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Deep brain stimulation in Tourette's syndrome.

Rizma Jalees Bajwa1, Alain J de Lotbinière, Robert A King

  • 1Department of Neurology, Yale University School of Medicine, New Haven, Connecticut 06520, USA.

Movement Disorders : Official Journal of the Movement Disorder Society
|June 21, 2007
PubMed
Summary
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Deep brain stimulation (DBS) effectively reduced severe tics in an adult with lifelong Tourette's syndrome (TS). This thalamic DBS approach offers hope for intractable cases.

Area of Science:

  • Neurology
  • Neurosurgery
  • Psychiatry

Background:

  • Tourette's syndrome (TS) is a neurological disorder characterized by involuntary motor and vocal tics.
  • Severe, lifelong TS can lead to significant self-injurious behaviors and functional impairment.
  • Obsessive-compulsive disorder (OCD) frequently co-occurs with TS.

Observation:

  • A 48-year-old male patient with severe, lifelong TS and OCD presented with progressive neurological decline due to self-injurious head jerks.
  • Bilateral deep brain stimulation (DBS) was surgically implanted targeting medial thalamic nuclei (centromedian, substantia periventricularis, nucleus ventro-oralis internus).

Findings:

  • The patient experienced a substantial reduction in the severity and frequency of motor tics following thalamic DBS.

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  • The intervention was deemed effective in managing the patient's debilitating tics.

    • Implications:

    • Bilateral thalamic DBS demonstrates therapeutic potential for severe, intractable Tourette's syndrome in adults.
    • This case highlights DBS as a viable option for patients with TS refractory to conventional treatments.
    • Further research into thalamic DBS targets may optimize outcomes for TS patients.