当前位置: X-MOL 学术Brain Stimul. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Thalamic deep brain stimulation for Tourette Syndrome: A naturalistic trial with brief randomized, double-blinded sham-controlled periods
Brain Stimulation ( IF 7.7 ) Pub Date : 2021-07-07 , DOI: 10.1016/j.brs.2021.07.003
Juan Carlos Baldermann 1 , Jens Kuhn 2 , Thomas Schüller 3 , Sina Kohl 3 , Pablo Andrade 4 , Sophia Schleyken 1 , Reinhild Prinz-Langenohl 5 , Martin Hellmich 6 , Michael T Barbe 7 , Lars Timmermann 8 , Veerle Visser-Vandewalle 4 , Daniel Huys 3
Affiliation  

Background

There is still a lack of controlled studies to prove efficacy of thalamic deep brain stimulation for Tourette's Syndrome.

Objectives

In this controlled trial, we investigated the course of tic severity, comorbidities and quality of life during thalamic stimulation and whether changes in tic severity can be assigned to ongoing compared to sham stimulation.

Methods

We included eight adult patients with medically refractory Tourette's syndrome. Bilateral electrodes were implanted in the centromedian-parafascicular-complex and the nucleus ventro-oralis internus. Tic severity, quality of life and comorbidities were assessed before surgery as well as six and twelve months after. Short randomized, double-blinded sham-controlled crossover sequences with either active or sham stimulation were implemented at both six- and twelve-months’ assessments. The primary outcome measurement was the difference in the Yale Global Tic Severity Scale tic score between active and sham stimulation. Adverse events were systematically surveyed for all patients to evaluate safety.

Results

Active stimulation resulted in significantly higher tic reductions than sham stimulation (F = 79.5; p = 0.001). Overall quality of life and comorbidities improved significantly in the open-label-phase. Over the course of the trial two severe adverse events occurred that were resolved without sequelae.

Conclusion

Our results provide evidence that thalamic stimulation is effective in improving tic severity and overall quality of life. Crucially, the reduction of tic severity was primarily driven by active stimulation. Further research may focus on improving stimulation protocols and refining patient selection to improve efficacy and safety of deep brain stimulation for Tourette's Syndrome.



中文翻译:

图雷特综合征的丘脑深部脑刺激:一项具有简短随机、双盲假手术控制期的自然试验

背景

仍然缺乏对照研究来证明丘脑深部脑刺激对图雷特综合征的疗效。

目标

在这项对照试验中,我们调查了丘脑刺激期间抽动严重程度、合并症和生活质量的过程,以及与假刺激相比,抽动严重程度的变化是否可以归因于持续的刺激。

方法

我们纳入了 8 名患有药物难治性图雷特综合征的成年患者。双侧电极植入中心束旁复合体和腹口内核。抽动严重程度、生活质量和合并症在手术前以及手术后 6 个月和 12 个月进行评估。在六个月和十二个月的评估中实施了具有主动或假刺激的短随机、双盲假控制交叉序列。主要结果测量是主动刺激和假刺激之间耶鲁全球抽动严重程度量表抽动评分的差异。系统地调查了所有患者的不良事件以评估安全性。

结果

主动刺激导致的抽动减少明显高于假刺激(F = 79.5;p = 0.001)。在开放标签阶段,整体生活质量和合并症显着改善。在试验过程中,发生了两起严重的不良事件,这些事件都得到了解决,没有后遗症。

结论

我们的研究结果证明丘脑刺激可有效改善抽动严重程度和整体生活质量。至关重要的是,抽动严重程度的降低主要是由主动刺激驱动的。进一步的研究可能集中在改进刺激方案和改进患者选择上,以提高图雷特综合征深部脑刺激的有效性和安全性。

更新日期:2021-07-16
down
wechat
bug