Deep Brain Stimulation for Tourette-Syndrome: A Systematic Review and Meta-Analysis

Brain Stimulation

Thomas Schüller¹  Daniel Huys²  Veerle Visser-Vandewalle³  Lars Timmermann⁴  Juan Carlos Baldermann⁴  Ingrid Becker⁴  Jens Kuhn⁴  Frank Jessen⁵ 

[1] Corresponding author. Tel.: [phone];fax: [phone].;Department of Neurology, University of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany;Department of Psychiatry and Psychotherapy, University of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany;Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany;

关键词: Tourette;    Tourette syndrome;    Deep brain stimulation;    DBS;    Meta-analysis;    Review;   

DOI  :  

来源: DOAJ

【 摘 要 】

Background: A significant proportion of patients with Tourette syndrome (TS) continue to experience symptoms across adulthood that in severe cases fail to respond to standard therapies. For these cases, deep brain stimulation (DBS) is emerging as a promising treatment option. Objective: We conducted a systematic literature review to evaluate the efficacy of DBS for GTS. Methods: Individual data of case reports and series were pooled; the Yale Global Tic Severity Scale (YGTSS) was chosen as primary outcome parameter. Results: In total, 57 studies were eligible, including 156 cases. Overall, DBS resulted in a significant improvement of 52.68% (IQR = 40.74, p < 0.001) in the YGTSS. Analysis of controlled studies significantly favored stimulation versus off stimulation with a standardized mean difference of 0.96 (95% CI: 0.36–1.56). Disentangling different target points revealed significant YGTSS reductions after stimulation of the thalamus, the posteroventrolateral part and the anteromedial part of the globus pallidus internus, the anterior limb of the internal capsule and nucleus accumbens with no significant difference between these targets. A significant negative correlation of preoperative tic scores with the outcome of thalamic stimulation was found. Conclusions: Despite small patient numbers, we conclude that DBS for GTS is a valid option for medically intractable patients. Different brain targets resulted in comparable improvement rates, indicating a modulation of a common network. Future studies might focus on a better characterization of the clinical effects of distinct regions, rather than searching for a unique target.

【 授权许可】

Unknown