Universität zu Köln

Wehmeyer, Laura, Schueller, Thomas, Kiess, Jana, Heiden, Petra, Visser-Vandewalle, Veerle, Baldermann, Juan Carlos and Andrade, Pablo (2021). Target-Specific Effects of Deep Brain Stimulation for Tourette Syndrome: A Systematic Review and Meta-Analysis. Front. Neurol., 12. LAUSANNE: FRONTIERS MEDIA SA. ISSN 1664-2295

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Abstract

Background: Extended research has pointed to the efficacy of deep brain stimulation (DBS) in treatment of patients with treatment-refractory Tourette syndrome (TS). The four most commonly used DBS targets for TS include the centromedian nucleus-nucleus ventrooralis internus (CM-Voi) and the centromedian nucleus-parafascicular (CM-Pf) complexes of the thalamus, and the posteroventrolateral (pvIGPi) and the anteromedial portion of the globus pallidus internus (amGPi). Differences and commonalities between those targets need to be compared systematically.</p> <br></p> Objective: Therefore, we evaluated whether DBS is effective in reducing TS symptoms and target-specific differences.</p> Methods: A PubMed literature search was conducted according to the PRISMA guidelines. Eligible literature was used to conduct a systematic review and meta-analysis.</p> <br></p> Results: In total, 65 studies with 376 patients were included. Overall, Yale Global Tic Severity Scale (YGTSS) scores were reduced by more than 50 in 69% of the patients. DBS also resulted in significant reductions of secondary outcome measures, including the total YGTSS, modified Rush Video-Based Tic Rating Scale (mRVRS), Yale-Brown Obsessive Compulsive Scale (YBOCS), and Becks Depression Inventory (BDI). All targets resulted in significant reductions of YGTSS scores and, with the exception of the CM-Pf, also in reduced YBOCS scores. Interestingly, DBS of pallidal targets showed increased YGTSS and YBOCS reductions compared to thalamic targets. Also, the meta-analysis including six randomized controlled and double-blinded trials demonstrated clinical efficacy of DBS for TS, that remained significant for GPi but not thalamic stimulation in two separate meta-analyses.</p> <br></p> Conclusion: We conclude that DBS is a clinically effective treatment option for patients with treatment-refractory TS, with all targets showing comparable improvement rates. Future research might focus on personalized and symptom-specific target selection.</p>

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Wehmeyer, Laura UNSPECIFIED UNSPECIFIED UNSPECIFIED Schueller, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Kiess, Jana UNSPECIFIED UNSPECIFIED UNSPECIFIED Heiden, Petra UNSPECIFIED UNSPECIFIED UNSPECIFIED Visser-Vandewalle, Veerle UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldermann, Juan Carlos UNSPECIFIED UNSPECIFIED UNSPECIFIED Andrade, Pablo UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-565468
DOI:	10.3389/fneur.2021.769275
Journal or Publication Title:	Front. Neurol.
Volume:	12
Date:	2021
Publisher:	FRONTIERS MEDIA SA
Place of Publication:	LAUSANNE
ISSN:	1664-2295
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language GLOBUS-PALLIDUS INTERNUS; LONG-TERM; DOUBLE-BLIND; THALAMIC-STIMULATION; NUCLEUS-ACCUMBENS; ANTEROMEDIAL GPI; BASAL GANGLIA; TICS; PATIENT; TRIAL Multiple languages Clinical Neurology; Neurosciences Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/56546