Objective: Investigate the antineural antibodies (ANAb) level in the individuals with Tourette’s syndrome (TS) and the relationship with clinical characteristics. Analyze the clinical results and safety of globus pallidus internus (GPi) deep brain stimulation (DBS) in refractory TS patients and the comparison of ANAb level of preoperation and postoperation.

Background: Autoimmune etiology associated with TS. DBS is an effective and safe treatment.

Methods: The level of serum ANAb was detected in 15 refractory TS patients and 4 of them were treated with GPi DBS. The patients were interviewed to evaluate the severity of their tics and others by YGTSS, YALE-BROWN and SDS at preoperative and 1 month, 6months, 1 year and subsequent follow-up after the surgery. Side effects were documented. Comorbid neuropsychiatric disorders were also identified based on the information from the interviews with the patients.

Results: In the group of 15 TS patients the course of disease, YGTSS Motor scores and YGTSS total scores are positively associated with the age (P＜0.05), YGTSS Motor scores and YGTSS total scores are positively associated with the course of disease (P＜0.05). There is a lack of correlation between the ANAb level and the course of disease, gender and YGTSS scores (P＞0.05).4 refractory TS patients was performed GPi-DBS procedure. The time of follow-up is 60.00±21.91 months. Compare with the preoperation, there is a significant difference in YGTSS score from 6 months after Gpi-DBS. There is a lack of correlation between the ANAb level and DBS treatment. None of the 4 patients showed serious permanent side effects.

Conclusions: This study indicates patients’ symptoms are more severe, the patients are older and the courses of disease are longer. There is no significant correlation between the ANAb level and the course of disease, gender and YGTSS scores which showed that autoimmune has no effect on the development of the disease.The results suggest GPi DBS is an effective and safe treatment for refractory TS patients. There is a reduction of ANAb level compared with preoperation and postoperation which indicated the mechanism of DBS may involve autoimmune reaction. But there is no significant difference because of the small sample size (only 2 cases). So this study needs to expand the sample size to further clarify the relationship.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-study-of-deep-brain-stimulation-of-globus-pallidus-internus-for-refractory-tourette-syndrome/