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Related Experiment Video

Updated: Feb 13, 2026

Combining Transcranial Magnetic Stimulation and fMRI to Examine the Default Mode Network
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Global network modulation during thalamic stimulation for Tourette syndrome.

Hang Joon Jo1, Kevin W McCairn2, William S Gibson3

  • 1Department of Neurologic Surgery, Mayo Clinic, Rochester, MN 55905, USA; Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA.

Neuroimage. Clinical
|March 22, 2018
PubMed
Summary

Deep brain stimulation (DBS) of the thalamus effectively reduces tics in Tourette syndrome (TS) by modulating frontostriatal and motor networks. This study reveals network-level mechanisms underlying thalamic DBS therapeutic effects in TS patients.

Keywords:
Basal ganglia-cerebellar-thalamo-cortical networksDeep brain stimulationFunctional magnetic resonance imagingNeurological disordersVocal/motor tics

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Area of Science:

  • Neuroscience
  • Neurology
  • Neurosurgery

Background:

  • Deep brain stimulation (DBS) of the thalamus shows promise for treating medically refractory Tourette syndrome (TS).
  • The precise mechanisms and brain networks mediating thalamic DBS efficacy in TS remain poorly understood.
  • Few human studies have investigated the neural underpinnings of thalamic DBS for Tourette syndrome.

Purpose of the Study:

  • To investigate the brain network mechanisms underlying the therapeutic effects of thalamic DBS in patients with Tourette syndrome.
  • To correlate blood oxygen level-dependent (BOLD) responses evoked by thalamic DBS with clinical tic reduction in TS.
  • To explore the relationship between evoked BOLD responses and specific brain regions involved in TS.

Main Methods:

  • Five participants with severe, medically refractory Tourette syndrome received bilateral thalamic DBS.
  • Intraoperative functional MRI (fMRI) was used to characterize BOLD responses to thalamic DBS.
  • Therapeutic effectiveness was assessed using the Modified Rush Video Rating Scale, correlating with evoked BOLD responses.

Main Results:

  • Thalamic DBS modulated widespread brain networks, including frontostriatal, limbic, and motor circuits.
  • Suppression in motor and insula networks correlated with reduced motor tics.
  • Suppression in frontal and parietal networks correlated with reduced vocal tics, mapping to primate model regions.

Conclusions:

  • Effective TS treatment with thalamic DBS requires modulation of frontostriatal and motor networks, not just focal brain areas.
  • This study provides novel insights into basal ganglia-cerebellar-thalamo-cortical network mechanisms of thalamic DBS in TS using fMRI.
  • Future research should elucidate whether observed network changes are causative or consequential to TS symptoms.