PubMed Abstract
Curr Opin Neurol. 2007 Aug;20(4):470-6.
Surgery for other movement disorders: dystonia, tics.
Hamani C, Moro E.
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PURPOSE OF REVIEW: Various movement disorders are now treated with stereotactic procedures, particularly deep brain stimulation. We review the neurosurgical treatment of dystonias and tics, focusing mainly on the surgical aspects and outcome of deep brain stimulation.
RECENT FINDINGS: Pallidal stimulation is nowadays the mainstay surgical treatment for patients with dystonia, particularly generalized dystonia. Various well designed recent clinical trials support the efficacy of the procedure. Improvements of 40-80% have been reported in primary generalized, segmental and cervical dystonia. For secondary dystonia, a similar outcome has been described in patients with tardive dystonia and pantothenate kinase-associated neurodegeneration. In patients with Tourette's syndrome, the results of the first trials with thalamic and pallidal deep brain stimulation have been very promising. Improvements of 70-90% in the frequency of tics have been reported with surgery in both targets.
SUMMARY: Deep brain stimulation has become an established therapy for dystonia and is currently being used to treat Tourette's syndrome. With accumulation of experience, clinical features that are more responsive to surgery and the best surgical candidates will be revealed. This will likely improve even further the outcome of surgery for the treatment of these disorders.
PMID: 17620884 [PubMed - in process]
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PubMed Abstract
Curr Neurol Neurosci Rep. 2007 Jul;7(4):278-89.
Limbic, associative, and motor territories within the targets for deep brain stimulation: potential clinical implications.
Sudhyadhom A, Bova FJ, Foote KD, Rosado CA, Kirsch-Darrow L, Okun MS.
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The use of deep brain stimulation (DBS) has recently been expanding for the treatment of many neurologic disorders such as Parkinson disease, dystonia, essential tremor, Tourette's syndrome, cluster headache, epilepsy, depression, and obsessive compulsive disorder. The target structures for DBS include specific segregated territories within limbic, associative, or motor regions of very small subnuclei. In this review, we summarize current clinical techniques for DBS, the cognitive/mood/motor outcomes, and the relevant neuroanatomy with respect to functional territories within specific brain targets. Future development of new techniques and technology that may include a more direct visualization of "motor" territories within target structures may prove useful for avoiding side effects that may result from stimulation of associative and limbic regions. Alternatively, newer procedures may choose and specifically target non-motor territories for chronic electrical stimulation.
PMID: 17618533 [PubMed - in process]
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http://www.neurology.org/cgi/content/full/68/2/85
NEUROLOGY 2007;68:85
© 2007 American Academy of Neurology
January 9 Highlight and Commentary
Deep brain stimulation for a teen with tics?
Donald L. Gilbert, MD, MS
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This report describes short-term changes after deep brain stimulation (DBS) in a 16-year-old boy with unusually severe Tourette syndrome (TS) symptoms.1 The report illustrates important factors in considering DBS as an experimental treatment for TS.
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http://jnnp.bmj.com/cgi/content/abst...e2=tf_ipsecsha
Tourette’s syndrome and deep brain stimulation
J L Houeto, C Karachi, L Mallet, B Pillon, J Yelnik, V Mesnage, M L Welter, S Navarro, A Pelissolo, P Damier, B Pidoux, D Dormont, P Cornu and Y Agid
http://www.neurology.org/cgi/content...e2=tf_ipsecsha
NEUROLOGY 2006;66:E12
NeuroImages
Hemi tics and deep brain stimulation
Catherine L. Gallagher, MD, P. Charles Garell, MD and Erwin B. Montgomery, Jr, MD
http://www.touchbriefings.com/pdf/2785/tipuaziz.pdf
Deep Brain Stimulation—Which Patients and When?