Universität zu Köln

Baldermann, Juan Carlos, Schueller, Thomas, Huys, Daniel, Becker, Ingrid ORCID: 0000-0001-5829-3553, Timmermann, Lars, Jessen, Frank, Visser-Vandewalle, Veerle and Kuhn, Jens (2016). Deep Brain Stimulation for Tourette-Syndrome: A Systematic Review and Meta-Analysis. Brain Stimul., 9 (2). S. 296 - 305. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1876-4754

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Abstract

Background: A significant proportion of patients with Tourette syndrome (TS) continue to experience symptoms across adulthood that in severe cases fail to respond to standard therapies. For these cases, deep brain stimulation (DBS) is emerging as a promising treatment option. Objective: We conducted a systematic literature review to evaluate the efficacy of DBS for GTS. Methods: Individual data of case reports and series were pooled; the Yale Global Tic Severity Scale (YGTSS) was chosen as primary outcome parameter. Results: In total, 57 studies were eligible, including 156 cases. Overall, DBS resulted in a significant improvement of 52.68% (IQR = 40.74, p < 0.001) in the YGTSS. Analysis of controlled studies significantly favored stimulation versus off stimulation with a standardized mean difference of 0.96 (95% CI: 0.36-1.56). Disentangling different target points revealed significant YGTSS reductions after stimulation of the thalamus, the posteroventrolateral part and the anteromedial part of the globus pallidus internus, the anterior limb of the internal capsule and nucleus accumbens with no significant difference between these targets. A significant negative correlation of preoperative tic scores with the outcome of thalamic stimulation was found. Conclusions: Despite small patient numbers, we conclude that DBS for GTS is a valid option for medically intractable patients. Different brain targets resulted in comparable improvement rates, indicating a modulation of a common network. Future studies might focus on a better characterization of the clinical effects of distinct regions, rather than searching for a unique target. (C) 2016 Elsevier Inc. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Baldermann, Juan Carlos UNSPECIFIED UNSPECIFIED UNSPECIFIED Schueller, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Huys, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Becker, Ingrid UNSPECIFIED orcid.org/0000-0001-5829-3553 UNSPECIFIED Timmermann, Lars UNSPECIFIED UNSPECIFIED UNSPECIFIED Jessen, Frank UNSPECIFIED UNSPECIFIED UNSPECIFIED Visser-Vandewalle, Veerle UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhn, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-283615
DOI:	10.1016/j.brs.2015.11.005
Journal or Publication Title:	Brain Stimul.
Volume:	9
Number:	2
Page Range:	S. 296 - 305
Date:	2016
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1876-4754
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language GLOBUS-PALLIDUS INTERNUS; QUALITY-OF-LIFE; LONG-TERM; THALAMIC-STIMULATION; NUCLEUS-ACCUMBENS; DOUBLE-BLIND; TICS; PATIENT; IMPROVEMENT; TRIAL Multiple languages Clinical Neurology; Neurosciences Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/28361