Universität zu Köln

Huys, Daniel, Bartsch, Christina, Koester, Philip, Lenartz, Doris, Maarouf, Mohammad, Daumann, Joerg, Mai, Juergen K., Klosterkoetter, Joachim, Hunsche, Stefan, Visser-Vandewalle, Veerle, Woopen, Christiane, Timmermann, Lars, Sturm, Volker and Kuhn, Jens (2016). Motor Improvement and Emotional Stabilization in Patients With Tourette Syndrome After Deep Brain Stimulation of the Ventral Anterior and Ventrolateral Motor Part of the Thalamus. Biol. Psychiatry, 79 (5). S. 392 - 402. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1873-2402

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Abstract

BACKGROUND: Since its first application in 1999, the potential benefit of deep brain stimulation (DBS) in reducing symptoms of otherwise treatment-refractory Tourette syndrome (TS) has been documented in several publications. However, uncertainty regarding the ideal neural targets remains, and the eventuality of so far undocumented but possible negative long-term effects on personality fuels the debate about the ethical implications of DBS. METHODS: In this prospective open-label trial, eight patients (three female, five male) 19-56 years old with severe and medically intractable TS were treated with high-frequency DBS of the ventral anterior and ventrolateral motor part of the thalamus. To assess the course of TS, its clinical comorbidities, personality parameters, and self-perceived quality of life, patients underwent repeated psychiatric assessments at baseline and 6 and 12 months after DBS onset. RESULTS: Analysis indicated a strongly significant and beneficial effect of DBS on TS symptoms, trait anxiety, quality of life, and global functioning with an apparently low side-effect profile. In addition, presurgical compulsivity, anxiety, emotional dysregulation, and inhibition appeared to be significant predictors of surgery outcome. CONCLUSIONS: Trading off motor effects and desirable side effects against surgery-related risks and negative implications, stimulation of the ventral anterior and ventrolateral motor part of the thalamus seems to be a valuable option when considering DBS for TS.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Huys, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Bartsch, Christina UNSPECIFIED UNSPECIFIED UNSPECIFIED Koester, Philip UNSPECIFIED UNSPECIFIED UNSPECIFIED Lenartz, Doris UNSPECIFIED UNSPECIFIED UNSPECIFIED Maarouf, Mohammad UNSPECIFIED UNSPECIFIED UNSPECIFIED Daumann, Joerg UNSPECIFIED UNSPECIFIED UNSPECIFIED Mai, Juergen K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Klosterkoetter, Joachim UNSPECIFIED UNSPECIFIED UNSPECIFIED Hunsche, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Visser-Vandewalle, Veerle UNSPECIFIED UNSPECIFIED UNSPECIFIED Woopen, Christiane UNSPECIFIED UNSPECIFIED UNSPECIFIED Timmermann, Lars UNSPECIFIED UNSPECIFIED UNSPECIFIED Sturm, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhn, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-284118
DOI:	10.1016/j.biopsych.2014.05.014
Journal or Publication Title:	Biol. Psychiatry
Volume:	79
Number:	5
Page Range:	S. 392 - 402
Date:	2016
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1873-2402
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language QUALITY-OF-LIFE; PERSONALITY; DISORDERS; CIRCUITS; SYSTEM; SCALE Multiple languages Neurosciences; Psychiatry Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/28411