TY - JOUR
T1 - Long-term outcome of globus pallidus internus deep brain stimulation in patients with tourette syndrome
AU - Zhang, Jian Guo
AU - Ge, Yan
AU - Stead, Matt
AU - Zhang, Kai
AU - Yan, Shuang Shuang
AU - Hu, Wei
AU - Meng, Fan Gang
N1 - Funding Information:
Grant Support: This study was supported in part by grants 81071224 and 81241048 from the National Natural Science Foundation of China (F.-G.M.), grant 2011-3-032 from the Beijing Health System Advanced Health Technology Talent Cultivation Plan (F.-G.M.), and grant ZY201305 from the Beijing Municipal Administration of Hospitals Clinical Medicine Development (J.-G.Z.).
Publisher Copyright:
© 2014 Mayo Foundation for Medical Education and Research.
PY - 2014/11/1
Y1 - 2014/11/1
N2 - Objective To evaluate the effectiveness of deep brain stimulation (DBS) of the globus pallidus internus (GPi) on tic severity and common comorbidities in patients with severe Tourette syndrome that is refractory to pharmacological treatment and psychotherapy.Patients and Methods We retrospectively assessed the long-term clinical outcomes of 13 patients with treatment-refractory Tourette syndrome who underwent DBS targeting the GPi at the Beijing Tiantan Hospital from January 1, 2006, through May 31, 2013. The primary outcome was a change in tic severity as measured by the Yale Global Tic Severity Scale, and the secondary outcome was a change in associated behavioral disorders and mood as measured by the Gilles de la Tourette Syndrome-Quality of Life Scale assessment.Results Compared with baseline, the mean reduction in the total Yale Global Tic Severity Scale scores at last follow-up (mean, 41.9 months; range, 13-80 months) was 52.1% (range, 4.3%-83.6%), and the mean improvement rates at 1 month, 6 months, 12 months, 18 months, 24 months, 30 months, and 36 or more months were 11.8%, 20.0%, 26.8%, 36.7%, 44.7%, 49.0%, and 56.7%, respectively. A paired-sample t test revealed significant improvement of tic symptoms after 6 months of DBS programming (P<.05). The Gilles de la Tourette Syndrome-Quality of Life Scale score improved by a mean of 45.7% (range, 11.0%-77.2%).Conclusion This study is currently the largest reported GPi DBS case series of patients with treatment-refractory TS with the longest follow-up. Our results support the potential beneficial effect of GPi DBS on disabling tic reduction and improvement of quality of life.
AB - Objective To evaluate the effectiveness of deep brain stimulation (DBS) of the globus pallidus internus (GPi) on tic severity and common comorbidities in patients with severe Tourette syndrome that is refractory to pharmacological treatment and psychotherapy.Patients and Methods We retrospectively assessed the long-term clinical outcomes of 13 patients with treatment-refractory Tourette syndrome who underwent DBS targeting the GPi at the Beijing Tiantan Hospital from January 1, 2006, through May 31, 2013. The primary outcome was a change in tic severity as measured by the Yale Global Tic Severity Scale, and the secondary outcome was a change in associated behavioral disorders and mood as measured by the Gilles de la Tourette Syndrome-Quality of Life Scale assessment.Results Compared with baseline, the mean reduction in the total Yale Global Tic Severity Scale scores at last follow-up (mean, 41.9 months; range, 13-80 months) was 52.1% (range, 4.3%-83.6%), and the mean improvement rates at 1 month, 6 months, 12 months, 18 months, 24 months, 30 months, and 36 or more months were 11.8%, 20.0%, 26.8%, 36.7%, 44.7%, 49.0%, and 56.7%, respectively. A paired-sample t test revealed significant improvement of tic symptoms after 6 months of DBS programming (P<.05). The Gilles de la Tourette Syndrome-Quality of Life Scale score improved by a mean of 45.7% (range, 11.0%-77.2%).Conclusion This study is currently the largest reported GPi DBS case series of patients with treatment-refractory TS with the longest follow-up. Our results support the potential beneficial effect of GPi DBS on disabling tic reduction and improvement of quality of life.
KW - Abbreviations and Acronyms CM-Pfc centromedian-parafascicular complex DBS deep brain stimulation GPi globus pallidus internus TS Tourette syndrome TSQOL Gilles de la Tourette Syndrome-Quality of Life Scale YGTSS Yale Global Tic Severity Scale
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U2 - 10.1016/j.mayocp.2014.05.019
DO - 10.1016/j.mayocp.2014.05.019
M3 - Article
C2 - 25444487
AN - SCOPUS:84913592090
SN - 0025-6196
VL - 89
SP - 1506
EP - 1514
JO - Mayo Clinic Proceedings
JF - Mayo Clinic Proceedings
IS - 11
ER -