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One-year outcomes of deep brain stimulation in refractory Tourette syndrome

Authors
 Junghan Lee  ;  Kyung Won Chang  ;  Hyun Ho Jung  ;  Dre Kim  ;  Jin Woo Chang  ;  Dong-Ho Song 
Citation
 PSYCHIATRY AND CLINICAL NEUROSCIENCES, Vol.77(11) : 605-612, 2023-11 
Journal Title
PSYCHIATRY AND CLINICAL NEUROSCIENCES
ISSN
 1323-1316 
Issue Date
2023-11
MeSH
Deep Brain Stimulation* / adverse effects ; Humans ; Retrospective Studies ; Tics* ; Tourette Syndrome* / therapy ; Treatment Outcome
Keywords
Tourette syndrome ; deep brain syndrome ; refractory
Abstract
Aim: Deep brain stimulation (DBS) is one option for treating refractory Tourette syndrome (TS); however, it remains unclear which preoperative factors are predictive of DBS outcomes. This study investigated the efficacy of DBS targeting the anteromedial globus pallidus internus and evaluated predisposing factors affecting the outcomes of DBS in a single center in Korea.

Method: Twenty patients who had undergone DBS for refractory TS were reviewed retrospectively. Tic symptoms were followed up at 3-month intervals for up to 1 year after surgery. The Yale Global Tic Severity Scale was used to evaluate preoperative/postoperative tic symptoms. Scores from the Yale-Brown Obsessive Compulsive Scale, Beck Depression Inventory-II, and Beck Anxiety Inventory were also evaluated.

Results: Patients with refractory TS achieved improvement in tic symptoms within 1 year after DBS. Initial responders who achieved a 35% reduction in Yale Global Tic Severity Scale total score within the first 3 months after DBS showed larger treatment effects during 1-year follow-up. Although no clinical or demographic factors were predictive of initial responses, patients with serious self-injurious behaviors tended to show delayed responses.

Conclusion: This is the first study to our knowledge to report the DBS outcomes of 20 patients with TS in a single center in Asia. Our study supports the efficacy of DBS targeting anteromedial globus pallidus internus in refractory TS with no evident serious adverse events. Initial responses after DBS seem to be a predictor of long-term outcomes after surgery.
Full Text
https://onlinelibrary.wiley.com/doi/10.1111/pcn.13584
DOI
10.1111/pcn.13584
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Psychiatry (정신과학교실) > 1. Journal Papers
Yonsei Authors
Song, Dong Ho(송동호) ORCID logo https://orcid.org/0000-0002-9647-3130
Lee, Junghan(이정한)
Chang, Kyung Won(장경원)
Chang, Jin Woo(장진우) ORCID logo https://orcid.org/0000-0002-2717-0101
Jung, Hyun Ho(정현호)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/196749
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