• Biological psychiatry · Mar 2016

    Clinical Trial

    Motor Improvement and Emotional Stabilization in Patients With Tourette Syndrome After Deep Brain Stimulation of the Ventral Anterior and Ventrolateral Motor Part of the Thalamus.

    • Daniel Huys, Christina Bartsch, Philip Koester, Doris Lenartz, Mohammad Maarouf, Jörg Daumann, Jürgen K Mai, Joachim Klosterkötter, Stefan Hunsche, Veerle Visser-Vandewalle, Christiane Woopen, Lars Timmermann, Volker Sturm, and Jens Kuhn.
    • Departments of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany. Electronic address: Daniel.Huys@uk-koeln.de.
    • Biol. Psychiatry. 2016 Mar 1; 79 (5): 392-401.

    BackgroundSince its first application in 1999, the potential benefit of deep brain stimulation (DBS) in reducing symptoms of otherwise treatment-refractory Tourette syndrome (TS) has been documented in several publications. However, uncertainty regarding the ideal neural targets remains, and the eventuality of so far undocumented but possible negative long-term effects on personality fuels the debate about the ethical implications of DBS.MethodsIn this prospective open-label trial, eight patients (three female, five male) 19-56 years old with severe and medically intractable TS were treated with high-frequency DBS of the ventral anterior and ventrolateral motor part of the thalamus. To assess the course of TS, its clinical comorbidities, personality parameters, and self-perceived quality of life, patients underwent repeated psychiatric assessments at baseline and 6 and 12 months after DBS onset.ResultsAnalysis indicated a strongly significant and beneficial effect of DBS on TS symptoms, trait anxiety, quality of life, and global functioning with an apparently low side-effect profile. In addition, presurgical compulsivity, anxiety, emotional dysregulation, and inhibition appeared to be significant predictors of surgery outcome.ConclusionsTrading off motor effects and desirable side effects against surgery-related risks and negative implications, stimulation of the ventral anterior and ventrolateral motor part of the thalamus seems to be a valuable option when considering DBS for TS.Copyright © 2016 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

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