Long-term Outcome of Globus Pallidus Internus Deep Brain Stimulation in Patients With Tourette Syndrome
Long-term Outcome of Globus Pallidus Internus Deep Brain Stimulation in Patients With Tourette Syndrome
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DOI：
10.1016/j.mayocp.2014.05.019
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发表时间：
2014-11-01
影响因子：
8.9
通讯作者：
Meng, Fan-Gang
中科院分区：
文献类型：
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作者：
Zhang, Jian-Guo;Ge, Yan;Meng, Fan-Gang
目的：评价苍白球内脑部深部电刺激(DBS)对药物治疗和心理治疗无效的重症Tourette综合征患者抽动严重程度和常见并发症的疗效。方法：回顾分析2006年1月1日至2013年5月31日在北京天坛医院接受DBS治疗的13例难治性Tourette综合征患者的长期临床结果。主要结果是由耶鲁全球抽动严重程度量表衡量抽动的严重程度，次要结果是相关行为障碍和情绪的改变，由Gilles de la Tourette综合征-生活质量量表评估。结果：与基线相比，耶鲁全球抽动严重程度量表在最后一次随访时(平均41.9个月；1个月、6个月、12个月、18个月、24个月、30个月、36个月以上的平均好转率分别为11.8%、20.0%、26.8%、36.7%、44.7%、49.0%、56.7%。配对样本t检验显示，DBS治疗6个月后抽动症状明显改善(P
Objective: To evaluate the effectiveness of deep brain stimulation (DBS) of the globus pallidus internus (GPi) on tic severity and common comorbidities in patients with severe Tourette syndrome that is refractory to pharmacological treatment and psychotherapy.Patients and Methods: We retrospectively assessed the long-term clinical outcomes of 13 patients with treatment-refractory Tourette syndrome who underwent DBS targeting the GPi at the Beijing Tiantan Hospital from January 1, 2006, through May 31, 2013. The primary outcome was a change in tic severity as measured by the Yale Global Tic Severity Scale, and the secondary outcome was a change in associated behavioral disorders and mood as measured by the Gilles de la Tourette Syndrome-Quality of Life Scale assessment.Results: Compared with baseline, the mean reduction in the total Yale Global Tic Severity Scale scores at last follow-up (mean, 41.9 months; range, 13-80 months) was 52.1% (range, 4.3%-83.6%), and the mean improvement rates at 1 month, 6 months, 12 months, 18 months, 24 months, 30 months, and 36 or more months were 11.8%, 20.0%, 26.8%, 36.7%, 44.7%, 49.0%, and 56.7%, respectively. A paired-sample t test revealed significant improvement of tic symptoms after 6 months of DBS programming (P