Thalamic deep brain stimulation improves movement in a cerebellar model of lesion-based status dystonicus

Dystonia is the third most common movement disorder and an incapacitating co-morbidity in a variety of neurologic conditions. Dystonia can be caused by genetic, degenerative, idiopathic, and acquired etiologies, which are hypothesized to converge on a “dystonia network” consisting of the basal gangl...

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Main Authors: Megan X. Nguyen, Amanda M. Brown, Tao Lin, Roy V. Sillitoe, Jason S. Gill
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Neurotherapeutics
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Online Access:http://www.sciencedirect.com/science/article/pii/S1878747925000212
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author Megan X. Nguyen
Amanda M. Brown
Tao Lin
Roy V. Sillitoe
Jason S. Gill
author_facet Megan X. Nguyen
Amanda M. Brown
Tao Lin
Roy V. Sillitoe
Jason S. Gill
author_sort Megan X. Nguyen
collection DOAJ
description Dystonia is the third most common movement disorder and an incapacitating co-morbidity in a variety of neurologic conditions. Dystonia can be caused by genetic, degenerative, idiopathic, and acquired etiologies, which are hypothesized to converge on a “dystonia network” consisting of the basal ganglia, thalamus, cerebellum, and cerebral cortex. In acquired dystonia, focal lesions to subcortical network regions lead to dystonia that can be difficult to manage with canonical treatments, including deep brain stimulation (DBS). While studies in animal models have begun to parse the contribution of individual nodes in the dystonia network, how acquired injury to the cerebellar outflow tracts instigates dystonia; and how network modulation interacts with symptom latency remain unexplored questions. Here, we present an electrolytic lesioning paradigm that bilaterally targets the cerebellar outflow tracts. We found that lesioning these tracts, at the junction of the superior cerebellar peduncles and the medial and intermediate cerebellar nuclei, resulted in transient, acute, and severe dystonia with immobility and fixed posturing similar to status dystonicus. We observed a rapid reduction in dystonia with 1 ​h of DBS of the centrolateral thalamic nucleus, a first order node in the network downstream of the cerebellar nuclei. In contrast, 1 ​h of stimulation at a second order node in the short latency, disynaptic projection from the cerebellar nuclei, the striatum, did not show similar rapid modulation of dystonia. Our study introduces a robust paradigm for inducing acute, severe dystonia, and demonstrates that targeted modulation based on network principles powerfully rescues motor behavior. These data inspire the identification of a short latency therapeutic target for acquired dystonia and status dystonicus.
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spelling doaj-art-2f4c2c5d480a4a6a8621de351d595fee2025-08-20T02:55:27ZengElsevierNeurotherapeutics1878-74792025-03-01222e0054310.1016/j.neurot.2025.e00543Thalamic deep brain stimulation improves movement in a cerebellar model of lesion-based status dystonicusMegan X. Nguyen0Amanda M. Brown1Tao Lin2Roy V. Sillitoe3Jason S. Gill4Department of Pediatrics, Division of Neurology and Developmental Neuroscience, Baylor College of Medicine, Houston, TX, USA; Jan and Dan Duncan Neurological Research Institute at Texas Children's Hospital, Houston, TX, USAJan and Dan Duncan Neurological Research Institute at Texas Children's Hospital, Houston, TX, USA; Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX, USAJan and Dan Duncan Neurological Research Institute at Texas Children's Hospital, Houston, TX, USA; Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX, USAJan and Dan Duncan Neurological Research Institute at Texas Children's Hospital, Houston, TX, USA; Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX, USA; Department of Neuroscience, Baylor College of Medicine, Houston, TX, USA; Development, Disease Models & Therapeutics Graduate Program, Baylor College of Medicine, Houston, TX, USA; Corresponding authors.Department of Pediatrics, Division of Neurology and Developmental Neuroscience, Baylor College of Medicine, Houston, TX, USA; Jan and Dan Duncan Neurological Research Institute at Texas Children's Hospital, Houston, TX, USA; Corresponding authors.Dystonia is the third most common movement disorder and an incapacitating co-morbidity in a variety of neurologic conditions. Dystonia can be caused by genetic, degenerative, idiopathic, and acquired etiologies, which are hypothesized to converge on a “dystonia network” consisting of the basal ganglia, thalamus, cerebellum, and cerebral cortex. In acquired dystonia, focal lesions to subcortical network regions lead to dystonia that can be difficult to manage with canonical treatments, including deep brain stimulation (DBS). While studies in animal models have begun to parse the contribution of individual nodes in the dystonia network, how acquired injury to the cerebellar outflow tracts instigates dystonia; and how network modulation interacts with symptom latency remain unexplored questions. Here, we present an electrolytic lesioning paradigm that bilaterally targets the cerebellar outflow tracts. We found that lesioning these tracts, at the junction of the superior cerebellar peduncles and the medial and intermediate cerebellar nuclei, resulted in transient, acute, and severe dystonia with immobility and fixed posturing similar to status dystonicus. We observed a rapid reduction in dystonia with 1 ​h of DBS of the centrolateral thalamic nucleus, a first order node in the network downstream of the cerebellar nuclei. In contrast, 1 ​h of stimulation at a second order node in the short latency, disynaptic projection from the cerebellar nuclei, the striatum, did not show similar rapid modulation of dystonia. Our study introduces a robust paradigm for inducing acute, severe dystonia, and demonstrates that targeted modulation based on network principles powerfully rescues motor behavior. These data inspire the identification of a short latency therapeutic target for acquired dystonia and status dystonicus.http://www.sciencedirect.com/science/article/pii/S1878747925000212DystoniaCerebellumCerebellar peduncleThalamusDeep brain stimulation
spellingShingle Megan X. Nguyen
Amanda M. Brown
Tao Lin
Roy V. Sillitoe
Jason S. Gill
Thalamic deep brain stimulation improves movement in a cerebellar model of lesion-based status dystonicus
Neurotherapeutics
Dystonia
Cerebellum
Cerebellar peduncle
Thalamus
Deep brain stimulation
title Thalamic deep brain stimulation improves movement in a cerebellar model of lesion-based status dystonicus
title_full Thalamic deep brain stimulation improves movement in a cerebellar model of lesion-based status dystonicus
title_fullStr Thalamic deep brain stimulation improves movement in a cerebellar model of lesion-based status dystonicus
title_full_unstemmed Thalamic deep brain stimulation improves movement in a cerebellar model of lesion-based status dystonicus
title_short Thalamic deep brain stimulation improves movement in a cerebellar model of lesion-based status dystonicus
title_sort thalamic deep brain stimulation improves movement in a cerebellar model of lesion based status dystonicus
topic Dystonia
Cerebellum
Cerebellar peduncle
Thalamus
Deep brain stimulation
url http://www.sciencedirect.com/science/article/pii/S1878747925000212
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