Universität zu Köln

Baldermann, Juan Carlos, Kuhn, Jens, Schueller, Thomas, Kohl, Sina, Andrade, Pablo, Schleyken, Sophia, Prinz-Langenohl, Reinhild, Hellmich, Martin, Barbe, Michael T. ORCID: 0000-0003-1149-8054, Timmermann, Lars, Visser-Vandewalle, Veerle and Huys, Daniel ORCID: 0000-0002-9124-4128 (2021). Thalamic deep brain stimulation for Tourette Syndrome: A naturalistic trial with brief randomized, double-blinded sham-controlled periods. Brain Stimul., 14 (5). S. 1059 - 1068. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1876-4754

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Abstract

Background: There is still a lack of controlled studies to prove efficacy of thalamic deep brain stimulation for Tourette's Syndrome. Objectives: In this controlled trial, we investigated the course of tic severity, comorbidities and quality of life during thalamic stimulation and whether changes in tic severity can be assigned to ongoing compared to sham stimulation. Methods: We included eight adult patients with medically refractory Tourette's syndrome. Bilateral electrodes were implanted in the centromedian-parafascicular-complex and the nucleus ventro-oralis internus. Tic severity, quality of life and comorbidities were assessed before surgery as well as six and twelve months after. Short randomized, double-blinded sham-controlled crossover sequences with either active or sham stimulation were implemented at both six-and twelve-months' assessments. The primary outcome measurement was the difference in the Yale Global Tic Severity Scale tic score between active and sham stimulation. Adverse events were systematically surveyed for all patients to evaluate safety. Results: Active stimulation resulted in significantly higher tic reductions than sham stimulation (F = 79.5; p = 0.001). Overall quality of life and comorbidities improved significantly in the open-label phase. Over the course of the trial two severe adverse events occurred that were resolved without sequelae. Conclusion: Our results provide evidence that thalamic stimulation is effective in improving tic severity and overall quality of life. Crucially, the reduction of tic severity was primarily driven by active stimulation. Further research may focus on improving stimulation protocols and refining patient selection to improve efficacy and safety of deep brain stimulation for Tourette's Syndrome. (c) 2021 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Baldermann, Juan Carlos UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhn, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Schueller, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Kohl, Sina UNSPECIFIED UNSPECIFIED UNSPECIFIED Andrade, Pablo UNSPECIFIED UNSPECIFIED UNSPECIFIED Schleyken, Sophia UNSPECIFIED UNSPECIFIED UNSPECIFIED Prinz-Langenohl, Reinhild UNSPECIFIED UNSPECIFIED UNSPECIFIED Hellmich, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Barbe, Michael T. UNSPECIFIED orcid.org/0000-0003-1149-8054 UNSPECIFIED Timmermann, Lars UNSPECIFIED UNSPECIFIED UNSPECIFIED Visser-Vandewalle, Veerle UNSPECIFIED UNSPECIFIED UNSPECIFIED Huys, Daniel UNSPECIFIED orcid.org/0000-0002-9124-4128 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-583704
DOI:	10.1016/j.brs.2021.07.003
Journal or Publication Title:	Brain Stimul.
Volume:	14
Number:	5
Page Range:	S. 1059 - 1068
Date:	2021
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1876-4754
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language Clinical Neurology; Neurosciences Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/58370