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… 
Tourette syndrome deep brain stimulation: A review and updated recommendations
  • L. SchrockJ. Mink M. Okun
  • 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.
Selection of Patients with Tourette Syndrome for Deep Brain Stimulation Surgery
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.
Issues Related to Deep Brain Stimulation for Treatment-Refractory Tourette’s Syndrome
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.
An approach to deep brain stimulation for severe treatment-refractory Tourette syndrome: the UK perspective
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.
Deep Brain Stimulation in Tourette’s Syndrome
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.
Reply: Patient selection and assessment recommendations for deep brain stimulation in Tourette syndrome
TLDR
A comprehensive neuropsychological battery should be utilized until the impact of DBS is more adequately documented, and the importance placed on discussing a potential negative outcome following DBS.
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.
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.
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.
...
...

References

SHOWING 1-10 OF 63 REFERENCES
Deep Brain Stimulation of the Anterior Internal Capsule for the Treatment of Tourette Syndrome: Technical Case Report
TLDR
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.
Efficient internal pallidal stimulation in Gilles de la Tourette syndrome: A case report
TLDR
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.
Tourette’s syndrome and deep brain stimulation
TLDR
Severe forms of Tourette’s syndrome may benefit from stimulation of neuronal circuits within the basal ganglia, thus confirming the role of the dysfunction of limbic striato-pallido-thalamo-cortical systems in this disorder.
Deep Brain Stimulation and Essential Tremor
  • K. LyonsR. Pahwa
  • Medicine
    Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society
  • 2004
TLDR
Deep brain stimulation of the thalamus is a safe and efficacious procedure and should be considered in patients with ET who experience medication-resistant disabling tremor, and a majority of patients continue to experience improvement in tremor.
Deep brain stimulation surgery for Parkinson's disease: mechanisms and consequences.
Chronic bilateral thalamic stimulation: a new therapeutic approach in intractable Tourette syndrome. Report of three cases.
TLDR
Chronic thalamic HFS may be an effective and safe treatment for medically intractable Tourette syndrome in adult patients and a slight sedative effect was noted in all three patients.
Thalamic stimulation for tremorSubtle changes in episodic memory are related to stimulation per se and not to a microthalamotomy effect
TLDR
This study confirms that chronic unilateral DBS is a safe method with regard to cognitive function, and confirms that subtle changes in episodic memory are related to stimulation per se and not to a microthalamotomy effect.
Surgery in Tourette syndrome
TLDR
A review of the literature from 1960 until 2003 revealed 21 reports and 3 descriptions in textbooks covering about 65 patients in total who had undergone ablative procedures for intractable TS, with promising results on tics and obsessive‐compulsive symptoms.
Basal ganglia dysfunction in Tourette's syndrome: a new hypothesis.
  • J. Mink
  • Psychology, Medicine
    Pediatric neurology
  • 2001
Core assessment program for surgical interventional therapies in Parkinson's disease (CAPSIT‐PD)
TLDR
A dedicated program entitled “Neurosurgical Interventions in Parkinson's Disease” (NIPD) was funded by the European Union Biomed 2 program to develop a new Core Assessment Program for Surgical Interventional Therapies in PD (CAPSIT‐PD) and to establish an European registry for patients with PD subjected to functional neurosurgery.
...
...