Supplementary Material for: Long-Term Follow-Up on Bilateral Posterior Hypothalamic Deep Brain Stimulation for Treating Refractory Aggressive Behavior in a Patient with Cri du Chat Syndrome: Analysis of Clinical Data, Intraoperative Microdialysis, and Imaging Connectomics

Posterior hypothalamic-deep brain stimulation (pHyp-DBS) has been reported as a successful treatment for reducing refractory aggressive behaviors in patients with distinct primary diagnoses. Here, we report on a patient with cri du chat syndrome presenting severe self-injury and aggressive behaviors toward others, who was treated with pHyp-DBS. Positive results were observed at long-term follow-up in aggressive behavior and quality of life. Intraoperative microdialysis and imaging connectomics analysis were performed to investigate possible mechanisms of action. Our results suggest the involvement of limbic and motor areas and alterations in main neurotransmitter levels in the targeted area that are associated with positive results following treatment.

下丘脑后部深部脑刺激（Posterior hypothalamic-deep brain stimulation，pHyp-DBS）已被证实可有效改善存在不同原发性诊断的患者的难治性攻击行为。本文报道1例合并严重自伤行为与人际攻击行为的猫叫综合征（Cri du Chat Syndrome）患者接受pHyp-DBS治疗的临床案例。长期随访结果显示，患者的攻击行为与生活质量均获得积极改善。术中通过微透析与影像连接组学分析，对该疗法的潜在作用机制进行了探索。本研究结果表明，治疗后的积极疗效与边缘系统及运动脑区的参与、靶区主要神经递质水平的改变密切相关。