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Neuronal activity in the globus pallidus internus in patients with tics
  1. P Zhuang1,
  2. M Hallett2,
  3. X Zhang1,
  4. J Li1,
  5. Y Zhang1,
  6. Y Li1
  1. 1
    Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Key Laboratory for Neurodegenerative Diseases of Ministry of Education, China
  2. 2
    Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
  1. Correspondence to Dr Y Li, No 45 Changchun Street, Xuanwu, Beijing 100053, China; lyj8828{at}


Objective: To explore the role of neuronal activity in the globus pallidus internus (GPi) in the generation of tic movements.

Methods: 8 patients with Tourette’s syndrome with medically intractable tics who underwent a unilateral pallidotomy for severe tics were studied. They ranged in age from 17 to 24 years; disease duration was 7–19 years. Microelectrode recording was performed in the GPi. The electromyogram (EMG) was simultaneously recorded in muscle groups appropriate for the patient’s tics. The relationship between neuronal firing pattern and the EMG was studied.

Results: 232 neurons were recorded during tics from eight trajectories. Of these neurons, in addition to decreased neuronal firing rate and irregular firing pattern, 105 (45%) were tic related showing either a burst of activity or a pause in ongoing tonic activity. They could be synchronous (n = 75), earlier than EMG onset (n = 27) or following EMG onset (n = 3). The GPi neuronal bursts preceded EMG onset with decreased (n = 6) or increased activity (n = 21). The initial change in neural activity occurred about 50 ms to 2 s before the EMG onset.

Conclusions: Although the data are descriptive and preliminary, the tic related neuronal activity observed in GPi appears to indicate that the basal ganglia motor circuit is involved in tic movements. The early neuronal activity seen in GPi may reflect premonitory sensations that precede a tic.

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  • Funding This study was supported by grants NSFC (30370473, 30770746) and NSFB (7042027) and supported in part by the Intramural Program of the NIH.

  • Competing interests None.

  • Ethics approval The protocol was approved by the Institutional Review Board at Xuanwu Hospital of the Capital Medical University.

  • Provenance and Peer review Not commissioned; externally peer reviewed.