Cui Zhi-Qiang, Wang Jian, Mao Zhi-Qi, Pan Long-Sheng, Jiang Chao, Gao Qing-Yao, Ling Zhi-Pei, Xu Bai-Nan, Yu Xin-Guang, Zhang Jian-Ning, Chen Tong
Department of Neurosurgery, Chinese PLA General Hospital, Beijing, 100853, China.
Hebei Key Laboratory for Chronic Diseases, Tangshan Key Laboratory for Preclinical and Basic Research on Chronic Diseases, School of Basic Medical Sciences, North China University of Science and Technology, Tangshan, Hebei, 063210, China.
J Psychiatr Res. 2022 Jul;151:523-530. doi: 10.1016/j.jpsychires.2022.05.025. Epub 2022 May 23.
To evaluate the long-term efficacy, prognostic factors, and safety of posteroventral globus pallidus internus deep brain stimulation (DBS) in patients with refractory Tourette syndrome (RTS).
This retrospective study recruited 61 patients with RTS who underwent posteroventral globus pallidus internus (GPi) DBS from January 2010 to December 2020 at the Chinese People's Liberation Army General Hospital. The Yale Global Tic Severity Scale (YGTSS), Yale-Brown Obsessive-Compulsive Scale (YBOCS), Beck Depression Inventory (BDI), Gilles de la Tourette Syndrome Quality-of-Life Scale (GTS-QOL) were used to evaluate the preoperative and postoperative clinical condition in all patients. Prognostic factors and adverse events following surgery were analyzed.
Patient follow up was conducted for an average of 73.33 ± 28.44 months. The final postoperative YGTSS (32.39 ± 22.34 vs 76.61 ± 17.07), YBOCS (11.26 ± 5.57 vs 18.31 ± 8.55), BDI (14.36 ± 8.16 vs 24.79 ± 11.03) and GTS-QOL (39.69 ± 18.29 vs 78.08 ± 14.52) scores at the end of the follow-up period were significantly lower than those before the surgery (p < 0.05). While age and the duration of follow-up were closely related to prognosis, the disease duration and gender were not. No serious adverse events were observed and only one patient exhibited symptomatic deterioration.
Posteroventral-GPI DBS provides long-term effectiveness, acceptable safety and can improve the quality of life in RTS patients. Moreover, DBS is more successful among younger patients and with longer treatment duration.
评估苍白球腹后内侧核深部脑刺激（DBS）治疗难治性抽动秽语综合征（RTS）患者的长期疗效、预后因素及安全性。
本回顾性研究纳入了2010年1月至2020年12月在中国人民解放军总医院接受苍白球腹后内侧核（GPi）DBS治疗的61例RTS患者。采用耶鲁综合抽动严重程度量表（YGTSS）、耶鲁-布朗强迫量表（YBOCS）、贝克抑郁量表（BDI）、抽动秽语综合征生活质量量表（GTS-QOL）评估所有患者术前和术后的临床状况。分析术后的预后因素及不良事件。
患者平均随访73.33±28.44个月。随访期末最终术后YGTSS（32.39±22.34 vs 76.61±17.07）、YBOCS（11.26±5.57 vs 18.31±8.55）、BDI（14.36±8.16 vs 24.79±11.03）和GTS-QOL（39.69±18.29 vs 78.08±14.52）评分均显著低于术前（p<0.05）。年龄和随访时间与预后密切相关，而病程和性别与预后无关。未观察到严重不良事件，仅1例患者出现症状恶化。
苍白球腹后内侧核DBS具有长期疗效、可接受的安全性，且能改善RTS患者的生活质量。此外，DBS在年轻患者及治疗时间较长的患者中更成功。
