| Issues related to deep brain stimulation for treatment-refractory Tourette's syndrome. | |
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MedLine Citation:
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PMID: 19690419 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Deep brain stimulation (DBS) has been used in a small number of patients with Tourette's syndrome and results on tics and comorbidities have been promising. The choice of the DBS target appears to influence the effectiveness; preliminary studies and case reports suggest that certain target areas may be more effective than others in patients with specific symptoms and comorbidities. Clinical data on the effect of DBS on tics and behavioral symptoms support its use in patients with severe, refractory Tourette's syndrome, particularly in younger adults who have a greater severity and prevalence of tics and comorbidities, and are more likely to experience social impairment. Although DBS has shown potential as an 'add-on' therapy for Tourette's syndrome patients failing to show adequate improvement with conventional conservative treatments, several issues remain to be resolved, including patient selection, choice of target, and adverse effects. Successful DBS requires an experienced multidisciplinary team for the management of these complex pre-, peri- and postoperative issues. Future studies should include establishment of consistent inclusion criteria and specific practical requirements for clinical trials, evaluation of the impact of DBS on non-tic symptoms and their influence on outcome, social impairment and quality of life, and the identification of optimum neurophysiologically based DBS targets for improved efficacy in specific patient subtypes. |
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Authors:
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Mauro Porta; Domenico Servello; Domenico Sevello; Marco Sassi; Arianna Brambilla; Stefano Defendi; Alberto Priori; Mary Robertson |
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Publication Detail:
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Type: Journal Article; Review Date: 2009-08-19 |
Journal Detail:
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Title: European neurology Volume: 62 ISSN: 1421-9913 ISO Abbreviation: Eur. Neurol. Publication Date: 2009 |
Date Detail:
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Created Date: 2009-10-09 Completed Date: 2009-10-28 Revised Date: 2010-01-26 |
Medline Journal Info:
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Nlm Unique ID: 0150760 Medline TA: Eur Neurol Country: Switzerland |
Other Details:
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Languages: eng Pagination: 264-73 Citation Subset: IM |
Copyright Information:
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Copyright 2009 S. Karger AG, Basel. |
Affiliation:
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Tourette Centre and Functional Neurosurgery, Istituto Galeazzi IRCCS, Milan, Italy. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Deep Brain Stimulation
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adverse effects* Humans Patient Care Team Patient Selection Quality of Life Tourette Syndrome / diagnosis, therapy* |
| Comments/Corrections | |
Erratum In:
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Eur Neurol. 2009;62(6):374 Note: Sevello, Domenico [corrected to Servello, Domenico] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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