Abstract

Objective

To investigate the effect of stereotactic radiofrequency thermocoagulation in the globus pallidus internus on refractory tic disorders.

Materials and methods

Forty patients with refractory tic disorders were enrolled between January 2015 and July 2017 to experience stereotactic radiofrequency thermocoagulation in the globus pallidus internus. All clinical data, Yale Global Tic Severity Scale (YGTSS) scores, serum dopamine (SDA), and 5-hydroxytryptamine (5-HT) were analyzed.

Results

Radiofrequency thermocoagulation was successfully performed in all patients. Periprocedural complications occurred in two patients (5.0%), one with fever (2.5%) and one with a urination disorder (2.5%); both returned to normal after treatment. After 12 months of follow-ups, excellent improvement was exhibited in 18 patients (45.0%), marked improvement in 10 (25.0%), good improvement in 9 (22.5%), and invalid in 3 (7.5%), with a total efficacy rate of 92.5% (37/40). Twenty-eight patients (70%) showed excellent or marked improvement without additional treatment after surgery. YGTSS scores were significantly (p < 0.05) decreased after compared with before thermocoagulation. SDA was significantly (p < 0.05) decreased 6 months (80.78 ± 18.82 ng/ml) and 12 months (75.65 ± 15.23 ng/ml) after compared with before (125.63 ± 35.26 ng/ml) surgery, whereas 5-HT was significantly (p < 0.05) increased 6 months (58.93 ± 16.88 ng/ml) and 12 months (62.63 ± 15.21 ng/ml) after compared with before (35.62 ± 3.41 ng/ml) surgery.

Conclusion

Stereotactic radiofrequency thermocoagulation can be safely applied in the globus pallidus internus to treat refractory tic disorders, resulting in significant tic symptom relief and a decrease in SDA but increase in 5-HT.

中文翻译：

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苍白球内部立体定向射频热凝对难治性抽动障碍的影响

摘要

目的

目的研究苍白球内部立体定向射频热凝对难治性抽动障碍的影响。

材料和方法

在2015年1月至2017年7月之间招募了40例难治性抽动症患者，以进行苍白球内翻的立体定向射频热凝治疗。分析了所有临床数据，耶鲁全球Tic严重程度评分（YGTSS）得分，血清多巴胺（SDA）和5-羟色胺（5-HT）。

结果

所有患者均成功进行了射频热凝。围手术期并发症发生在两名患者（5.0％），一名发烧（2.5％）和一名排尿障碍（2.5％）；治疗后均恢复正常。随访12个月后，有18例患者（45.0％）表现出显着改善，其中10例（25.0％）显着改善，9例（22.5％）显着改善，3例（7.5％）无效，总计有效率92.5％（37/40）。28名患者（70％）表现出优异或显着的改善，而在手术后未进行其他治疗。 与热凝之前相比，YGTSS评分显着降低（p <0.05）。SDA显着（p <0.05）与之前（125.63±35.26 ng / ml）手术后相比，分别减少了6个月（80.78±18.82 ng / ml）和12个月（75.65±15.23 ng / ml），而5-HT显着（p  <0.05）与之前的手术（35.62±3.41 ng / ml）相比，增加了6个月（58.93±16.88 ng / ml）和12个月（62.63±15.21 ng / ml）。

结论

立体定向射频热凝可安全地应用于苍白球内膜，以治疗难治性抽动障碍，导致抽动症状明显缓解，SDA降低，但5-HT升高。