16-Jan-2018: DBS Linked to Symptomatic Improvement in Tourette Syndrome

Deep brain stimulation (DBS) has been found to be associated with a symptomatic improvement in patients with Tourette syndrome. A study found that 1 year after the implantation of a DBS device, the average tic severity for patients improved by 45%.

With DBS, brain surgeons run thin electric leads to specific regions of the basal ganglia, a cluster of nerves in the brain related to motor control and behaviour. Doctors then apply electricity to the brain circuits they’ve most closely linked to Tourette, to try to control the patient’s tics. However, the procedure still needs more work. More than a third of patients experienced adverse events, most often slurred speech or a pins-and-needles sensation.

The adverse events at 1 year were consistent with previous Tourette DBS studies and were mostly reversible with programming. Longitudinal follow-up of safety and adverse events will be an important endpoint for this registry and database. It is clear that future technological innovations will be needed to improve the risk-benefit ratio of the procedure.

DBS, while a promising therapy for Tourette, still leaves some “critical questions” unanswered, including information on how to determine the appropriate candidates for the therapy. The results thus far, however, suggest it is a worthy treatment option to explore.

There are many neuropsychiatric disorders being studied in animal and early human experiments and it is likely we will see the indications for DBS expand. Additionally, DBS in the future will likely be personalized to individual symptoms that are impacting the quality of life.

What is Tourette syndrome?

Tourette syndrome (TS) is a neurological disorder characterized by repetitive, stereotyped, involuntary movements and vocalizations called tics. The disorder is named for Dr. Georges Gilles de la Tourette, the pioneering French neurologist who in 1885 first described the condition in an 86-year-old French noblewoman.

The early symptoms of TS are typically noticed first in childhood, with the average onset between the ages of 3 and 9 years. TS occurs in people from all ethnic groups; males are affected about three to four times more often than females. It is estimated that 200,000 Americans have the most severe form of TS, and as many as one in 100 exhibit milder and less complex symptoms such as chronic motor or vocal tics. Although TS can be a chronic condition with symptoms lasting a lifetime, most people with the condition experience their worst tic symptoms in their early teens, with improvement occurring in the late teens and continuing into adulthood.