Martinez-Ramirez, Daniel, Jimenez-Shahed, Joohi ORCID: 0000-0002-9772-7569, Leckman, James Frederick, Porta, Mauro, Servello, Domenico ORCID: 0000-0002-0123-1615, Meng, Fan-Gang, Kuhn, Jens, Huys, Daniel, Baldermann, Juan Carlos, Foltynie, Thomas, Hariz, Marwan I., Joyce, Eileen M., Zrinzo, Ludvic, Kefalopoulou, Zinovia, Silburn, Peter, Coyne, Terry, Mogilner, Alon Y., Pourfar, Michael H., Khandhar, Suketu M., Auyeung, Man, Ostrem, Jill Louise, Visser-Vandewalle, Veerle, Welter, Marie-Laure, Mallet, Luc ORCID: 0000-0001-8061-1167, Karachi, Carine, Houeto, Jean Luc, Klassen, Bryan Timothy, Ackermans, Linda, Kaido, Takanobu, Temel, Yasin, Gross, Robert E., Walker, Harrison C., Lozano, Andres M., Walter, Benjamin L., Mari, Zoltan, Anderson, William S., Changizi, Barbara Kelly, Moro, Elena, Zauber, Sarah Elizabeth, Schrock, Lauren E., Zhang, Jian-Guo, Hu, Wei, Rizer, Kyle, Monari, Erin H., Foote, Kelly D., Malaty, Irene A., Deeb, Wissam, Gunduz, Aysegul ORCID: 0000-0001-7925-0747 and Okun, Michael S. (2018). Efficacy and Safety of Deep Brain Stimulation in Tourette Syndrome The International Tourette Syndrome Deep Brain Stimulation Public Database and Registry. JAMA Neurol., 75 (3). S. 353 - 360. CHICAGO: AMER MEDICAL ASSOC. ISSN 2168-6157

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Abstract

IMPORTANCE Collective evidence has strongly suggested that deep brain stimulation (DBS) is a promising therapy for Tourette syndrome. OBJECTIVE To assess the efficacy and safety of DBS in a multinational cohort of patients with Tourette syndrome. DESIGN, SETTING, AND PARTICIPANTS The prospective International Deep Brain Stimulation Database and Registry included 185 patients with medically refractory Tourette syndrome who underwent DBS implantation from January 1, 2012, to December 31, 2016, at 31 institutions in 10 countries worldwide. EXPOSURES Patients with medically refractory symptoms received DBS implantation in the centromedian thalamic region (93 of 163 [57.1%]), the anterior globus pallidus internus (41 of 163 [25.2%]), the posterior globus pallidus internus (25 of 163 [15.3%]), and the anterior limb of the internal capsule (4 of 163 [2.5%]). MAINOUTCOMES AND MEASURES Scores on the Yale Global Tic Severity Scale and adverse events. RESULTS The International Deep Brain Stimulation Database and Registry enrolled 185 patients (of 171 with available data, 37 females and 134 males; mean [SD] age at surgery, 29.1 [10.8] years [range, 13-58 years]). Symptoms of obsessive-compulsive disorder were present in 97 of 151 patients (64.2%) and 32 of 148 (21.6%) had a history of self-injurious behavior. The mean (SD) total Yale Global Tic Severity Scale score improved from 75.01 (18.36) at baseline to 41.19 (20.00) at 1 year after DBS implantation (P<.001). The mean (SD) motor tic subscore improved from 21.00 (3.72) at baseline to 12.91 (5.78) after 1 year (P <.001), and the mean (SD) phonic tic subscore improved from 16.82 (6.56) at baseline to 9.63 (6.99) at 1 year (P <.001). The overall adverse event rate was 35.4%(56 of 158 patients), with intracranial hemorrhage occurring in 2 patients (1.3%), infection in 4 patients with 5 events (3.2%), and lead explantation in 1 patient (0.6%). The most common stimulation-induced adverse effects were dysarthria (10 [6.3%]) and paresthesia (13 [8.2%]). CONCLUSIONS AND RELEVANCE Deep brain stimulationwas associated with symptomatic improvement in patients with Tourette syndrome but also with important adverse events. A publicly available website on outcomes of DBS in patients with Tourette syndrome has been provided.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Martinez-Ramirez, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jimenez-Shahed, JoohiUNSPECIFIEDorcid.org/0000-0002-9772-7569UNSPECIFIED
Leckman, James FrederickUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Porta, MauroUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Servello, DomenicoUNSPECIFIEDorcid.org/0000-0002-0123-1615UNSPECIFIED
Meng, Fan-GangUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kuhn, JensUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Huys, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Baldermann, Juan CarlosUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Foltynie, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hariz, Marwan I.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Joyce, Eileen M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zrinzo, LudvicUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kefalopoulou, ZinoviaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Silburn, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Coyne, TerryUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mogilner, Alon Y.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pourfar, Michael H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Khandhar, Suketu M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Auyeung, ManUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ostrem, Jill LouiseUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Visser-Vandewalle, VeerleUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Welter, Marie-LaureUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mallet, LucUNSPECIFIEDorcid.org/0000-0001-8061-1167UNSPECIFIED
Karachi, CarineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Houeto, Jean LucUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Klassen, Bryan TimothyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ackermans, LindaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kaido, TakanobuUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Temel, YasinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gross, Robert E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Walker, Harrison C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lozano, Andres M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Walter, Benjamin L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mari, ZoltanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Anderson, William S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Changizi, Barbara KellyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Moro, ElenaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zauber, Sarah ElizabethUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schrock, Lauren E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zhang, Jian-GuoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hu, WeiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rizer, KyleUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Monari, Erin H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Foote, Kelly D.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Malaty, Irene A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Deeb, WissamUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gunduz, AysegulUNSPECIFIEDorcid.org/0000-0001-7925-0747UNSPECIFIED
Okun, Michael S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-193451
DOI: 10.1001/jamaneurol.2017.4317
Journal or Publication Title: JAMA Neurol.
Volume: 75
Number: 3
Page Range: S. 353 - 360
Date: 2018
Publisher: AMER MEDICAL ASSOC
Place of Publication: CHICAGO
ISSN: 2168-6157
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
Clinical NeurologyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/19345

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