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Surgery for Tourette syndrome.

Linda Ackermans¹, Jens Kuhn, Irene Neuner

¹Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, The Netherlands; MIND (Maastricht Institute for Neuromodulative Development), Maastricht, The Netherlands.

World Neurosurgery

|June 23, 2012

Summary

This summary is machine-generated.

Deep brain stimulation shows promise for intractable Tourette syndrome, effectively reducing tics in many patients. Further research with larger trials is needed to confirm optimal targeting and patient selection for this neurosurgical option.

Keywords:

DBS Deep brain stimulation GPE GPI Globus pallidus externus Globus pallidus internus IC Internal capsule NAC Nucleus accumbens OCD Obsessive-compulsive disorder SIB Self-injurious behavior TS Tourette syndrome YBOCS YGTSS Yale Global Tic Severity Scale Yale-Brown Obsessive-Compulsive Scale

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Area of Science:

Neuroscience
Neurosurgery
Psychiatry

Background:

Tourette syndrome is a chronic neuropsychiatric disorder causing motor and vocal tics, often accompanied by behavioral issues like obsessive-compulsive disorder.
Symptoms typically emerge in childhood and often resolve by adulthood, with treatments including behavioral therapy and medication.
For refractory cases, neurosurgical interventions have been explored, including ablative procedures and, more recently, deep brain stimulation.

Purpose of the Study:

To review the current landscape of deep brain stimulation as a treatment for intractable Tourette syndrome.
To identify potential target areas and assess the efficacy and limitations of existing deep brain stimulation approaches.

Main Methods:

Review of published cases and suggested target areas for deep brain stimulation in Tourette syndrome.
Analysis of reported effects on tic reduction in patients with therapy-refractory symptoms.

Main Results:

Deep brain stimulation has demonstrated a clear effect on reducing tics in the majority of published cases.
Five distinct brain areas have been utilized or proposed as targets for deep brain stimulation in Tourette syndrome.
Most studies involve a limited number of patients, highlighting the need for rigorous patient selection.

Conclusions:

Deep brain stimulation is a viable option for intractable Tourette syndrome, offering tic reduction.
Strict patient selection criteria are essential for successful outcomes.
Future research should focus on double-blind, multicenter trials with larger patient cohorts to validate efficacy and refine treatment protocols.