Movement disorders clinical practice · 2018
Prefrontal Cortical Stimulation in Tourette Disorder: Proof-of-concept Clinical and Neuroimaging Study.
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Perani Daniela, Lalli Stefania, Iaccarino Leonardo, Alongi Pierpaolo, Gambini Orsola, Franzini Angelo, Albanese Alberto
Аннотация
BACKGROUND: The benefits of neurosurgery in Tourette Syndrome (TS) are still incompletely understood. Prefrontal cortical electrical stimulation offers a less invasive alternative to deep brain stimulation.
OBJECTIVE: To perform a pilot assessment on safety and efficacy of prefrontal cortical bilateral electrical stimulation in TS using clinical and brain metabolic assessments.
METHODS: Four adult TS patients underwent tic assessment using the Yale Global Tic Severity Scale and the Rush Video Rating Scale at baseline and 1, 3, 6, and 12-months after implant; whereas FDG-PET scans were acquired at baseline and after 6 and 12 months.
RESULTS: Tic clinical scores were improved at 6 months after implant, meanwhile they showed a tendency to re-emerge at the 12-month follow-up. There was a correlation between FDG-PET and tics, mainly consisting in a reduction of baseline brain hypermetabolism, which paralleled tic score reduction.
CONCLUSION: Epidural stimulation in TS is safe and yields a modulation of tics, paralleled by FDG-PET metabolic modulation.
OBJECTIVE: To perform a pilot assessment on safety and efficacy of prefrontal cortical bilateral electrical stimulation in TS using clinical and brain metabolic assessments.
METHODS: Four adult TS patients underwent tic assessment using the Yale Global Tic Severity Scale and the Rush Video Rating Scale at baseline and 1, 3, 6, and 12-months after implant; whereas FDG-PET scans were acquired at baseline and after 6 and 12 months.
RESULTS: Tic clinical scores were improved at 6 months after implant, meanwhile they showed a tendency to re-emerge at the 12-month follow-up. There was a correlation between FDG-PET and tics, mainly consisting in a reduction of baseline brain hypermetabolism, which paralleled tic score reduction.
CONCLUSION: Epidural stimulation in TS is safe and yields a modulation of tics, paralleled by FDG-PET metabolic modulation.