Long-term effect of deep brain stimulation on adult patients with Tourette syndrome

Abstract

Objective To assess the long-term outcome of globus pallidus intema (Gpi) deep brain stimulation (DBS) in adult patients with Tourette syndrome (TS). Methods Five adult drug-resistant TS patients, performed bilateral Gpi DBS in our hospital from May 2007 to May 2008,were chosen in our study; their symptoms before DBS and 3 and 6 months and 1 year after DBS,and over a year of DBS were evaluated by Yale global tic severity scale. Results The duration of follow-up ranged from 21 to 33 months.Scores of motor tic,phonic tic and social impairment in the last follow-up were significantly decreased as compared with those before DBS (P＜0.05); Scores of motor tic,phonic tic and social impairment 3 and 6 months and 1 year after DBS,and over a year of DBS were significantly decreased as compared with those before DBS (P＜0.05).The symptoms were gradually improved; in the first 6 months,the symptoms were obviously improved; 6 months after DBS,the symptoms were solid and can be mildly improved.3 and 6 months,1 year after DBS and till to the last follow-up (mean 26.4 months),the severity of symptom meanly improved 28.50％,52.35％,57.62％ and 62.88％,respectively;and till the last follow-up,the motor tic,phonic tic and social impairment was improved 51.38％,46.16％ and 71.00％,respectively; no serious adverse effects were noted. Conclusion Gpi DBS,improving the symptoms as motor tic,phonic tic and social impairment,is a useful and safe treatment method for adult patients with medically refractory TS; the long-term efficiency is solid. Key words: Tourette syndrome; Globus pallidus intema; Deep brain stimulation