Deep brain stimulation for Tourette syndrome
29 April 2015
In the largest trial ever performed, and recruiting the most severely affected patients with Tourette syndrome, researchers led by Dr Tom Foltynie, UCL Institute of Neurology, have shown that Deep Brain stimulation of an area of the brain called the globus pallidus (GPi) can lead to significant reduction in tic severity when stimulation is switched ON compared with when switched OFF.
In the study, published in Lancet Neurology, when researchers compared patients' tic severity before surgery to severity at their latest follow up, the mean improvement was 40%, accompanied by similar improvements in quality of life.
We are now learning which patients with severe Tourette syndrome really benefit from the technique of DBS. While the safety record of DBS surgery at NHNN is second to none, it is of paramount importance that we only consider surgical treatment option in those most likely to benefit. We very much hope to be able to offer this treatment option to future patients who are severely affected by this disorder. Dr Tom Foltynie, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology
Most people affected by Tourette syndrome develop minor involuntary movements or noises (known as motor or phonic tics) during childhood. These tend to disappear as they reach adulthood. In a minority of individuals however they persist into adulthood and can be severe. In the most extremely affected people, tics can occur relentlessly preventing normal conversation, walking, or day to day function. Some patients have developed spinal injuries because of the violent nature of their tics.Drug treatments for Tourette syndrome are only partially helpful, and frequently have sedating side effects. New treatment options are therefore necessary.
The researchers are now working hard to use the findings of the trial to try and persuade NHS England to commission a small Deep Brain stimulation service for similarly affected patients at the National Hospital for Neurology and Neurosurgery (NHNN).
- Kefalopoulou et al. Bilateral globus pallidus stimulation for severe Tourette's syndrome: a double-blind, randomised crossover trial. Lancet Neurology 2015. Published Online: 13 April 2015. DOI: 0.1016/S1474-4422(15)00008-3
- Dr Tom Foltynie's academic profile on IRIS