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Deep Brain Stimulation of the Antero-Medial Globus Pallidus Interna for Tourette Syndrome

BACKGROUND: We have previously reported the results of Deep Brain Stimulation (DBS) of the antero-medial globus pallidus interna (GPi) for severe Tourette Syndrome (TS) in 11 patients. We extend this case series to 17 patients and a longer follow-up to a maximum of 46 months. METHODS: 17 patients (1...

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Autores principales: Sachdev, Perminder S., Mohan, Adith, Cannon, Elisabeth, Crawford, John D., Silberstein, Paul, Cook, Raymond, Coyne, Terrence, Silburn, Peter A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4138156/
https://www.ncbi.nlm.nih.gov/pubmed/25136825
http://dx.doi.org/10.1371/journal.pone.0104926
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author Sachdev, Perminder S.
Mohan, Adith
Cannon, Elisabeth
Crawford, John D.
Silberstein, Paul
Cook, Raymond
Coyne, Terrence
Silburn, Peter A.
author_facet Sachdev, Perminder S.
Mohan, Adith
Cannon, Elisabeth
Crawford, John D.
Silberstein, Paul
Cook, Raymond
Coyne, Terrence
Silburn, Peter A.
author_sort Sachdev, Perminder S.
collection PubMed
description BACKGROUND: We have previously reported the results of Deep Brain Stimulation (DBS) of the antero-medial globus pallidus interna (GPi) for severe Tourette Syndrome (TS) in 11 patients. We extend this case series to 17 patients and a longer follow-up to a maximum of 46 months. METHODS: 17 patients (14 male; mean age 29.1 years, range 17–51 years) with severe and medically intractable TS were implanted with Medtronic quadripolar electrodes bilaterally in the antero-medial GPi. The primary outcome measure was the Yale Global Tic Severity Scale (YGTSS). Secondary outcome measures included the Yale-Brown Obsessive Compulsive Scale, Hamilton Depression Rating Scale, Gilles de la Tourette Quality of Life Scale and Global Assessment of Functioning. Follow up was at one month, three months and finally at a mean 24.1 months (range 8–46 months) following surgery. RESULTS: Overall, there was a 48.3% reduction in motor tics and a 41.3% reduction in phonic tics at one month, and this improvement was maintained at final follow-up. 12 out of 17 (70.6%) patients had a>50% reduction in YGTSS score at final follow up. Only 8 patients required ongoing pharmacotherapy for tics post-surgery. Patients improved significantly on all secondary measures. Adverse consequences included lead breakage in 4 patients, infection (1), transient anxiety (2), dizziness (1), poor balance (1) and worsening of stuttering (1). CONCLUSIONS: This case series provides further support that antero-medial GPi DBS is an effective and well tolerated treatment for a subgroup of severe TS, with benefits sustained up to 4 years.
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spelling pubmed-41381562014-08-20 Deep Brain Stimulation of the Antero-Medial Globus Pallidus Interna for Tourette Syndrome Sachdev, Perminder S. Mohan, Adith Cannon, Elisabeth Crawford, John D. Silberstein, Paul Cook, Raymond Coyne, Terrence Silburn, Peter A. PLoS One Research Article BACKGROUND: We have previously reported the results of Deep Brain Stimulation (DBS) of the antero-medial globus pallidus interna (GPi) for severe Tourette Syndrome (TS) in 11 patients. We extend this case series to 17 patients and a longer follow-up to a maximum of 46 months. METHODS: 17 patients (14 male; mean age 29.1 years, range 17–51 years) with severe and medically intractable TS were implanted with Medtronic quadripolar electrodes bilaterally in the antero-medial GPi. The primary outcome measure was the Yale Global Tic Severity Scale (YGTSS). Secondary outcome measures included the Yale-Brown Obsessive Compulsive Scale, Hamilton Depression Rating Scale, Gilles de la Tourette Quality of Life Scale and Global Assessment of Functioning. Follow up was at one month, three months and finally at a mean 24.1 months (range 8–46 months) following surgery. RESULTS: Overall, there was a 48.3% reduction in motor tics and a 41.3% reduction in phonic tics at one month, and this improvement was maintained at final follow-up. 12 out of 17 (70.6%) patients had a>50% reduction in YGTSS score at final follow up. Only 8 patients required ongoing pharmacotherapy for tics post-surgery. Patients improved significantly on all secondary measures. Adverse consequences included lead breakage in 4 patients, infection (1), transient anxiety (2), dizziness (1), poor balance (1) and worsening of stuttering (1). CONCLUSIONS: This case series provides further support that antero-medial GPi DBS is an effective and well tolerated treatment for a subgroup of severe TS, with benefits sustained up to 4 years. Public Library of Science 2014-08-19 /pmc/articles/PMC4138156/ /pubmed/25136825 http://dx.doi.org/10.1371/journal.pone.0104926 Text en © 2014 Sachdev et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Sachdev, Perminder S.
Mohan, Adith
Cannon, Elisabeth
Crawford, John D.
Silberstein, Paul
Cook, Raymond
Coyne, Terrence
Silburn, Peter A.
Deep Brain Stimulation of the Antero-Medial Globus Pallidus Interna for Tourette Syndrome
title Deep Brain Stimulation of the Antero-Medial Globus Pallidus Interna for Tourette Syndrome
title_full Deep Brain Stimulation of the Antero-Medial Globus Pallidus Interna for Tourette Syndrome
title_fullStr Deep Brain Stimulation of the Antero-Medial Globus Pallidus Interna for Tourette Syndrome
title_full_unstemmed Deep Brain Stimulation of the Antero-Medial Globus Pallidus Interna for Tourette Syndrome
title_short Deep Brain Stimulation of the Antero-Medial Globus Pallidus Interna for Tourette Syndrome
title_sort deep brain stimulation of the antero-medial globus pallidus interna for tourette syndrome
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4138156/
https://www.ncbi.nlm.nih.gov/pubmed/25136825
http://dx.doi.org/10.1371/journal.pone.0104926
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