Microelectrode-guided deep brain stimulation for Tourette syndrome: Within-subject comparison of different stimulation sites
Microelectrode-guided deep brain stimulation for Tourette syndrome: Within-subject comparison of different stimulation sites
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DOI：
10.1159/000112429
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发表时间：
2008-01-01
影响因子：
1.7
通讯作者：
Eskandar, Emad N.
中科院分区：
文献类型：
--
作者：
Shields, Donald C.;Cheng, Ming L.;Eskandar, Emad N.
背景：由于抽动秽语综合症（TS）的药物治疗对一小部分患者无效，近年来已经开发了手术干预措施，包括不同部位的深部脑刺激。病例描述：我们介绍一名患有 TS 的 40 岁女性，其严重抽动导致单眼失明。尽管尝试了 40 多种药物，但只有在前下内囊放置双侧深部脑刺激器后，她的症状才显着改善。然而，症状改善并不完全，她的电极连接最终因剩余的结肠后抽搐而永久损坏。她接受了内囊电极的移除和丘脑中心正中核刺激器的放置，抽动控制得到了显着改善。结论：虽然前内囊部位也产生了精神副作用，例如情绪和冲动控制改变，但丘脑部位迄今为止尚未产生这种副作用。因此，不同的 TS 手术目标可能适合患有特定合并症的患者。版权所有 (C) 2007 S. Karger AG，巴塞尔。
Background: As medical therapy for Tourette syndrome (TS) is ineffective in a small subset of patients, surgical interventions, including deep brain stimulation at various sites, have been developed in recent years. Case Description: We present the case of a 40-year-old woman with TS whose severe tics had caused unilateral blindness. Despite trials of more than 40 medications, her symptoms improved significantly only after placement of bilateral deep brain stimulators in the anterior inferior internal capsule. However, symptomatic improvement was not complete, and her electrode connections eventually became permanently damaged by the remaining retrocollic jerks. She underwent removal of the internal capsule electrodes and placement of centromedian nucleus thalamic stimulators with significantly improved tic control. Conclusion: Whereas the anterior internal capsule site had also produced psychiatric side effects such as altered mood and impulse control, the thalamic site has not done so to date. Thus, distinct surgical targets for TS may be appropriate for patients with specific comorbidities. Copyright (C) 2007 S. Karger AG, Basel.