Article2006

Deep brain stimulation in Tourette's syndrome: Two targets?

Linda P.C.M. Ackermans · Yasin Temel · Daniëlle C. Cath · Chris van der Linden · Richard Bruggeman · Mariska Kleijer +5 more

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Obsessive-Compulsive Spectrum Disorders Neurological disorders and treatments Transcranial Magnetic Stimulation Studies

Abstract

In this report, we describe the effects of bilateral thalamic stimulation in one patient and of bilateral pallidal stimulation in another patient. Both patients suffered from intractable Tourette's syndrome (TS). Any conservative treatment had failed or had been stopped because of unbearable side effects in the 2 patients. In both cases, there was no comorbidity except for associated behavioral symptoms (compulsions). Electrodes were implanted at the level of the medial part of the thalamus (centromedian nucleus, the substantia periventricularis, and the nucleus ventro-oralis internus) in one patient and in the posteroventral part of the globus pallidus internus (GPi) in the other patient. In both cases, deep brain stimulation (DBS) resulted in a substantial reduction of tics and compulsions. These data show that bilateral DBS of the thalamus as well as of the GPi can have a good effect on tics and behavioral symptoms in patients suffering from intractable TS.

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References

2002Tourette's syndrome 1996Revision of the Padua Inventory of obsessive compulsive disorder symptoms: Distinctions between worry, obsessions, and compulsions 1999Stereotactic treatment of Gilles de la Tourette syndrome by high frequency stimulation of thalamus 2001Basal ganglia dysfunction in Tourette’s syndrome: a new hypothesis 2003Chronic bilateral thalamic stimulation: a new therapeutic approach in intractable Tourette syndrome 2004Surgery in Tourette syndrome

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2007Deep brain stimulation of the nucleus accumbens and the internal capsule in therapeutically refractory Tourette-syndrome 2011European clinical guidelines for Tourette Syndrome and other tic disorders 2011European clinical guidelines for Tourette syndrome and other tic disorders. Part IV: deep brain stimulation 2012Deep Brain Stimulation in the Treatment of Obsessive-Compulsive Disorder 2007Deep brain stimulation in Tourette's syndrome 2019Tics and Tourette Syndrome 2011Deep brain stimulation for Gilles de la Tourette syndrome: A case series targeting subregions of the globus pallidus internus

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