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Deep Brain Stimulation for Refractory Tourette Syndrome: Electrode Position and Clinical Outcome

The efficacy of deep brain stimulation (DBS) for refractory Tourette syndrome (TS) is accepted, but whether the efficacy of DBS treatment in the Japanese population is equivalent to those reported internationally and whether adverse effects are comparable are not yet known. This study evaluated the...

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Autores principales: KIMURA, Yuiko, IIJIMA, Keiya, TAKAYAMA, Yutaro, YOKOSAKO, Suguru, KANEKO, Yuu, OMORI, Mayu, KAIDO, Takanobu, KANO, Yukiko, IWASAKI, Masaki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japan Neurosurgical Society 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7812307/
https://www.ncbi.nlm.nih.gov/pubmed/33239475
http://dx.doi.org/10.2176/nmc.oa.2020-0202
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author KIMURA, Yuiko
IIJIMA, Keiya
TAKAYAMA, Yutaro
YOKOSAKO, Suguru
KANEKO, Yuu
OMORI, Mayu
KAIDO, Takanobu
KANO, Yukiko
IWASAKI, Masaki
author_facet KIMURA, Yuiko
IIJIMA, Keiya
TAKAYAMA, Yutaro
YOKOSAKO, Suguru
KANEKO, Yuu
OMORI, Mayu
KAIDO, Takanobu
KANO, Yukiko
IWASAKI, Masaki
author_sort KIMURA, Yuiko
collection PubMed
description The efficacy of deep brain stimulation (DBS) for refractory Tourette syndrome (TS) is accepted, but whether the efficacy of DBS treatment in the Japanese population is equivalent to those reported internationally and whether adverse effects are comparable are not yet known. This study evaluated the clinical practice and outcome of DBS for TS in a Japanese institution. This study included 25 consecutive patients with refractory TS treated with thalamic centromedian-parafascicular nucleus DBS. The severity of tics was evaluated with the Yale Global Tic Severity Scale (YGTSS) before surgery, at 1 year after surgery, and at the last follow-up of 3 years or more after surgery. The occurrence of adverse events, active contact locations, and stimulation conditions were also evaluated. YGTSS tic severity score decreased by average 45.2% at 1 year, and by 56.6% at the last follow-up. The reduction was significant for all aspects of the scores including motor tics, phonic tics, and impairment. The mean coordinates of active contacts were 7.62 mm lateral to the midline, 3.28 mm posterior to the midcommissural point, and 3.41 mm above anterior commissure–posterior commissure plane. Efficacy and stimulation conditions were equivalent to international reports. The stimulation-induced side effects included dysarthria (32.0%) and paresthesia (12.0%). Device infection occurred in three patients (12.0%) as a surgical complication. The DBS device was removed because of infection in two patients. DBS is an effective treatment for refractory TS, although careful indication is necessary because of the surgical risks and unknown long-term outcome.
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spelling pubmed-78123072021-01-25 Deep Brain Stimulation for Refractory Tourette Syndrome: Electrode Position and Clinical Outcome KIMURA, Yuiko IIJIMA, Keiya TAKAYAMA, Yutaro YOKOSAKO, Suguru KANEKO, Yuu OMORI, Mayu KAIDO, Takanobu KANO, Yukiko IWASAKI, Masaki Neurol Med Chir (Tokyo) Original Article The efficacy of deep brain stimulation (DBS) for refractory Tourette syndrome (TS) is accepted, but whether the efficacy of DBS treatment in the Japanese population is equivalent to those reported internationally and whether adverse effects are comparable are not yet known. This study evaluated the clinical practice and outcome of DBS for TS in a Japanese institution. This study included 25 consecutive patients with refractory TS treated with thalamic centromedian-parafascicular nucleus DBS. The severity of tics was evaluated with the Yale Global Tic Severity Scale (YGTSS) before surgery, at 1 year after surgery, and at the last follow-up of 3 years or more after surgery. The occurrence of adverse events, active contact locations, and stimulation conditions were also evaluated. YGTSS tic severity score decreased by average 45.2% at 1 year, and by 56.6% at the last follow-up. The reduction was significant for all aspects of the scores including motor tics, phonic tics, and impairment. The mean coordinates of active contacts were 7.62 mm lateral to the midline, 3.28 mm posterior to the midcommissural point, and 3.41 mm above anterior commissure–posterior commissure plane. Efficacy and stimulation conditions were equivalent to international reports. The stimulation-induced side effects included dysarthria (32.0%) and paresthesia (12.0%). Device infection occurred in three patients (12.0%) as a surgical complication. The DBS device was removed because of infection in two patients. DBS is an effective treatment for refractory TS, although careful indication is necessary because of the surgical risks and unknown long-term outcome. The Japan Neurosurgical Society 2021-01 2020-11-26 /pmc/articles/PMC7812307/ /pubmed/33239475 http://dx.doi.org/10.2176/nmc.oa.2020-0202 Text en © 2021 The Japan Neurosurgical Society This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/
spellingShingle Original Article
KIMURA, Yuiko
IIJIMA, Keiya
TAKAYAMA, Yutaro
YOKOSAKO, Suguru
KANEKO, Yuu
OMORI, Mayu
KAIDO, Takanobu
KANO, Yukiko
IWASAKI, Masaki
Deep Brain Stimulation for Refractory Tourette Syndrome: Electrode Position and Clinical Outcome
title Deep Brain Stimulation for Refractory Tourette Syndrome: Electrode Position and Clinical Outcome
title_full Deep Brain Stimulation for Refractory Tourette Syndrome: Electrode Position and Clinical Outcome
title_fullStr Deep Brain Stimulation for Refractory Tourette Syndrome: Electrode Position and Clinical Outcome
title_full_unstemmed Deep Brain Stimulation for Refractory Tourette Syndrome: Electrode Position and Clinical Outcome
title_short Deep Brain Stimulation for Refractory Tourette Syndrome: Electrode Position and Clinical Outcome
title_sort deep brain stimulation for refractory tourette syndrome: electrode position and clinical outcome
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7812307/
https://www.ncbi.nlm.nih.gov/pubmed/33239475
http://dx.doi.org/10.2176/nmc.oa.2020-0202
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