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Deep Brain Stimulation for Gilles de la Tourette Syndrome: Toward Limbic Targets
Gilles de la Tourette syndrome (GTS) is a complex neurodevelopmental disorder characterized by tics and, frequently, psychiatric and behavioral comorbidities. Above all, obsessive compulsive disorder/behavior (OCD/OCB) influences the clinical picture and has a severe impact on quality of life, event...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7287742/ https://www.ncbi.nlm.nih.gov/pubmed/32429219 http://dx.doi.org/10.3390/brainsci10050301 |
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author | Servello, Domenico Galbiati, Tommaso Francesco Balestrino, Roberta Iess, Guglielmo Zekaj, Edvin De Michele, Sara Porta, Mauro |
author_facet | Servello, Domenico Galbiati, Tommaso Francesco Balestrino, Roberta Iess, Guglielmo Zekaj, Edvin De Michele, Sara Porta, Mauro |
author_sort | Servello, Domenico |
collection | PubMed |
description | Gilles de la Tourette syndrome (GTS) is a complex neurodevelopmental disorder characterized by tics and, frequently, psychiatric and behavioral comorbidities. Above all, obsessive compulsive disorder/behavior (OCD/OCB) influences the clinical picture and has a severe impact on quality of life, eventually more than the tics themselves. Deep brain stimulation (DBS) is an effective therapy in selected, refractory cases. Clinical response to DBS may vary according to the clinical picture, comorbidities, and to the anatomical target. This retrospective study compares the results obtained from DBS in the ventralis oralis/centromedian-parascicular nucleus of the thalamus (Voi-Cm/Pf) (41 patients) and antero-medial Globus Pallidus internus (am-GPi) (14 patients), evaluating clinical response over time by means of Yale Global Tic Severity Scale (YGTSS) and Yale–Brown Obsessive-Compulsive Scale (YBOCS) scores over a period of 48 months. A significant and stable improvement in the YGTSS and YBOCS has been obtained in both groups (p < 0.001). There was a significant difference in YBOCS improvement over time between the am-GPi group and the Voi-Cm/Pf group, indicating a better and faster control of OCD/OCB symptoms in the former group. The ratio of hardware removal was 23% and limited to 13 patients in the Voi-Cm/Pf group. These results confirm that DBS is an effective therapy in treating GTS and suggest that the am-GPi might be superior to Voi-Cm/Pf in alleviating comorbid OCD/OCB. |
format | Online Article Text |
id | pubmed-7287742 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-72877422020-06-15 Deep Brain Stimulation for Gilles de la Tourette Syndrome: Toward Limbic Targets Servello, Domenico Galbiati, Tommaso Francesco Balestrino, Roberta Iess, Guglielmo Zekaj, Edvin De Michele, Sara Porta, Mauro Brain Sci Article Gilles de la Tourette syndrome (GTS) is a complex neurodevelopmental disorder characterized by tics and, frequently, psychiatric and behavioral comorbidities. Above all, obsessive compulsive disorder/behavior (OCD/OCB) influences the clinical picture and has a severe impact on quality of life, eventually more than the tics themselves. Deep brain stimulation (DBS) is an effective therapy in selected, refractory cases. Clinical response to DBS may vary according to the clinical picture, comorbidities, and to the anatomical target. This retrospective study compares the results obtained from DBS in the ventralis oralis/centromedian-parascicular nucleus of the thalamus (Voi-Cm/Pf) (41 patients) and antero-medial Globus Pallidus internus (am-GPi) (14 patients), evaluating clinical response over time by means of Yale Global Tic Severity Scale (YGTSS) and Yale–Brown Obsessive-Compulsive Scale (YBOCS) scores over a period of 48 months. A significant and stable improvement in the YGTSS and YBOCS has been obtained in both groups (p < 0.001). There was a significant difference in YBOCS improvement over time between the am-GPi group and the Voi-Cm/Pf group, indicating a better and faster control of OCD/OCB symptoms in the former group. The ratio of hardware removal was 23% and limited to 13 patients in the Voi-Cm/Pf group. These results confirm that DBS is an effective therapy in treating GTS and suggest that the am-GPi might be superior to Voi-Cm/Pf in alleviating comorbid OCD/OCB. MDPI 2020-05-15 /pmc/articles/PMC7287742/ /pubmed/32429219 http://dx.doi.org/10.3390/brainsci10050301 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Servello, Domenico Galbiati, Tommaso Francesco Balestrino, Roberta Iess, Guglielmo Zekaj, Edvin De Michele, Sara Porta, Mauro Deep Brain Stimulation for Gilles de la Tourette Syndrome: Toward Limbic Targets |
title | Deep Brain Stimulation for Gilles de la Tourette Syndrome: Toward Limbic Targets |
title_full | Deep Brain Stimulation for Gilles de la Tourette Syndrome: Toward Limbic Targets |
title_fullStr | Deep Brain Stimulation for Gilles de la Tourette Syndrome: Toward Limbic Targets |
title_full_unstemmed | Deep Brain Stimulation for Gilles de la Tourette Syndrome: Toward Limbic Targets |
title_short | Deep Brain Stimulation for Gilles de la Tourette Syndrome: Toward Limbic Targets |
title_sort | deep brain stimulation for gilles de la tourette syndrome: toward limbic targets |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7287742/ https://www.ncbi.nlm.nih.gov/pubmed/32429219 http://dx.doi.org/10.3390/brainsci10050301 |
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