한빛사논문
Mayo Clinic
Aaron E Rusheen 1,2, Juan Rojas-Cabrera 2, Abhinav Goyal 1,2, Hojin Shin 2,3, Jason Yuen 2,4, Dong-Pyo Jang 5, Keven E Bennet 2,6, Charles D Blaha 2, Kendall H Lee 2,3, Yoonbae Oh 2,3
1Medical Scientist Training Program, Mayo Clinic, Rochester, MN 55902, USA.
2Department of Neurologic Surgery, Mayo Clinic, Rochester, MN 55902, USA.
3Department of Biomedical Engineering, Mayo Clinic, Rochester, MN 55902, USA.
4Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong VIC 3216, Australia.
5Department of Biomedical Engineering, Hanyang University, Seoul 04763, South Korea.
6Division of Engineering, Mayo Clinic, Rochester, MN 55902, USA.
Correspondence to: Yoonbae Oh, PhD
Abstract
Tourette syndrome is a childhood-onset neuropsychiatric disorder characterized by intrusive motor and vocal tics that can lead to self-injury and deleterious mental health complications. While dysfunction in striatal dopamine neurotransmission has been proposed to underlie tic behavior, evidence is scarce and inconclusive. Deep brain stimulation (DBS) of the thalamic centromedian parafascicular complex (CMPf), an approved surgical interventive treatment for medical refractory Tourette syndrome, may reduce tics by affecting striatal dopamine release. Here, we use electrophysiology, electrochemistry, optogenetics, pharmacological treatments, and behavioral measurements to mechanistically examine how thalamic DBS modulates synaptic and tonic dopamine activity in the dorsomedial striatum. Previous studies demonstrated focal disruption of GABAergic transmission in the dorsolateral striatum of rats led to repetitive motor tics recapitulating the major symptom of Tourette Syndrome. We employed this model under light anesthesia and found CMPf DBS evoked synaptic dopamine release and elevated tonic dopamine levels via striatal cholinergic interneurons while concomitantly reducing motor tic behavior. The improvement in tic behavior was found to be mediated by D2 receptor activation as blocking this receptor prevented the therapeutic response. Our results demonstrate that release of striatal dopamine mediates the therapeutic effects of CMPf DBS, and points to striatal dopamine dysfunction as a driver for motor tics in the pathoneurophysiology of Tourette syndrome.
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