Observation on the efficacy of deep brain stimulation in the treatment of refractory Tourette syndrome
Objective To explore the clinical efficacy of deep brain stimulation(DBS)in the treatment of Tourette syndrome(TS),and to preliminarily observe the difference in the effects of targeting the globus pallidus interna(GPi)and the centromedian-parafascicular complex(CM-Pf)on the symptom improvement of TS.Methods The clinical data of 40 TS patients who received DBS at the Neurosurgery Center of Beijing Tiantan Hospital,Capital Medical University from October 2006 to January 2023 were retrospectively analyzed.Among them,33 cases were in the GPi-DBS group and 7 cases were in the CM-Pf-DBS group.The improvement of clinical symptoms of the patients was followed up 6 and 12 months after surgery.The main evaluation index of clinical symptoms was the Yale Global Tic Severity Scale(YGTSS)score,and the secondary evaluation indexes were the Beck Depression Inventory(BDI),Hamilton Depression Rating Scale(HRDS),Hospital Anxiety and Depression Scale(HADS)and Yale-Brown Obsessive Compulsive Scale(YBOSC).Comparative analysis of the improvement of YGTSS scores were conducted between the two groups.Results The YGTSS scores of40 patients before surgery,6 months after surgery,and 12 months after surgery were 63.6±14.2 points,42.0±15.0 points,and 36.1± 16.9 points respectively,and the differences were statistically significant(P＜0.001).The improvement rates of YGTSS scores 6 and 12 months after surgery were(33.7±19.0)％and(43.1±23.3)％respectively.BDI(24 cases),HDRS(24 cases),HADS(25 cases),and YBOCS(14 cases)scores also showed a decreasing trend at 6 months and 12 months post surgery(all P＜0.05).Compared with the CM-Pf-DBS group,there was no statistical significance in the improvement of YGTSS scores at 6 or 12 months after operation in the GPi-DBS group or the CM-Pf-DBS group(both P＞0.05).In addition,5 patients in the GPi-DBS group developed symptoms of nausea,vomiting or dyskinesia after turning on the device.Conclusions DBS can improve tic symptoms,anxiety and depression in TS patients,and the improvement rate tends to increase with the prolongation of postoperative follow-up.Preliminary observations show that there is no significant difference between GPi-DBS and CM-Pf-DBS in improving tic symptoms.
万方数据
维普
