Objective: The efficacy of deep brain stimulation (DBS) for Tourette syndrome (TS) was investigated in Japanese patients.

Background: DBS is becoming an alternative treatment for refractory TS. However, few comprehensive studies have examined the surgical treatment of TS in the Japanese population. The clinical characteristics were assessed of Japanese patients with refractory TS treated by bilateral thalamic centromedian-parafascicular nucleus (CM-Pf) DBS.

Method: This study included 28 patients, 19 males and 9 females, from five institutions in Japan who underwent CM-Pf DBS for refractory TS between 2008 and 2018. Postoperative courses scored by the Yale Global Tic Severity Scale (YGTSS) were retrospectively analyzed. Surgical, stimulation, and device-related complications and other long-term events were also investigated.

Results: Mean age at DBS surgery was 26.8 years and at survey was 31.6 years. Average YGTSS was 41.6 at baseline and 21.4 at one year after DBS. Tic symptoms showed rapid improvement in the first year after DBS, and continued to improve during the long follow up. Adverse events including temporary side effects caused by stimulation were observed in 28 patients during the entire course. Three patients had severe device infection and two required removal of the DBS system. Re-implantation of the DBS system was performed in one patient for recurrent symptoms. Three patients required removal of the DBS system due to device problems but without recurrence of symptoms.

Conclusion: Our study showed the efficacy of DBS for severe tics in TS was similar to that found in previous studies. The risks of adverse events should be balanced against the expected long-term efficacy.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/efficacy-of-deep-brain-stimulation-for-japanese-patients-with-refractory-gilles-de-la-tourette-syndrome/