Thalamic deep brain stimulation for treatment-refractory Tourette syndrome: Two-year outcome

Neurology ◽  
2009 ◽  
Vol 73 (17) ◽  
pp. 1375-1380 ◽  
Author(s):  
M. Porta ◽  
A. Brambilla ◽  
A. E. Cavanna ◽  
D. Servello ◽  
M. Sassi ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Tourette Syndrome ◽  
Brain Stimulation ◽  
Treatment Refractory ◽  
Deep Brain

An approach to deep brain stimulation for severe treatment-refractory Tourette syndrome: the UK perspective

2010 ◽  
Vol 25 (1) ◽  
pp. 38-44 ◽  
Author(s):  
Andrea E. Cavanna ◽  
Clare M. Eddy ◽  
Rosalind Mitchell ◽  
Hardev Pall ◽  
Ian Mitchell ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Tourette Syndrome ◽  
Brain Stimulation ◽  
Treatment Refractory ◽  
The Uk ◽  
Deep Brain

scholarly journals Target-Specific Effects of Deep Brain Stimulation for Tourette Syndrome: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Laura Wehmeyer ◽  
Thomas Schüller ◽  
Jana Kiess ◽  
Petra Heiden ◽  
Veerle Visser-Vandewalle ◽  
...  
Keyword(s):  
Systematic Review ◽  
Deep Brain Stimulation ◽  
Tourette Syndrome ◽  
Brain Stimulation ◽  
Rating Scale ◽  
Meta Analysis ◽  
Secondary Outcome ◽  
Centromedian Nucleus ◽  
Treatment Refractory ◽  
Deep Brain

Background: Extended research has pointed to the efficacy of deep brain stimulation (DBS) in treatment of patients with treatment-refractory Tourette syndrome (TS). The four most commonly used DBS targets for TS include the centromedian nucleus–nucleus ventrooralis internus (CM-Voi) and the centromedian nucleus–parafascicular (CM-Pf) complexes of the thalamus, and the posteroventrolateral (pvIGPi) and the anteromedial portion of the globus pallidus internus (amGPi). Differences and commonalities between those targets need to be compared systematically.Objective: Therefore, we evaluated whether DBS is effective in reducing TS symptoms and target-specific differences.Methods: A PubMed literature search was conducted according to the PRISMA guidelines. Eligible literature was used to conduct a systematic review and meta-analysis.Results: In total, 65 studies with 376 patients were included. Overall, Yale Global Tic Severity Scale (YGTSS) scores were reduced by more than 50 in 69% of the patients. DBS also resulted in significant reductions of secondary outcome measures, including the total YGTSS, modified Rush Video-Based Tic Rating Scale (mRVRS), Yale-Brown Obsessive Compulsive Scale (YBOCS), and Becks Depression Inventory (BDI). All targets resulted in significant reductions of YGTSS scores and, with the exception of the CM-Pf, also in reduced YBOCS scores. Interestingly, DBS of pallidal targets showed increased YGTSS and YBOCS reductions compared to thalamic targets. Also, the meta-analysis including six randomized controlled and double-blinded trials demonstrated clinical efficacy of DBS for TS, that remained significant for GPi but not thalamic stimulation in two separate meta-analyses.Conclusion: We conclude that DBS is a clinically effective treatment option for patients with treatment-refractory TS, with all targets showing comparable improvement rates. Future research might focus on personalized and symptom-specific target selection.

scholarly journals Inhibitory Control on a Stop Signal Task in Tourette Syndrome before and after Deep Brain Stimulation of the Internal Segment of the Globus Pallidus

2021 ◽  
Vol 11 (4) ◽  
pp. 461
Author(s):  
Francesca Morreale ◽  
Zinovia Kefalopoulou ◽  
Ludvic Zrinzo ◽  
Patricia Limousin ◽  
Eileen Joyce ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Tourette Syndrome ◽  
Globus Pallidus ◽  
Brain Stimulation ◽  
Stop Signal ◽  
Stop Signal Task ◽  
Healthy Controls ◽  
Reactive Inhibition ◽  
Double Blind ◽  
Deep Brain

As part of the first randomized double-blind trial of deep brain stimulation (DBS) of the globus pallidus (GPi) in Tourette syndrome, we examined the effect of stimulation on response initiation and inhibition. A total of 14 patients with severe Tourette syndrome were recruited and tested on the stop signal task prior to and after GPi-DBS surgery and compared to eight age-matched healthy controls. Tics were significantly improved following GPi-DBS. The main measure of reactive inhibition, the stop signal reaction time did not change from before to after surgery and did not differ from that of healthy controls either before or after GPi-DBS surgery. This suggests that patients with Tourette syndrome have normal reactive inhibition which is not significantly altered by GPi-DBS.

scholarly journals Efficacy and Safety of Deep Brain Stimulation in Tourette Syndrome

2018 ◽  
Vol 75 (3) ◽  
pp. 353 ◽  
Author(s):  
Daniel Martinez-Ramirez ◽  
Joohi Jimenez-Shahed ◽  
James Frederick Leckman ◽  
Mauro Porta ◽  
Domenico Servello ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Tourette Syndrome ◽  
Brain Stimulation ◽  
Efficacy And Safety ◽  
Deep Brain

A Prospective Randomized Double-blind Trial of Bilateral Thalamic Deep Brain Stimulation in Adults with Tourette Syndrome

Neurosurgery ◽  
2006 ◽  
Vol 59 (2) ◽  
pp. 482
Author(s):  
Robert J. Maciunas ◽  
Brian Maddux ◽  
David E. Riley ◽  
Christina M. Whitney ◽  
Michael R. Schoenberg ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Tourette Syndrome ◽  
Brain Stimulation ◽  
Double Blind Trial ◽  
Double Blind ◽  
Blind Trial ◽  
Deep Brain

Deep Brain Stimulation in Tourette Syndrome

2012 ◽  
pp. 113-129
Author(s):  
L. Ackermans ◽  
I. Neuner ◽  
J. Kuhn ◽  
V. Visser-Vandewalle
Keyword(s):  
Deep Brain Stimulation ◽  
Tourette Syndrome ◽  
Brain Stimulation ◽  
Deep Brain

scholarly journals Paediatric deep brain stimulation: ethical considerations in malignant Tourette syndrome

2020 ◽  
Vol 46 (10) ◽  
pp. 668-673
Author(s):  
Rosemary T. Behmer Hansen ◽  
Arjun Dubey ◽  
Cynthia Smith ◽  
Patrick J. Henry ◽  
Antonios Mammis
Keyword(s):  
Deep Brain Stimulation ◽  
Suicidal Ideation ◽  
Tourette Syndrome ◽  
Brain Stimulation ◽  
Severe Disease ◽  
Young Patients ◽  
Best Interest ◽  
Self Harm ◽  
A Minor ◽  
Deep Brain

Gilles de la Tourette syndrome (TS) is a childhood neuropsychiatric disorder characterised by the presence of motor and vocal tics. Patients with malignant TS experience severe disease sequelae; risking morbidity and mortality due to tics, self-harm, psychiatric comorbidities and suicide. By definition, those cases termed ‘malignant’ are refractory to all conventional psychiatric and pharmacological regimens. In these instances, deep brain stimulation (DBS) may be efficacious. Current 2015 guidelines recommend a 6-month period absent of suicidal ideation before DBS is offered to patients with TS. We therefore wondered whether it may be ethically justifiable to offer DBS to a minor with malignant TS. We begin with a discussion of non-maleficence and beneficence. New evidence suggests that suicide risk in young patients with TS has been underestimated. In turn, DBS may represent an invaluable opportunity for children with malignant TS to secure future safety, independence and fulfilment. Postponing treatment is associated with additional risks. Ultimately, we assert this unique risk-benefit calculus justifies offering DBS to paediatric patients with malignant TS. A multidisciplinary team of clinicians must determine whether DBS is in the best interest of their individual patients. We conclude with a suggestion for future TS-DBS guidelines regarding suicidal ideation. The importance of informed consent and assent is underscored.

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