here, we review the most recent experimental evidence for the pivotal role of CM-Pf in the pathophysiology of TS, discuss potential mechanisms of action that may mediate the effects of CM-Pf DBS in TS, and summarize its clinical efficacy.
authors.affiliation: Department of Neurosurgery, Mayo Clinic , Rochester, MN , USA.
authors.forename: Paola
authors.initials: P
authors.lastname: Testini
authors.affiliation: Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA; Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA; Department of Radiology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Hoon-Ki
authors.initials: HK
authors.lastname: Min
authors.affiliation: Department of Neurosurgery, JFK New Jersey Neuroscience Institute , Edison, NJ , USA.
authors.forename: Asif
authors.initials: A
authors.lastname: Bashir
authors.affiliation: Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA; Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA.
authors.forename: Kendall H
authors.initials: KH
authors.lastname: Lee
keywords: CM-Pf; DBS; Tourette; centromedian–parafascicular; thalamus; tics