Deep Brain Stimulation for Refractory Tourette Syndrome: Electrode Position and Clinical Outcome
| Autor: | Keiya Iijima, Mayu Omori, Suguru Yokosako, Yuiko Kimura, Yukiko Kano, Masaki Iwasaki, Yuu Kaneko, Yutaro Takayama, Takanobu Kaido |
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| Rok vydání: | 2020 |
| Předmět: |
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Adult Male Deep brain stimulation Tics Deep Brain Stimulation medicine.medical_treatment Stimulation Tourette syndrome Neurosurgical Procedures 030218 nuclear medicine & medical imaging Young Adult 03 medical and health sciences Dysarthria 0302 clinical medicine Japan Refractory Humans Medicine Adverse effect Phonic Tic Intralaminar Thalamic Nuclei business.industry medicine.disease nervous system diseases centromedian-parafascicular nuclei Implantable Neurostimulators Treatment Outcome Anesthesia Original Article Female Surgery Neurology (clinical) medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Neurologia medico-chirurgica |
| ISSN: | 1349-8029 0470-8105 |
| DOI: | 10.2176/nmc.oa.2020-0202 |
| Popis: | The efficacy of deep brain stimulation (DBS) for refractory Tourette syndrome (TS) is accepted, but whether the efficacy of DBS treatment in the Japanese population is equivalent to those reported internationally and whether adverse effects are comparable are not yet known. This study evaluated the clinical practice and outcome of DBS for TS in a Japanese institution. This study included 25 consecutive patients with refractory TS treated with thalamic centromedian-parafascicular nucleus DBS. The severity of tics was evaluated with the Yale Global Tic Severity Scale (YGTSS) before surgery, at 1 year after surgery, and at the last follow-up of 3 years or more after surgery. The occurrence of adverse events, active contact locations, and stimulation conditions were also evaluated. YGTSS tic severity score decreased by average 45.2% at 1 year, and by 56.6% at the last follow-up. The reduction was significant for all aspects of the scores including motor tics, phonic tics, and impairment. The mean coordinates of active contacts were 7.62 mm lateral to the midline, 3.28 mm posterior to the midcommissural point, and 3.41 mm above anterior commissure-posterior commissure plane. Efficacy and stimulation conditions were equivalent to international reports. The stimulation-induced side effects included dysarthria (32.0%) and paresthesia (12.0%). Device infection occurred in three patients (12.0%) as a surgical complication. The DBS device was removed because of infection in two patients. DBS is an effective treatment for refractory TS, although careful indication is necessary because of the surgical risks and unknown long-term outcome. |
| Databáze: | OpenAIRE |
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