Universität zu Köln

Smeets, Anouk Y. J. M., Duits, Annelien A., Leentjens, Albert F. G., Schruers, Koen, van Kranen-Mastenbroek, Vivianne, Visser-Vandewalle, Veerle, Temel, Yasin and Ackermans, Linda (2018). Thalamic Deep Brain Stimulation for Refractory Tourette Syndrome: Clinical Evidence for Increasing Disbalance of Therapeutic Effects and Side Effects at Long-Term Follow-Up. Neuromodulation, 21 (2). S. 197 - 203. HOBOKEN: WILEY. ISSN 1525-1403

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Abstract

ObjectiveThalamic deep brain stimulation (DBS) is effective in reducing tics in patients with refractory Tourette syndrome at the short-term. Here, we report on the long-term outcome. Materials and MethodsSeven patients underwent bilateral DBS between 2001 and 2008. The target was the centromedian nucleus, substantia periventricularis and nucleus ventro-oralis internus cross point of the thalamus. The effect on tics and side effects were evaluated with a variable follow-up duration of 12 to 78 months. ResultsPatient 1 and 2 showed good tic improvements of 81.6% (60 months) and 50% (36 months), respectively. However, side effects like reducing levels of energy and visual disturbances increased. In patient 1, the target was changed to the anterior part of the internal pallidum and patient 2 switched the stimulator permanently off. Patient 3 experiences still satisfying results with a tic improvement of 88.9% (78 months). Patient 4 and 7 showed minor tic improvements of 34% (16 months) and 9% (60 months), respectively. In both patients side effects became more severe and the target was changed to the anterior part of the internal pallidum. Patient 5 showed a tic improvement of 27.5% (12 months) and went abroad for stimulation of the external globus pallidus. Patient 6 developed cerebellar atrophy. He experienced several nonstimulation related side effects and turned the stimulator off. ConclusionsThere seems to be an increasing disbalance of therapeutic effects and side effects at long-term follow-up, often leading to either switching the stimulator off or new surgery with a different neuro-anatomic target.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Smeets, Anouk Y. J. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Duits, Annelien A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Leentjens, Albert F. G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schruers, Koen UNSPECIFIED UNSPECIFIED UNSPECIFIED van Kranen-Mastenbroek, Vivianne UNSPECIFIED UNSPECIFIED UNSPECIFIED Visser-Vandewalle, Veerle UNSPECIFIED UNSPECIFIED UNSPECIFIED Temel, Yasin UNSPECIFIED UNSPECIFIED UNSPECIFIED Ackermans, Linda UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-197852
DOI:	10.1111/ner.12556
Journal or Publication Title:	Neuromodulation
Volume:	21
Number:	2
Page Range:	S. 197 - 203
Date:	2018
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1525-1403
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language GLOBUS-PALLIDUS Multiple languages Medicine, Research & Experimental; Clinical Neurology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/19785