Electric field simulations were created for each patient using information on electrode location and individual stimulation parameters. Methods: Validated clinical assessments were used to measure tics, OCB, quality of life, anxiety, and depression before DBS and at the latest follow-up (17-82 months). Objectives: This study of 15 patients with long-term amGPi DBS for severe TS investigated whether a specific anatomical site within the amGPi correlated with optimal clinical outcome for the measures of tics, obsessive compulsive behaviour (OCB), and mood. The thalamus and anteromedial globus pallidus internus (amGPi) have been the most commonly stimulated sites within the cortico-striato thalamic circuit, but an optimal target is yet to be elucidated.
The optic radiations emerge from the lateral geniculate nucleus of the thalamus (located deep to this image) and course posteriorly through the temporal and parietal lobes to the primary visual cortex.Background: Deep brain stimulation (DBS) in patients with severe, refractory Tourette syndrome (TS) has demonstrated promising but variable results thus far. The inferior occipitofrontal fasciculus connects the ipsilateral occipital and frontal lobes and lies just lateral to the uncinate fasciculus. The uncinate fasciculus, which connects the orbitofrontal cortices with the anterior temporal lobe, lies ventrolateral to the anterior limb of the internal capsule. The anterior commissure contains commissural fibers that reciprocally interconnect the middle and inferior temporal gyri. The genu of the internal capsule, the point at which the posterior and anterior limbs of the internal capsule come together, is located approximately at the posterior border of the anterior commissure.
The internal capsule lies medial to the globus pallidus and merges dorsally with the massive, fan-shaped corona radiata. The globus pallidus, the medial cell mass of the lentiform nucleus, is located at the center of the image. Magnified view of deep white matter tracts around the globus pallidus.
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