Since 1999, several targets for deep brain stimulation (DBS) in Gilles de la Tourette syndrome (GTS) have emerged showing similar success rates. Studies using different tractography techniques have identified connectivity profiles associated with a better outcome for individual targets. However, GTS patients might need individualized therapy. The objective of this study is to analyze the connectivity profile of different DBS targets for GTS. We identified standard target coordinates for the centromedian nucleus/nucleus ventro-oralis internus (CM/Voi), the CM/parafascicular (CM-Pf) complex, the anteromedial globus pallidus internus (amGPi), the posteroventral GPi (pvGPi), the ventral anterior/ventrolateral thalamus (VA/VL), and the nucleus accumbens/anterior limb of the internal capsule (Nacc/ALIC). Probabilistic tractography was performed from the targets to different limbic and motor areas based on patient-specific imaging and a normative connectome (HCP). Our analysis showed significant differences between the connectivity profiles of standard DBS targets (p < 0.05). Among all targets, the pvGPi showed the strongest connection to the sensorimotor cortex, while the amGPi showed the strongest connection to the prefrontal cortex in patient-specific imaging. Differences were observed between the connectivity profiles when using probabilistic tractography based on patient data and HCP. Our findings showed that the connectivity profiles of different DBS targets to major motor and limbic areas differ significantly. In the future, these differences may be considered when planning DBS for GTS patients employing an individualized approach. There were compelling differences in connectivity profiles when using different tractography techniques.

中文翻译：

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Gilles de Tourette综合征患者深部脑刺激目标的连通性模式

自1999年以来，出现了吉尔斯·德·图雷特综合症（GTS）的几种深部脑刺激（DBS）目标，显示出相似的成功率。使用不同的射线照相技术的研究已经确定了与单个目标更好的结局相关的连通性特征。但是，GTS患者可能需要个体化治疗。这项研究的目的是分析GTS的不同DBS目标的连接配置文件。我们确定了着丝粒核/腹侧腹核（CM / Voi），CM /束旁（CM-Pf）复合体，前内侧苍白球内膜（amGPi），后腹GPi（pvGPi），腹侧的标准目标坐标前/后外侧丘脑（VA / VL）和伏隔核/内囊的前肢（Nacc / ALIC）。基于患者特异性影像学和规范性连接套（HCP），从目标到不同的边缘和运动区域进行了概率性的体检。我们的分析表明，标准DBS目标的连接配置文件之间存在显着差异（p＜0.05）。在所有目标中，pvGPi显示出与感觉运动皮层的最强连接，而amGPi显示出与特定患者的成像中的前额叶皮层的最强连接。当使用基于患者数据和HCP的概率性体检时，在连接配置文件之间观察到差异。我们的研究结果表明，不同DBS目标与主要运动和边缘区域的连通性概况存在显着差异。将来，在采用个性化方法为GTS患者计划DBS时可能会考虑这些差异。当使用不同的射线照相术技术时，连通性方面存在令人信服的差异。