Deep Brain Stimulation Tied to Improved Symptoms in Tourette
TUESDAY, Jan. 16, 2018 -- For patients with Tourette syndrome, deep brain stimulation (DBS) is associated with symptomatic improvement but also some important adverse events, according to a study published online Jan. 16 in JAMA Neurology.
Daniel Martinez-Ramirez, M.D., from the University of Florida in Gainesville, and colleagues examined the efficacy and safety of DBS in a multinational cohort of 185 patients with medically refractory Tourette syndrome. Patients received DBS implantation in the centromedian thalamic region, the anterior globus pallidus internus, the posterior globus pallidus internus, and the anterior limb of the internal capsule (57.1, 25.2, 15.3, and 2.5 percent, respectively).
The researchers found that 64.2 percent of patients had symptoms of obsessive-compulsive disorder and 21.6 percent had a history of self-injurious behavior. At one year after DBS implantation, there was improvement in the mean total Yale Global Tic Severity Scale score from 75.01 to 41.19. From baseline to one year, there was improvement in the mean motor tic subscore from 21 to 12.97, and in the mean phonic tic subscore from 16.82 to 9.63. The overall adverse event rate was 35.4 percent, with intracranial hemorrhage, infection, and lead explantation occurring in two, four, and one patient, respectively. Dysarthria and paresthesia were the most common stimulation-induced adverse effects (6.3 and 8.2 percent, respectively).
"Deep brain stimulation was associated with symptomatic improvement in patients with Tourette syndrome but also with important adverse events," the authors write.
One author disclosed financial ties to the pharmaceutical industry.
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Posted: January 2018