Tourette Syndrome: Pre and Postoperative Analysis

Background: Tourette Syndrome (TS) is a neuropsychiatric disorder characterized by motor and vocal tics. Recent studies have shown that Deep Brain Stimulation (DBS) may be helpful for patients with treatment-refractory TS.

Methods: A retrospective analysis was performed to evaluate the treatment outcomes with DBS of 5 patients with TS based on Yale Global Tic Severity Scale (YGTSS) and Yale-Brown Obsessive-Compulsive Scale (YBOCS). Psychiatric disorders, DBS target, disease onset, duration of TS at surgery and side effects were also evaluated.

Results: 3 patients showed a decrease of at least 55% in the total tic severity, while 2 patients had no improvement. These 2 patients had the most recent surgery at the evaluation time. 4 patients had no obsessive-compulsive symptoms before and after surgery, and 1 patient, who scored 8 points on YBOCS, presented total improvement of symptoms after surgery. The DBS target was medial thalamus in 4 patients and internal pallidum in 1 patient. No important clinical manifestation was found between these patients. The disease onset ranged from 5 to 10 years, and the duration of TS at surgery ranged from 12 to 35 years. The patients had no significant side effect after surgery.

Conclusion: These data were consistent with other studies, which have shown DBS as an option to treatment-refractory TS. We also noted that time after surgery affects the treatment outcomes, which shows that postoperative adjust of DBS plays crucial role on the treatment.