Publication date: July 2013
Source:Neuroscience & Biobehavioral Reviews, Volume 37, Issue 6
Author(s): Kirsten R. Müller-Vahl
In severely affected, treatment resistant patients with Tourette syndrome (TS) new therapeutic strategies are urgently needed. Since 1999, 34 studies including more than 90 patients have been performed to investigate the efficacy and safety of deep brain stimulation (DBS) in the treatment of tics resulting in the vast majority of patients in an improvement of tics and in some patients even of comorbidities. Both surgery-related (e.g., bleeding, infection) and stimulation-related adverse events (e.g., loss of energy, blurred vision) seem to occur only in a minority of patients and not to cause significant impairment, respectively. Since randomized controlled studies including a larger number of patients are still lacking, up to now, no definite conclusion can be drawn. Therefore, at present time DBS is recommended only in adult, treatment resistant, and severely affected patients. However, most experts have no doubt that DBS is indeed effective in the treatment of tics. Future studies should aim to identify which target in which patient is optimal depending on the individual symptomatology.
Highlights
► DBS is a promising, but still experimental treatment for patients with TS. ► There is substantial evidence that DBS improves tics. ► It is unclear whether and which psychiatric comorbidities improve after DBS. ► Only adult, treatment resistant, and severely affected patients should undergo DBS. ► Up to now, it is unclear which target is the optimal.
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