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Stereotactic Surgery for Treating Intractable Tourette Syndrome: A Single-Center Pilot Study

To evaluate the potential effect of radiofrequency ablation and deep brain stimulation in patients with treatment-refractory Tourette syndrome (TS), this study enrolled thirteen patients with TS who were admitted to our hospital between August 2002 and September 2018. Four patients received a single...

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Autores principales: Wang, Xin, Qu, Liang, Ge, Shunnan, Li, Nan, Wang, Jing, Qiu, Chun, Kou, Huijuan, Li, Jiaming, Jing, Jiangpeng, Su, Mingming, Zheng, Zhaohui, Li, Yang, Qu, Yan, Wang, Xuelian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9313141/
https://www.ncbi.nlm.nih.gov/pubmed/35884645
http://dx.doi.org/10.3390/brainsci12070838
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author Wang, Xin
Qu, Liang
Ge, Shunnan
Li, Nan
Wang, Jing
Qiu, Chun
Kou, Huijuan
Li, Jiaming
Jing, Jiangpeng
Su, Mingming
Zheng, Zhaohui
Li, Yang
Qu, Yan
Wang, Xuelian
author_facet Wang, Xin
Qu, Liang
Ge, Shunnan
Li, Nan
Wang, Jing
Qiu, Chun
Kou, Huijuan
Li, Jiaming
Jing, Jiangpeng
Su, Mingming
Zheng, Zhaohui
Li, Yang
Qu, Yan
Wang, Xuelian
author_sort Wang, Xin
collection PubMed
description To evaluate the potential effect of radiofrequency ablation and deep brain stimulation in patients with treatment-refractory Tourette syndrome (TS), this study enrolled thirteen patients with TS who were admitted to our hospital between August 2002 and September 2018. Four patients received a single- or multi-target radiofrequency ablation after local, potentiated, or general anesthesia; eight patients underwent deep brain stimulation (DBS) surgery; and one patient underwent both ablation and DBS surgery. The severity of tics and obsessive compulsive disorder symptoms and the quality of life were evaluated using the Yale Global Tic Severity Scale (YGTSS), Yale–Brown Obsessive Compulsive Scale (YBOCS), and Gilles de la Tourette Syndrome Quality of Life scale (GTS-QOL), respectively, before surgery, one month after surgery, and at the final follow-up after surgery, which was conducted in December 2018. A paired-sample t test and a multiple linear regression analysis were performed to analyze the data. All patients underwent the operation successfully without any severe complications. Overall, the YGTSS total scores at one month post-surgery (44.1 ± 22.3) and at the final visit (35.1 ± 23.7) were significantly decreased compared with those at baseline (75.1 ± 6.2; both p < 0.05). Additionally, the YBOCS scores at one month post-surgery (16.5 ± 10.1) and at the final visit (12.0 ± 9.5) were significantly decreased compared with those at baseline (22.5 ± 13.1; both p < 0.05). Furthermore, the GTS-QOL scores at one month post-surgery (44.0 ± 12.8) and at the final visit (31.0 ± 17.8) were significantly decreased compared with those at baseline (58.4 ± 14.2; both p < 0.05). Results from a multiple linear regression analysis revealed that the improvement in the YGTSS total score was independently associated with the improvement in the GTS-QOL score at one month post-surgery (standardized β = 0.716, p = 0.023) and at the final visit (standardized β = 1.064, p = 0.000). Conversely, changes in YBOCS scores did not correlate with changes in GTS-QOL scores (p > 0.05). Our results demonstrate that tics, psychiatric symptoms, and the quality of life in patients with intractable TS may be relieved by stereotactic ablation surgery and deep brain stimulation. Furthermore, it appears that the improvement in tics contributes more to the post-operative quality of life of patients than does the improvement in obsessive compulsive symptoms.
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spelling pubmed-93131412022-07-26 Stereotactic Surgery for Treating Intractable Tourette Syndrome: A Single-Center Pilot Study Wang, Xin Qu, Liang Ge, Shunnan Li, Nan Wang, Jing Qiu, Chun Kou, Huijuan Li, Jiaming Jing, Jiangpeng Su, Mingming Zheng, Zhaohui Li, Yang Qu, Yan Wang, Xuelian Brain Sci Article To evaluate the potential effect of radiofrequency ablation and deep brain stimulation in patients with treatment-refractory Tourette syndrome (TS), this study enrolled thirteen patients with TS who were admitted to our hospital between August 2002 and September 2018. Four patients received a single- or multi-target radiofrequency ablation after local, potentiated, or general anesthesia; eight patients underwent deep brain stimulation (DBS) surgery; and one patient underwent both ablation and DBS surgery. The severity of tics and obsessive compulsive disorder symptoms and the quality of life were evaluated using the Yale Global Tic Severity Scale (YGTSS), Yale–Brown Obsessive Compulsive Scale (YBOCS), and Gilles de la Tourette Syndrome Quality of Life scale (GTS-QOL), respectively, before surgery, one month after surgery, and at the final follow-up after surgery, which was conducted in December 2018. A paired-sample t test and a multiple linear regression analysis were performed to analyze the data. All patients underwent the operation successfully without any severe complications. Overall, the YGTSS total scores at one month post-surgery (44.1 ± 22.3) and at the final visit (35.1 ± 23.7) were significantly decreased compared with those at baseline (75.1 ± 6.2; both p < 0.05). Additionally, the YBOCS scores at one month post-surgery (16.5 ± 10.1) and at the final visit (12.0 ± 9.5) were significantly decreased compared with those at baseline (22.5 ± 13.1; both p < 0.05). Furthermore, the GTS-QOL scores at one month post-surgery (44.0 ± 12.8) and at the final visit (31.0 ± 17.8) were significantly decreased compared with those at baseline (58.4 ± 14.2; both p < 0.05). Results from a multiple linear regression analysis revealed that the improvement in the YGTSS total score was independently associated with the improvement in the GTS-QOL score at one month post-surgery (standardized β = 0.716, p = 0.023) and at the final visit (standardized β = 1.064, p = 0.000). Conversely, changes in YBOCS scores did not correlate with changes in GTS-QOL scores (p > 0.05). Our results demonstrate that tics, psychiatric symptoms, and the quality of life in patients with intractable TS may be relieved by stereotactic ablation surgery and deep brain stimulation. Furthermore, it appears that the improvement in tics contributes more to the post-operative quality of life of patients than does the improvement in obsessive compulsive symptoms. MDPI 2022-06-28 /pmc/articles/PMC9313141/ /pubmed/35884645 http://dx.doi.org/10.3390/brainsci12070838 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/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 (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Wang, Xin
Qu, Liang
Ge, Shunnan
Li, Nan
Wang, Jing
Qiu, Chun
Kou, Huijuan
Li, Jiaming
Jing, Jiangpeng
Su, Mingming
Zheng, Zhaohui
Li, Yang
Qu, Yan
Wang, Xuelian
Stereotactic Surgery for Treating Intractable Tourette Syndrome: A Single-Center Pilot Study
title Stereotactic Surgery for Treating Intractable Tourette Syndrome: A Single-Center Pilot Study
title_full Stereotactic Surgery for Treating Intractable Tourette Syndrome: A Single-Center Pilot Study
title_fullStr Stereotactic Surgery for Treating Intractable Tourette Syndrome: A Single-Center Pilot Study
title_full_unstemmed Stereotactic Surgery for Treating Intractable Tourette Syndrome: A Single-Center Pilot Study
title_short Stereotactic Surgery for Treating Intractable Tourette Syndrome: A Single-Center Pilot Study
title_sort stereotactic surgery for treating intractable tourette syndrome: a single-center pilot study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9313141/
https://www.ncbi.nlm.nih.gov/pubmed/35884645
http://dx.doi.org/10.3390/brainsci12070838
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