Universität zu Köln

Visser-Vandewalle, Veerle, Huys, Daniel ORCID: 0000-0002-9124-4128, Neuner, Irene ORCID: 0000-0002-5164-8873, Zrinzo, Ludvic, Okun, Michael S. and Kuhn, Jens (2014). Deep Brain Stimulation for Tourette syndrome: The Current State of the Field. J. Obsessive-Compuls. Relat. Disord., 3 (4). S. 401 - 407. AMSTERDAM: ELSEVIER. ISSN 2211-3649

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Abstract

In 1999, Deep Brain Stimulation (DBS) was introduced as a new therapeutic approach for patients suffering from refractory Tourette syndrome (TS). This initial target was located in the medial part of the thalamus, based on the good results of thalamotomies described by Hassler and Dieckmann (1970). Up until now, more than 100 cases have been published worldwide of burette patients receiving DBS. The targets have been diverse and can be divided into four brain areas: the thalamus (medial parts, and ventral parts), the globus pallidus internus (posteroventrolateral part, and anteromedial part), the globus pallidus externus, and the internal capsule/nucleus accumbens. The subthalamic nucleus has also been suggested as a potential target for DBS in TS, based on the good effect of DBS on tics in a patient suffering from Parkinson's disease and TS. In the majority of cases, there was a clear effect on tics. The effect on associated behavioural disorders varies. Although stimulation-induced unwanted effects have been described, severe complications are rare and include two small haematomas at the tip of one electrode. Serious and lasting side effects or complications are rare. Although stimulation-induced and mainly transient unwanted effects have been described, the positive effect seems clearly to predominate. The majority of published studies include only a small number of patients. This underlines the importance of all cases being published, and that ideally the same protocol be followed so that results can be compared. A strict selection of patients and a standardized evaluation of the effects on tics, associated behavioural disorders, complications and exact position of the electrodes are therefore of great importance. The actual published reports suggest that the best effects can be obtained with DBS of the thalamus, and the anteromedial part of the globus pallidus internus. (C) 2014 Elsevier Inc. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Visser-Vandewalle, Veerle UNSPECIFIED UNSPECIFIED UNSPECIFIED Huys, Daniel UNSPECIFIED orcid.org/0000-0002-9124-4128 UNSPECIFIED Neuner, Irene UNSPECIFIED orcid.org/0000-0002-5164-8873 UNSPECIFIED Zrinzo, Ludvic UNSPECIFIED UNSPECIFIED UNSPECIFIED Okun, Michael S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhn, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-426349
DOI:	10.1016/j.jocrd.2014.06.005
Journal or Publication Title:	J. Obsessive-Compuls. Relat. Disord.
Volume:	3
Number:	4
Page Range:	S. 401 - 407
Date:	2014
Publisher:	ELSEVIER
Place of Publication:	AMSTERDAM
ISSN:	2211-3649
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language GLOBUS-PALLIDUS INTERNUS; OBSESSIVE-COMPULSIVE-DISORDER; THALAMIC-STIMULATION; NUCLEUS-ACCUMBENS; STEREOTACTIC SURGERY; TICS; PATIENT; IMPROVEMENT; TARGET; TRIAL Multiple languages Psychiatry Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/42634