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Tourette syndrome helped with deep brain stimulation

Kathleen Blanchard's picture

Tourette syndrome, (Gilles de la Tourette syndrome), is a neurological disorder that manifests before age 18, usually in childhood or adolescence. The involuntary movements that occur in individuals with the disease include facial tics, grimacing, involuntary movements of the limbs and trunk. Involuntary outbursts that include grunting, throat clearing, and shouting, barking, and even word repetition makes Tourette syndrome unbearable for those diagnosed.

Tourette syndrome can be mild, but it can also be so severe as to induce depression and decreased quality of life. The condition occurs more commonly in boys, worsens in early teens, and might be outgrown. Excitement makes tics, involuntary movements, and verbalizations worse. Treatment for Tourette syndrome with medication includes low dose psychotropics, used cautiously, including haloperidol (Haldol®), pimozide (Orap®), fluphenazine (Prolixin®),and risperidone (Risperdal®). Antidepressants and anti-anxiety medications can help, but for some, Tourette syndrome can be severe and unresponsive to traditional treatment.

Deep brain stimulation found to help

Research published in the October 27, 2009, print issue of Neurology®, shows that deep brain stimulation can help individuals with severe Tourette syndrome. The technique was helpful for treating fifteen patients with Tourette’s who failed to respond to medications and psychobehavioral treatments designed to minimize the effects of the neurological disorder.

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Deep brain stimulation used to treat Tourette syndrome in the study involves implantation of a stimulator that sends paced electrical signals to the brain.

The patients treated also had symptoms of depression and anxiety, and were followed for two years following initiation of deep brain stimulation.

Study author Andrea Cavanna, MD, of the University of Birmingham, in the United Kingdom said, "Despite having only 15 patients in this study, it is the largest to date on the effectiveness of deep brain stimulation as a treatment for Tourette syndrome. The results showed that all 15 people who were assessed after two years' treatment experienced improvements in disabling tics and neurological problems, which is encouraging. Unfortunately three patients from the original group of 18 were no longer part of the study at follow up and this limits the ability to generalize our findings. More research needs to be done to confirm that deep brain stimulation is a safe and effective treatment for Tourette syndrome."

Deep brain stimulation had no negative effect on thinking in the study group. The participants experienced 52 percent fewer tics and neurologic effects associated with Tourette syndrome, less depression, and improvements in other behavioral health symptoms. Deep brain stimulation is approved by the FDA for treatment of tremors with Parkinson’s disease. The technique now shows promise for treating Tourette syndrome that is severe and unresponsive to medications and behavioral health therapies.

AAN Press Release
NINDS Tourette Syndrome Information Page