Sustained Relief after Pallidal Stimulation Interruption in Tourette's Syndrome Treated with Simultaneous Capsulotomy

© 2020 S. Karger AG, Basel..

INTRODUCTION: Globus pallidus internus (GPi) deep brain stimulation (DBS) combined with anterior capsulotomy offers a promising treatment option for severe medication-refractory cases of Tourette's syndrome (TS) with psychiatric comorbidities. Several patients treated with this combined surgery experienced sustained relief after discontinuation of stimulation over the course of treatment.

METHODS: Retrospectively, the medical records and clinical outcomes were reviewed of 8 patients (6 men; 2 women with mean age of 20.3 years) who had undergone bilateral GPi-DBS combined with anterior capsulotomy for medically intractable TS and psychiatric comorbidities. All patients had experienced an accidental interruption or intentional withdrawal of pallidal stimulation during treatment.

RESULTS: The widespread clinical benefits achieved during the combined treatment were fully maintained after intentional or accidental DBS discontinuation. The improvement in overall tic symptoms achieved was on average 78% at the follow-up or close to the DBS discontinuation, while it was 83% at last follow-up (LFU). At LFU, most patients had functionally recovered; exhibited only mild tics; displayed minor or no obsessive-compulsive disorder symptoms, anxiety, or depression; and experienced a much better quality of life.

CONCLUSION: Bilateral GPi-DBS combined with anterior capsulotomy appears to result in marked and sustained improvements in TS symptoms and psychiatric comorbidities, which are fully maintained over time, even without pallidal stimulation.

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:99

Enthalten in:

Stereotactic and functional neurosurgery - 99(2021), 2 vom: 11., Seite 140-149

Sprache:

Englisch

Beteiligte Personen:

Xu, Wenying [VerfasserIn]
Zhang, Xiaoxiao [VerfasserIn]
Wang, Yuhan [VerfasserIn]
Gong, Hengfen [VerfasserIn]
Wu, Yiwen [VerfasserIn]
Sun, Bomin [VerfasserIn]
Zhang, ChenCheng [VerfasserIn]
Li, Dianyou [VerfasserIn]

Links:

Volltext

Themen:

Anterior capsulotomy
Clinical outcome
Deep brain stimulation
Journal Article
Stimulation discontinuation
Tourette’s syndrome

Anmerkungen:

Date Completed 22.10.2021

Date Revised 22.10.2021

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1159/000510946

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM317745263