Patient selection and assessment recommendations for deep brain stimulation in Tourette syndrome

@article{Mink2006PatientSA,
  title={Patient selection and assessment recommendations for deep brain stimulation in Tourette syndrome},
  author={Jonathan W. Mink and John T. Walkup and Kirk A. Frey and Peter G. Como and Danielle C. Cath and Mahlon R. Delong and Gerald Erenberg and Joseph Jankovic and Jorge L. Juncos and James Frederick Leckman and Neal R. Swerdlow and Veerle Visser-Vandewalle and Jerrold L. Vitek},
  journal={Movement Disorders},
  year={2006},
  volume={21}
}
In response to recent publicity regarding the potential use of deep brain stimulation (DBS) for reducing tic severity in Tourette's syndrome (TS), the Tourette Syndrome Association convened a group of TS and DBS experts to develop recommendations to guide the early use and potential clinical trials of DBS for TS and other tic disorders. The goals of these recommendations are to ensure that all surgical candidates are (1) fully informed about the risks, benefits, and alternative treatments… Expand
Tourette syndrome deep brain stimulation: A review and updated recommendations
  • L. Schrock, J. Mink, +32 authors M. Okun
  • Psychology, Medicine
  • Movement disorders : official journal of the Movement Disorder Society
  • 2015
TLDR
Tourette syndrome DBS, though still evolving, is a promising approach for a subset of medication refractory and severely affected patients and should be offered to patients only by experienced DBS centers after evaluation by a multidisciplinary team. Expand
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TLDR
The need for a comprehensive assessment of associated co-morbidities, which are not considered integral part of the syndrome and are not sufficiently evaluated in relation to DBS, is highlighted. Expand
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TLDR
Clinical data on the effect of DBS on tic 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. Expand
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TLDR
The UK perspective on DBS in TS is illustrated and consensus-based recommendations for double-blind controlled trials are proposed, mainly in relation to eligibility criteria and brain targets. Expand
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TLDR
DBS for Tourette’s syndrome is safe and feasible, but large multi-center clinical trials are needed to determine the ideal target and optimal location within a particular target. Expand
Reply: Patient selection and assessment recommendations for deep brain stimulation in Tourette syndrome
target selection and imaging, using standardized measures to track outcome, and postsurgery follow-up. We seek to bring attention to additional relevant issues that have arisen in our clinic, whereExpand
European clinical guidelines for Tourette syndrome and other tic disorders. Part IV: deep brain stimulation
TLDR
There is general agreement that, at present time, DBS should only be used in adult, treatment resistant, and severely affected patients and it is highly recommended to perform DBS in the context of controlled trials. Expand
Deep brain stimulation in tourette syndrome: a description of 3 patients with excellent outcome.
TLDR
3 patients with TS who underwent DBS targeting the bilateral thalamic centromedian/parafascicular complex (CM/Pf) with an excellent clinical outcome are described, supporting the role of the CM/PF DBS target in medically intractable TS. Expand
Patient selection and assessment recommendations for deep brain stimulation in Tourette syndrome
TLDR
It is the impression that atypical patients, who deteriorate in adulthood and become disabled as a result, whose benefit-to-risk ratio thus increases and for whom DBS surgery may be most appropriate, may actually turn out to be the most suitable. Expand
Deep Brain Stimulation for Tourette Syndrome: Potential Role in the Pediatric Population
TLDR
Analysis of published reports on the use of deep brain stimulation in Tourette syndrome reveals that 2 anatomical targets have been most commonly used: the centromedian thalamus and the globus pallidus internus. Expand
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A 37-year-old woman with severe Tourette syndrome, whose symptoms included frequent vocalizations and severe head and arm jerks that resulted in unilateral blindness, is treated with stimulation of the anterior internal capsule. Expand
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Bilateral DBS of the internal globus pallidus of thalamic nuclei in Gilles de la Tourette syndrome could become a valuable rescue therapy for otherwise intractable GTS. Expand
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