Efficacy and Safety of Deep Brain Stimulation in Tourette Syndrome The International Tourette Syndrome Deep Brain Stimulation Public Database and Registry
Efficacy and Safety of Deep Brain Stimulation in Tourette Syndrome The International Tourette Syndrome Deep Brain Stimulation Public Database and Registry
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DOI：
10.1001/jamaneurol.2017.4317
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发表时间：
2018-03-01
期刊：
影响因子：
29
通讯作者：
Okun, Michael S.
中科院分区：
文献类型：
--
作者：
Martinez-Ramirez, Daniel;Jimenez-Shahed, Joohi;Okun, Michael S.
重要性集体证据强烈表明，脑深部电刺激（DBS）是一种有前途的治疗Tourette syndrome.Objective评估DBS在一个多国Tourette syndrome患者队列中的有效性和安全性。设计、设置和参与者前瞻性国际脑深部电刺激数据库和登记研究包括185名患有医学难治性Tourette syndrome的患者，他们从2010年1月1日开始接受DBS植入术，2012年至2016年12月31日，在全球10个国家的31家机构进行。（93/163 [57.1%]），前苍白球内侧（41/163 [25.2%]），后苍白球内侧（163人中的25人[15.3%]），和内囊的前肢（4/163 [2.5%]）.主要结果和指标耶鲁全球抽动严重程度量表评分和不良事件。结果国际脑深部电刺激数据库和登记处招募了185名患者（在171例有可用数据的患者中，37例女性和134例男性;手术时的平均[SD]年龄为29.1 [10.8]岁[范围：13-58岁]）。151例患者中有97例（64.2%）存在强迫症症状，148例患者中有32例（21.6%）有自伤行为史。平均（SD）耶鲁整体抽动严重程度量表评分从基线时的75.01（18.36）改善至DBS植入后1年的41.19（20.00）（P
IMPORTANCE Collective evidence has strongly suggested that deep brain stimulation (DBS) is a promising therapy for Tourette syndrome.OBJECTIVE To assess the efficacy and safety of DBS in a multinational cohort of patients with Tourette syndrome.DESIGN, SETTING, AND PARTICIPANTS The prospective International Deep Brain Stimulation Database and Registry included 185 patients with medically refractory Tourette syndrome who underwent DBS implantation from January 1, 2012, to December 31, 2016, at 31 institutions in 10 countries worldwide.EXPOSURES Patients with medically refractory symptoms received DBS implantation in the centromedian thalamic region (93 of 163 [57.1%]), the anterior globus pallidus internus (41 of 163 [25.2%]), the posterior globus pallidus internus (25 of 163 [15.3%]), and the anterior limb of the internal capsule (4 of 163 [2.5%]).MAINOUTCOMES AND MEASURES Scores on the Yale Global Tic Severity Scale and adverse events.RESULTS The International Deep Brain Stimulation Database and Registry enrolled 185 patients (of 171 with available data, 37 females and 134 males; mean [SD] age at surgery, 29.1 [10.8] years [range, 13-58 years]). Symptoms of obsessive-compulsive disorder were present in 97 of 151 patients (64.2%) and 32 of 148 (21.6%) had a history of self-injurious behavior. The mean (SD) total Yale Global Tic Severity Scale score improved from 75.01 (18.36) at baseline to 41.19 (20.00) at 1 year after DBS implantation (P