Double-blind clinical trial of thalamic stimulation in patients with Tourette syndrome (2024)

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Journal of Neurology, Neurosurgery & Psychiatry

Long-term outcome of thalamic deep brain stimulation in two patients with Tourette syndrome

2010 •

Annelien Duits

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Open Access Macedonian Journal of Medical Sciences

Long-term Outcome of Deep Brain Stimulation in Intralaminar Thalamus for Refractory Tourette Syndrome: A Case Report

ina dianata, Agus Mahendra, rocksy situmeang

BACKGROUND: Tourette syndrome (TS) is a neurobehavioral disease that has onset at an early age around 5–7 years old. This disease affects 0.3–0.8% of young age population. With criteria diagnosis at least one vocal and two motor tics beginning before 18 years old. The symptoms of tics remain unusual from a social point of view, thus making it difficult for patients to evolve their professional life and education level. We present a case report of a young male patient with refractory TS with a Yale Global Tic Severity Scale (YGTSS) score of 88 out of 100; he has experienced remarkable improvement after undergoing a deep brain stimulation (DBS) procedure. CASE REPORT: A 23-year-old male came to our neurosurgery outpatient clinic who had had a history of TS since 8 years ago. He had facial and jumping-type tics. Lately, his jumping movements cannot be controlled, with increasing frequency and intensity. The maximum tic-free interval is only 30 min. On 1st-time evaluation in the neurosu...

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Journal of Neurosurgery

Neuroanatomical considerations for optimizing thalamic deep brain stimulation in Tourette syndrome

2021 •

Yuki Sakai, Takashi Morishita

OBJECTIVE Deep brain stimulation (DBS) of the centromedian thalamic nucleus has been reportedly used to treat severe Tourette syndrome, yielding promising outcomes. However, it remains unclear how DBS electrode position and stimulation parameters modulate the specific area and related networks. The authors aimed to evaluate the relationships between the anatomical location of stimulation fields and clinical responses, including therapeutic and side effects. METHODS The authors collected data from 8 patients with Tourette syndrome who were treated with DBS. The authors selected the active contact following threshold tests of acute side effects and gradually increased the stimulation intensity within the therapeutic window such that acute and chronic side effects could be avoided at each programming session. The patients were carefully interviewed, and stimulation-induced side effects were recorded. Clinical outcomes were evaluated using the Yale Global Tic Severity Scale, the Yale-Brown Obsessive-Compulsive Scale, and the Hamilton Depression Rating Scale. The DBS lead location was evaluated in the normalized brain space by using a 3D atlas. The volume of tissue activated was determined, and the associated normative connective analyses were performed to link the stimulation field with the therapeutic and side effects. RESULTS The mean follow-up period was 10.9 ± 3.9 months. All clinical scales showed significant improvement. Whereas the volume of tissue activated associated with therapeutic effects covers the centromedian and ventrolateral nuclei and showed an association with motor networks, those associated with paresthesia and dizziness were associated with stimulation of the ventralis caudalis and red nucleus, respectively. Depressed mood was associated with the spread of stimulation current to the mediodorsal nucleus and showed an association with limbic networks. CONCLUSIONS This study addresses the importance of accurate implantation of DBS electrodes for obtaining standardized clinical outcomes and suggests that meticulous programming with careful monitoring of clinical symptoms may improve outcomes.

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Journal of Neurosurgery

Chronic bilateral thalamic stimulation: a new therapeutic approach in intractable Tourette syndrome

2003 •

Henry Colle

✓✓ Based on the results of thalamotomies described by Hassler in 1970, the authors performed bilateral thalamic highfrequency stimulation (HFS) in three patients with intractable Tourette syndrome (TS). In this report they describe the long-term effects. Three male patients (42, 28, and 45 years of age) had manifested motor and vocal tics since early childhood. The diagnosis of TS was made according to the criteria of the Tourette Syndrome Classification Study Group. Any drug or alternative treatment had been either ineffective or only temporarily effective in all three patients. There was no serious comorbidity. The target for stimulation was chosen at the level of the centromedian nucleus, substantia periventricularis, and nucleus ventrooralis internus. After 2 weeks of test stimulation, the pulse generators were implanted. After a follow-up period of 5 years in the patient in Case 1, 1 year in the patient in Case 2, and 8 months in the patient in Case 3, all major motor and vocal...

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Parkinsonism & Related Disorders

Scheduled, intermittent stimulation of the thalamus reduces tics in Tourette syndrome

2016 •

Kelly Foote

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Translational Psychiatry

Clinical effectiveness of unilateral deep brain stimulation in Tourette syndrome

2011 •

Joachim Klosterkötter, Joerg Daumann, Christiane Woopen

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Journal of Neurology Neurosurgery and Psychiatry

Tourette’s syndrome and deep brain stimulation

2005 •

Soledad Navarro

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Archives of Neurology

Internal Pallidal and Thalamic Stimulation in Patients With Tourette Syndrome

2008 •

Didier Dormont

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PLoS ONE

Increased Thalamic Gamma Band Activity Correlates with Symptom Relief following Deep Brain Stimulation in Humans with Tourette’s Syndrome

2012 •

Kelly Foote

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Movement Disorders

Patient selection and assessment recommendations for deep brain stimulation in Tourette syndrome

2006 •

Danielle Cath

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Double-blind clinical trial of thalamic stimulation in patients with Tourette syndrome (2024)
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