DBS in tourette syndrome: rationale, current status and future prospects

Area of Science:

• Neuroscience
• Neurology
• Psychiatry

Background:

• Tourette syndrome is a childhood-onset neuropsychiatric disorder characterized by tics and behavioral abnormalities.
• Standard treatments include psychotherapy and pharmacotherapy, but a subset of patients are refractory.
• Deep brain stimulation (DBS) emerged as a novel therapeutic approach in 1999.

Purpose of the Study:

• To review the efficacy of deep brain stimulation (DBS) in treating Tourette syndrome.
• To explore various brain nuclei targeted for DBS in Tourette syndrome patients.
• To propose an explanation for the beneficial effects of DBS on tics based on current circuit knowledge.

Main Methods:

• Review of published reports on DBS for Tourette syndrome.
• Analysis of tic reduction rates and effects on behavioral disorders.
• Discussion of cortico-basal ganglia-thalamocortical circuits in relation to DBS efficacy.

Main Results:

• Published reports indicate a tic reduction rate of at least 66% with DBS.
• The effects of DBS on associated behavioral disorders are more variable.
• The optimal DBS target for Tourette syndrome remains unclear due to a small number of treated patients.

Conclusions:

• Meticulous evaluation of electrode position and blinded clinical assessment are crucial.
• Identifying the best DBS target requires careful consideration of both tic reduction and behavioral outcomes.
• Further research is mandatory to optimize DBS therapy for Tourette syndrome.