Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA.
Mayo Clin Proc. 2012 Jan;87(1):59-62. doi: 10.1016/j.mayocp.2011.08.005.
Tourette syndrome (TS) is a complex neuropsychiatric disorder often starting in childhood and characterized by the presence of multiple motor and vocal tics and psychiatric comorbidities. Patients with TS usually respond to medical treatment, and the condition often improves during adolescence; however, surgery has been considered a possible approach for the subset of patients with ongoing medically refractory disease. Ablative procedures have been associated with unsatisfactory results and major adverse effects, prompting trials of deep brain stimulation (DBS) as an alternative therapy. It remains unclear which of the various nuclear targets is most effective in TS. We describe 3 patients with TS who underwent DBS targeting the bilateral thalamic centromedian/parafascicular complex (CM/Pf) with an excellent clinical outcome. At 1-year follow-up, the mean reduction in the total Yale Global Tic Severity Scale score in the 3 patients was 70% (range, 60%-80%).Our study further supports the role of the CM/Pf DBS target in medically intractable TS.
妥瑞氏症候群（TS）是一种复杂的神经精神疾病，通常始于儿童时期，其特征为存在多种运动性抽搐和发声性抽搐，以及精神共病。TS 患者通常对药物治疗有反应，并且病情通常在青春期改善；然而，对于持续药物难治性疾病的亚组患者，手术已被视为一种可能的治疗方法。消融性手术与不理想的结果和重大不良反应相关，促使人们尝试深部脑刺激（DBS）作为替代疗法。目前尚不清楚 TS 患者中哪种核靶点最有效。我们描述了 3 例接受双侧丘脑中央中核/中央旁核（CM/Pf）DBS 的 TS 患者，他们取得了极佳的临床效果。在 1 年的随访中，这 3 例患者的耶鲁总体抽动严重程度量表总分平均降低了 70%（范围为 60%-80%）。我们的研究进一步支持 CM/Pf DBS 靶点在药物难治性 TS 中的作用。
