Article
A prospective randomised clinical trial of thalamic DBS for Tourette syndrome
Eine prospektive randomisierte klinische Studie zur thalamischen DBS bei Tourette-Syndrom
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Authors
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Juan Carlos Baldermann
- Universitätsklinikum Köln, Department of Neurology, Köln, Deutschland
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Pablo Andrade
- Universitätsklinikum Köln, Klinik für Stereotaxie und funktionelle Neurochirurgie, Köln, Deutschland
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Veerle Visser-Vandewalle
- Universitätsklinikum Köln, Klinik für Stereotaxie und funktionelle Neurochirurgie, Köln, Deutschland
| Published: | May 25, 2022 |
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Outline
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Objective: To investigate the long-term outcome of tic severity, comorbidities and quality of life (QoL) during centromedian-parafascicular-complex (CM-Pf) and nucleus ventro-oralis internus (Voi) deep brain stimulation (DBS). Furthermore, to compare changes in tic severity after sham stimulation.
Methods: Bilateral electrodes were implanted in the CM-Pf/Voi complex in eight adult patients with treatment-refractory Tourette syndrome. Tic severity, comorbidities and QoL were assessed preoperatively and six and twelve months postoperatively. A brief randomized, double-blinded sham-controlled crossover trial with either DBS or sham stimulation was performed postoperatively after six and twelve months. The primary outcome measurement was the difference in the Yale Global Tic Severity Scale (YGTSS) comparing active DBS and sham stimulation. Secondary outcomes for the open label analysis included the Beck's Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Symptom Checklist-90-R (SCL-90), Gilles de la Tourette Syndrome- QoL (GTS-QoL) and the Yale-Brown Obsessive-Compulsive Scale (YBOCS).
Results: DBS resulted in significantly higher tic reductions in YGTSS than sham stimulation (F = 79.5; p = 0.001). Overall, QoL and comorbidities improved significantly in the open-label-phase in all scales. Only two severe adverse events were reported during the trial, which resolved without sequelae.
Conclusion: Thalamic CM-Pf/Voi DBS is effective in reducing tic severity and comorbidities as well as improving QoL in the long-term. The reduction of tic severity was achieved by active DBS when compared to sham.
