Deep brain stimulation of anteromedial globus pallidus interna for severe Tourette's syndrome

Cannon, Elisabeth, Silburn, Peter, Coyne, Terrence, O'Maley, Karen, Crawford, John D. and Sachdev, Perminder S. (2012) Deep brain stimulation of anteromedial globus pallidus interna for severe Tourette's syndrome. American Journal of Psychiatry, 169 8: 860-866. doi:10.1176/appi.ajp.2012.11101583


Author Cannon, Elisabeth
Silburn, Peter
Coyne, Terrence
O'Maley, Karen
Crawford, John D.
Sachdev, Perminder S.
Title Deep brain stimulation of anteromedial globus pallidus interna for severe Tourette's syndrome
Journal name American Journal of Psychiatry   Check publisher's open access policy
ISSN 0002-953X
Publication date 2012-08-01
Sub-type Article (original research)
DOI 10.1176/appi.ajp.2012.11101583
Volume 169
Issue 8
Start page 860
End page 866
Total pages 7
Place of publication Arlington, VA, United States
Publisher American Psychiatric Publishing
Collection year 2013
Language eng
Formatted abstract
Objective: Multiple anatomical targets for deep brain stimulation (DBS) have been proposed for the treatment of severe Tourette's syndrome. In this open study, the authors evaluated the effectiveness of DBS of the anteromedial globus pallidus interna on tic severity and common comorbidities.
Method: Eleven patients (eight of them men, mean age=39 years) with severe and medically intractable Tourette's syndrome underwent implantation of Medtronic quadripolar electrodes in the globus pallidus interna bilaterally. The primary outcome measure was the Yale Global Tic Severity Scale. Secondary outcome measures included the Yale-Brown Obsessive Compulsive Scale, the Hamilton Depression Rating Scale, the Gilles de la Tourette Syndrome–Quality of Life Scale, and the Global Assessment of Functioning Scale. Follow-up occurred at 1 month and then at a mean of 14 months after surgery (range=4–30 months).
Results: Ten patients (91%) reported improvement in tic severity soon after DBS. Overall, there was a 48% reduction in motor tics and a 56.5% reduction in phonic tics at final follow-up. Six patients (54.5%) had a more than 50% reduction, sustained for at least 3 months, in Yale Global Tic Severity Scale score. Only two patients required ongoing pharmacotherapy for tics after surgery, and patients improved significantly on all secondary measures. One patient did not tolerate DBS and discontinued treatment after 3 months. Greater anxiety in two patients and hardware malfunction in three patients were noteworthy adverse outcomes.
Conclusions: The results suggest anteromedial globus pallidus interna DBS for Tourette's syndrome is an effective and well-tolerated treatment for a subgroup of patients with severe Tourette's syndrome.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
Official 2013 Collection
 
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