Azimi Alireza, Parvaresh Mansour, Shahidi Gholamali, Habibi Amirhassan, Rohani Sadra, Safdarian Mahdi, Fattahi Arash, Taheri Morteza, Rohani Mohammad
Department of Neurosurgery, Hazrat Rasool Hospital, Iran University of Medical Sciences, Tehran, Iran.
Department of Neurology, Hazrat Rasool Hospital, Iran University of Medical Sciences, Tehran, Iran.
Clin Neurol Neurosurg. 2018 Sep;172:116-119. doi: 10.1016/j.clineuro.2018.06.045. Epub 2018 Jul 4.
Tourette syndrome (TS) is a neuropsychiatric disorder characterized by childhood onset motor and phonic tics. In refractory cases, deep brain stimulation (DBS) with different targets including anteromedial Globus pallidus (AM-GPi) looks promising.
Patients with TS diagnosed according to DSM-IV TR criteria with severe medication-recalcitrant disease referred to our DBS clinic, were recruited for this study. They underwent bilateral AM-GPi DBS with Model 3389, Medtronic electrodes. Patients were assessed using Yale Global Tic Severity Scale (YGTSS) and Gilles de la Touretts syndrome-quality of life (GTS-QOL) questionnaire before and one year after DBS.
Six patients (four men and two women) with severe medication-recalcitrant TS, mean age of 26.33 ± 7.25 years fulfilled the follow up visits. All patients revealed significant improvement in tics severity one year after surgery. Based on YGTSS, total tic severity score decreased from 75.66 ± 16.54 to 28.33 ± 13.95, P-value:0.005. Quality of life improved significantly after DBS (26.66 ± 20.65 before and 70.00 ± 17.88 one year after surgery, P-value:0.02).
Results of our study in accordance to previous ones suggest AM-GPi DBS as an effective and well-tolerated therapeutic modality for patients with medication refractory TS.
抽动秽语综合征（TS）是一种神经精神障碍，其特征为儿童期起病的运动性和发声性抽动。在难治性病例中，针对包括内侧苍白球前部（AM - GPi）在内的不同靶点进行的脑深部电刺激（DBS）看起来很有前景。
根据DSM - IV TR标准诊断为TS且患有严重药物抵抗性疾病并转诊至我们的DBS诊所的患者被纳入本研究。他们接受了使用美敦力3389型号电极进行的双侧AM - GPi DBS治疗。在DBS治疗前及治疗后一年，使用耶鲁全球抽动严重程度量表（YGTSS）和抽动秽语综合征生活质量（GTS - QOL）问卷对患者进行评估。
6例（4例男性和2例女性）患有严重药物抵抗性TS的患者，平均年龄26.33±7.25岁完成了随访。所有患者在术后一年抽动严重程度均有显著改善。根据YGTSS，抽动总严重程度评分从75.66±16.54降至28.33±13.95，P值：0.005。DBS治疗后生活质量显著改善（术前为26.66±20.65，术后一年为70.00±17.88，P值：0.02）。
我们的研究结果与之前的研究一致，表明AM - GPi DBS是治疗药物难治性TS患者的一种有效且耐受性良好的治疗方式。
