Norman Fixel Institute for Neurological Disease, Department of Neurology, University of Florida, Gainesville, FL, USA.
Department of Psychiatry, Maastricht University Medical Center, Maastricht, the Netherlands.
Parkinsonism Relat Disord. 2020 Aug;77:89-93. doi: 10.1016/j.parkreldis.2020.06.025. Epub 2020 Jun 25.
Tourette syndrome (TS) is a complex neuropsychiatric disorder. A small percentage of individuals with TS can experience persistent severe, refractory, and impairing tics. Deep brain stimulation (DBS) has been increasingly used for symptom management, especially in these settings. In this article, we aim to evaluate the rate and the reasons for removal of DBS hardware in TS patients.
Data was analyzed from patients enrolled in the Tourette Association of America's International Tourette Syndrome Registry and Database.
Fifteen of 269 (5.6%) patients required removal of their DBS systems. The mean age at explantation was 33.8 years. In these cases we observed a rate of 1.9 explantations per year of follow up from implantation. None of the removals took place in the immediate post-operative period. Infection was the most common cause (46.7%). Only one patient received explantation for tic resolution. There were no significant associations between explantation and the presence of specific psychiatric comorbidities, including OCD, depression, anxiety, or ADHD.
The rate of removal of 5.6% was lower than the previously reported rate in the TS DBS literature. Infections accounted for nearly half of the TS DBS explantations in this cohort. There was no relationship to psychiatric comorbidities.
妥瑞氏症（TS）是一种复杂的神经精神疾病。一小部分 TS 患者可能会出现持续严重、难治且致残的抽搐。深部脑刺激（DBS）已越来越多地用于症状管理，尤其是在这些情况下。本文旨在评估 TS 患者 DBS 硬件移除的发生率和原因。
从美国妥瑞氏症协会国际妥瑞氏症登记和数据库中招募的患者中分析数据。
269 名患者中有 15 名（5.6%）需要移除他们的 DBS 系统。取出装置的平均年龄为 33.8 岁。在这些病例中，我们观察到从植入到取出的随访期间每年有 1.9 例取出。没有一例在术后即刻发生。感染是最常见的原因（46.7%）。只有一名患者因抽搐缓解而接受了取出手术。取出与特定的精神共病之间没有显著关联，包括 OCD、抑郁、焦虑或 ADHD。
5.6%的移除率低于 TS DBS 文献中先前报道的比率。在本队列中，感染几乎占 TS DBS 取出的一半。与精神共病无关。
