{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T18:32:53Z","timestamp":1791484373917,"version":"4.3.4"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,3,18]],"date-time":"2024-03-18T00:00:00Z","timestamp":1710720000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,3,18]],"date-time":"2024-03-18T00:00:00Z","timestamp":1710720000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"NIH","award":["NIH R01 NR014852"],"award-info":[{"award-number":["NIH R01 NR014852"]}]},{"name":"NIH","award":["R01 NS096008"],"award-info":[{"award-number":["R01 NS096008"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>To report the results of \u2018responsive\u2019 deep brain stimulation (DBS) for Tourette syndrome (TS) in a National Institutes of Health funded experimental cohort. The use of \u2018brain derived physiology\u2019 as a method to trigger DBS devices to deliver trains of electrical stimulation is a proposed approach to address the paroxysmal motor and vocal tic symptoms which appear as part of TS. Ten subjects underwent bilateral staged DBS surgery and each was implanted with bilateral centromedian thalamic (CM) region DBS leads and bilateral M1 region cortical strips. A series of identical experiments and data collections were conducted on three groups of consecutively recruited subjects. Group 1 (n\u2009=\u20092) underwent acute responsive DBS using deep and superficial leads. Group 2 (n\u2009=\u20094) underwent chronic responsive DBS using deep and superficial leads. Group 3 (n\u2009=\u20094) underwent responsive DBS using only the deep leads. The primary outcome measure for each of the 8 subjects with chronic responsive DBS was calculated as the pre-operative baseline Yale Global Tic Severity Scale (YGTSS) motor subscore compared to the 6\u00a0month embedded responsive DBS setting. A responder for the study was defined as any subject manifesting a\u2009\u2265\u200930 points improvement on the YGTSS motor subscale. The videotaped Modified Rush Tic Rating Scale (MRVTRS) was a secondary outcome. Outcomes were collected at 6\u00a0months across three different device states: no stimulation, conventional open-loop stimulation, and embedded responsive stimulation. The experience programming each of the groups and the methods applied for programming were captured. There were 10 medication refractory TS subjects enrolled in the study (5 male and 5 female) and 4\/8 (50%) in the chronic responsive eligible cohort met the primary outcome manifesting a reduction of the YGTSS motor scale of\u2009\u2265\u200930% when on responsive DBS settings. Proof of concept for the use of responsive stimulation was observed in all three groups (acute responsive, cortically triggered and deep DBS leads only). The responsive approach was safe and well tolerated. TS power spectral changes associated with tics occurred consistently in the low frequency 2\u201310\u00a0Hz delta-theta-low alpha oscillation range. The study highlighted the variety of programming strategies which were employed to achieve responsive DBS and those used to overcome stimulation induced artifacts. Proof of concept was also established for a single DBS lead triggering bi-hemispheric delivery of therapeutic stimulation. Responsive DBS was applied to treat TS related motor and vocal tics through the application of three different experimental paradigms. The approach was safe and effective in a subset of individuals. The use of different devices in this study was not aimed at making between device comparisons, but rather, the study was adapted to the current state of the art in technology. Overall, four of the chronic responsive eligible subjects met the primary outcome variable for clinical effectiveness. Cortical physiology was used to trigger responsive DBS when therapy was limited by stimulation induced artifacts.<\/jats:p>","DOI":"10.1038\/s41598-024-57071-5","type":"journal-article","created":{"date-parts":[[2024,3,18]],"date-time":"2024-03-18T08:01:38Z","timestamp":1710748898000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Responsive deep brain stimulation for the treatment of Tourette syndrome"],"prefix":"10.1038","volume":"14","author":[{"given":"Michael S.","family":"Okun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackson","family":"Cagle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julieth","family":"Gomez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawn","family":"Bowers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Wong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly D.","family":"Foote","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aysegul","family":"Gunduz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,3,18]]},"reference":[{"issue":"1","key":"57071_CR1","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/bs.pbr.2022.01.025","volume":"270","author":"A De Salles","year":"2022","unstructured":"De Salles, A. et al. Modern neurosurgical techniques for psychiatric disorders. Prog. Brain Res. 270(1), 33\u201359 (2022).","journal-title":"Prog. Brain Res."},{"issue":"1","key":"57071_CR2","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/bs.pbr.2022.01.026","volume":"270","author":"G Messina","year":"2022","unstructured":"Messina, G., Vetrano, I. G., Bonomo, G. & Broggi, G. Role of deep brain stimulation in management of psychiatric disorders. Prog. Brain Res. 270(1), 61\u201396 (2022).","journal-title":"Prog. Brain Res."},{"issue":"3","key":"57071_CR3","doi-asserted-by":"publisher","first-page":"867","DOI":"10.1016\/j.brs.2023.05.011","volume":"16","author":"FL Hitti","year":"2023","unstructured":"Hitti, F. L. et al. Future directions in psychiatric neurosurgery: Proceedings of the 2022 American Society for Stereotactic and Functional Neurosurgery meeting on surgical neuromodulation for psychiatric disorder. 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