Centromedian-Parafascicular Complex Deep Brain Stimulation for Tourette Syndrome: A Retrospective Study

Area of Science:

• Neurology
• Neurosurgery
• Psychiatry

Background:

• Tourette syndrome (TS) is a complex neurological disorder often characterized by severe, treatment-resistant tics.
• Thalamic centromedian/parafascicular (CM-Pf) complex deep brain stimulation (DBS) is an emerging therapeutic option for refractory TS.

Purpose of the Study:

• To evaluate the safety and clinical outcomes of bilateral thalamic CM-Pf DBS in patients with severe, medically refractory Tourette syndrome.
• To assess the efficacy of CM-Pf DBS in reducing tic severity and frequency.

Main Methods:

• A series of 12 consecutive patients with medically refractory TS underwent bilateral thalamic CM-Pf DBS.
• Tic severity and frequency were assessed using the Yale Global Tic Severity Scale (YGTSS) over an average follow-up of 26 months.
• Safety outcomes including intraoperative and postoperative complications were meticulously recorded.

Main Results:

• Eleven patients completed at least 2 months of postsurgical follow-up, with five followed for over a year.
• A significant reduction in YGTSS scores was observed, with an average improvement of 54% in the total score (n=10).
• Specific improvements were noted in motor tics (46%), phonic tics (52%), and impairment (59%). No intraoperative complications occurred, and adverse events did not preclude system use.

Conclusions:

• Bilateral thalamic CM-Pf DBS is a safe and effective therapeutic option for carefully selected patients with severe, treatment-resistant Tourette syndrome.
• CM-Pf DBS demonstrates significant and sustained reduction in tic severity and frequency.
• The procedure is well-tolerated, with manageable adverse effects, supporting its role in managing refractory TS.