Deep brain stimulation in Tourette's syndrome: two targets?
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.
Ackermans
Linda
L
Department of Neurosurgery, University Hospital Maastricht, Maastricht, The Netherlands. ackermanslinda@hotmail.com
Temel
Yasin
Y
Cath
Danielle
D
van der Linden
Chris
C
Bruggeman
Richard
R
Kleijer
Mariska
M
Nederveen
Pieter
P
Schruers
Koen
K
Colle
Henry
H
Tijssen
Marina A J
MA
Visser-Vandewalle
Veerle
V
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*