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Sensory phenomena and obsessive-compulsive symptoms in Tourette syndrome following deep brain stimulation: Two case
Yukiko Kano1, Natsumi Matsuda1, Maiko Nonaka2
1Department of Child Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bukyo-ku, Tokyo 113-8655, Japan; Department of Child Psychiatry, The University of Tokyo Hospital, 7-3-1 Hongo, Bukyo-ku, Tokyo 113-8655, Japan.
Abstract:
Here, we assess sensory phenomena (SP) and obsessive-compulsive symptoms (OCS) in two patients with refractory Tourette syndrome (TS) before and after deep brain stimulation (DBS) targeting the centromedian-parafascicular complex (CM-Pfc)-ventral oral nuclei of the bilateral thalami. Based on changes in these clinical features, we also aimed to elucidate useful information regarding the use of DBS in TS. We administered the Yale Global Tic Severity Scale (YGTSS) to assess tics, the Premonitory Urge for Tics Scale (PUTS) for premonitory urges, the University of São Paulo Sensory Phenomena Scale (USP-SPS) for broader SP, the Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS) for OCS, and the Global Assessment of Functioning (GAF) scale for global functioning. We report on two male patients who showed consistent improvement in tics, premonitory urges, and global functioning two years after DBS. In contrast, there were differences between the patients in broader SP, including "just right" perceptions, and OCS. Our results suggest that systematic assessment of a wide range of SP and OCS dimensions is necessary to elucidate the usefulness of DBS in TS.
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