title: Deep brain stimulation in Tourette's syndrome: two targets?
abstract: In this report, we describe the effects of bilateral thalamic stimulation in one patient and of bilateral pallidal stimulation in another patient. Both patients suffered from intractable Tourette's syndrome (TS). Any conservative treatment had failed or had been stopped because of unbearable side effects in the 2 patients. In both cases, there was no comorbidity except for associated behavioral symptoms (compulsions). Electrodes were implanted at the level of the medial part of the thalamus (centromedian nucleus, the substantia periventricularis, and the nucleus ventro-oralis internus) in one patient and in the posteroventral part of the globus pallidus internus (GPi) in the other patient. In both cases, deep brain stimulation (DBS) resulted in a substantial reduction of tics and compulsions. These data show that bilateral DBS of the thalamus as well as of the GPi can have a good effect on tics and behavioral symptoms in patients suffering from intractable TS.
authors.affiliation: Department of Neurosurgery, University Hospital Maastricht, Maastricht, The Netherlands. ackermanslinda@hotmail.com
authors.forename: Linda
authors.initials: L
authors.lastname: Ackermans
authors.forename: Yasin
authors.initials: Y
authors.lastname: Temel
authors.forename: Danielle
authors.initials: D
authors.lastname: Cath
authors.forename: Chris
authors.initials: C
authors.lastname: van der Linden
authors.forename: Richard
authors.initials: R
authors.lastname: Bruggeman
authors.forename: Mariska
authors.initials: M
authors.lastname: Kleijer
authors.forename: Pieter
authors.initials: P
authors.lastname: Nederveen
authors.forename: Koen
authors.initials: K
authors.lastname: Schruers
authors.forename: Henry
authors.initials: H
authors.lastname: Colle
authors.forename: Marina A J
authors.initials: MA
authors.lastname: Tijssen
authors.forename: Veerle
authors.initials: V
authors.lastname: Visser-Vandewalle
mesh_terms: D000328:Adult; D046690:Deep Brain Stimulation / Q000379:methods*; D005500:Follow-Up Studies; D005917:Globus Pallidus / Q000528:radiation effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013788:Thalamus / Q000528:radiation effects; D005879:Tourette Syndrome / Q000473:pathology / Q000628:therapy*