| Abstract | BACKGROUND: There have been several reports of successful deep brain stimulation (DBS) for the treatment of severe Gilles de la Tourette syndrome (GTS). METHOD: 18 cases of GTS who were resistant to at least 6 months of standard and innovative treatments, as well as to psychobehavioural techniques, underwent DBS. DBS was placed bilaterally in the centromedian-parafascicular (CM-Pfc) and ventralis oralis complex of the thalamus. Patients were evaluated after surgery, with immediate and formal assessments at least every 3 months, including "on-off" and "sham off" in the first nine patients. RESULTS: All patients responded well to DBS, although to differing degrees. The duration of follow-up assessments ranged from 3 to 18 months. The comorbid symptoms of obsessive-compulsive behaviour, obsessive-compulsive disorder, self-injurious behaviours, anxiety and premonitory sensations decreased after treatment with DBS. There were no serious permanent adverse effects. CONCLUSIONS: DBS is a useful and safe treatment for severe GTS. The results of ours and previous DBS reports suggest that the CM-Pfc and ventralis oralis complex of the thalamus may be a good DBS target for GTS. |
| Authors | D Servello, M Porta, M Sassi, A Brambilla, M M Robertson
(Affiliation: Neurosurgical Division, Istituto Galeazzi IRCCS, via Galeazzi 4, 20161 Milano, Italy. servello at libero.it)
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| Journal | Journal of neurology, neurosurgery, and psychiatry
(J Neurol Neurosurg Psychiatry)
Vol. 79
Issue 2
Pg. 136-42
(Feb 2008)
ISSN: 1468-330X England |
| PMID | 17846115
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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| Topics |
- Adolescent
- Adult
- Deep Brain Stimulation
(instrumentation, methods)
- Dominance, Cerebral
(physiology)
- Equipment Design
- Female
- Follow-Up Studies
- Humans
- Intralaminar Thalamic Nuclei
(physiopathology)
- Magnetic Resonance Imaging
- Male
- Middle Aged
- Neurologic Examination
- Neuronavigation
- Neurons
(physiology)
- Quality of Life
- Retreatment
- Tomography, X-Ray Computed
- Tourette Syndrome
(diagnosis, physiopathology, therapy)
- Treatment Failure
- Treatment Outcome
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