The use of brain surgery to treat TS receives a lot of media attention. This three-part blog series will give you up-to-date information about this treatment approach. Stay tuned for part three, which will be published tomorrow. You may read part one here.
Deep Brain Stimulation (DBS) is a surgical procedure that involves implanting an electrode in the brain, implanting a pulse generator in the upper chest, and running a cable under the skin to connect the two. Electric pulses from the generator pass through the cable to the electrode deep within the brain with the goal of neuro-modulating or moderating abnormal signals common to patients with treatment-resistant TS.
To date, there are almost 100 reported cases of people with treatment-resistant TS receiving DBS. Among the 100 cases, DBS targeted several different places in brain, with nine different locations stimulated in total.
A new study published this month documented 17 DBS cases over periods of one to four years, each targeting the same location in the brain (thalamic stimulation). Most of the patients experienced tic reduction post-DBS, which was on average about a 48.3% decrease in motor and 41.3% decrease in vocal tics.
An important finding from this particular study was that the reduction in tics tended to last over time. This was the longest study ever conducted on patients who had DBS for medically-intractable TS. The authors checked in with the patients one month, three months and then between 8-46 months later, depending on the patient. The average final check-in was at the two year or 24 month mark. The study concluded that the benefits of the procedure tend to last and be stable over several years up to four years’ time.
On balance, it is also important to note that eight of the 17 patients or 47% needed to keep taking medication even after their DBS surgery. Four patients had negative side effects including anxiety, infection, dizziness, poor balance and worsening of stuttering. Two patients asked to have the device removed.
If you are interested in reading this article, it’s available online here.
Sachdev PS, Mohan A, Cannon E, Crawford JD, Silberstein P, et al. (2014) Deep Brain Stimulation of the Antero-Medial Globus Pallidus Interna for Tourette Syndrome. PLoS ONE 9(8): e104926. doi:10.1371/journal.pone.0104926