Anterior pallidal deep brain stimulation for Tourette's syndrome: a randomised, double-blind, controlled trial

Bissery, Anne; Oya, Hiroyuki; Hajji, M.; Tanguy, A.; Montcel, Sophie Tézenas du; Karachi, Carine; Mallet, Luc; Welter, Marie‐Laure; Hartmann, Andreas; Czernecki, Virginie; Yelnik, Jérôme; Bardinet, Éric; Agid, Yves; Worbe, Yulia; Dormont, Didier; Buot, Anne; Vidailhet, Marie; Cornu, Philippe; Aouizerate, Bruno; Burbaud, Pierre; Cuny, Emmanuel; Jalenques, Isabelle; Durif, Franck; Fauchon, Camille; Rondepierre, Fabien; Derost, Philippe; Kombo, Magaly Aya; Polosan, Mircea; Chabardès, Stéphan; Krainik, Andrew J.; Krack, Paul; Piallat, Brigitte; Pollak, Pierre; Thobois, Stéphane; Guénot, Marc; Poulet, Emmanuel; Klinger, Hélène; Serra, Giulia; Broussolle, Emannuel; Rouaud, Tiphaine; Sauvaget, Anne; Derkinderen, Pascal; Damier, Philippe; Raoul, Sylvie; Fontaine, Denys; Borg, M.; Giordana, B.; Magnie-Mauro, M.-N.; Houeto, Jean‐Luc; Jaafari, Nématollah; Bataille, B.; Ansquer, Solène; Bénatru, Isabelle; Fradet, A.; Dugast, E.; Ouerdani, A.; Rabois, Emilie; Quintin, Mathieu; Palfi, Stéphane

doi:10.1016/s1474-4422(17)30160-6

Cited by 81 publications

(64 citation statements)

References 28 publications

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“…Desipramine is now rarely used in children after several case reports of sudden death associated with the use of this medication. 37 People with tics receiving active DBS of the globus pallidus are probably more likely than those receiving sham DBS of the globus pallidus to have reduced tic severity (SMD 0.77 [95% CI 0.14-1.40], 2 Class II studies 38,39 [adults only]).…”

Section: Moderate Confidence In the Evidencementioning

confidence: 99%

Comprehensive systematic review summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders

et al. 2019

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ObjectiveTo systematically evaluate the efficacy of treatments for tics and the risks associated with their use. MethodsThis project followed the methodologies outlined in the 2011 edition of the American Academy of Neurology's guideline development process manual. We included systematic reviews and randomized controlled trials on the treatment of tics that included at least 20 participants (10 participants if a crossover trial), except for neurostimulation trials, for which no minimum sample size was required. To obtain additional information on drug safety, we included cohort studies or case series that specifically evaluated adverse drug effects in individuals with tics. ResultsThere was high confidence that the Comprehensive Behavioral Intervention for Tics was more likely than psychoeducation and supportive therapy to reduce tics. There was moderate confidence that haloperidol, risperidone, aripiprazole, tiapride, clonidine, onabotulinumtoxinA injections, 5-ling granule, Ningdong granule, and deep brain stimulation of the globus pallidus were probably more likely than placebo to reduce tics. There was low confidence that pimozide, ziprasidone, metoclopramide, guanfacine, topiramate, and tetrahydrocannabinol were possibly more likely than placebo to reduce tics. Evidence of harm associated with various treatments was also demonstrated, including weight gain, drug-induced movement disorders, elevated prolactin levels, sedation, and effects on heart rate, blood pressure, and ECGs. ConclusionsThere is evidence to support the efficacy of various medical, behavioral, and neurostimulation interventions for the treatment of tics. Both the efficacy and harms associated with interventions must be considered in making treatment recommendations. Glossary AAN = American Academy of Neurology; ADHD = attention-deficit/hyperactivity disorder; CI = confidence interval; COI = conflict of interest; DBS = deep brain stimulation; GDDI = Guideline Development, Dissemination, and Implementation; rTMS = repetitive transcranial magnetic stimulation; SMD = standardized mean difference; TS = Tourette syndrome; YGTSS = Yale Global Tic Severity Scale. c Riluzole, SMD 0.17 (95% CI −0.91 to 1.25), 1 Class I study 56 ; confidence in evidence downgraded due to imprecision (children only)

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Section: Moderate Confidence In the Evidencementioning

confidence: 99%

Comprehensive systematic review summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders

et al. 2019

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“…Although preliminary findings suggest that deep brain stimulation of the anterior internal pallidum (aGPi‐DBS) may reduce symptoms of severe and refractory forms of TS, long‐term outcomes have not been fully reported . We prospectively followed 16 TS patients treated with aGPi‐DBS for 48 months . The trial was conducted in 8 academic centers in accordance with the Declaration of Helsinki and Good Clinical Practice guidelines and approved by the local ethics committee (https://clinicaltrials.gov/ct2/show/NCT00478842).…”

Section: Changes In Tic Severity (Ygtss) After Anteromedial Gpi Stimumentioning

confidence: 99%

Long‐term effects of anterior pallidal deep brain stimulation for tourette's syndrome

et al. 2019

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“…However, the optimal target region needs still to be defined . Two structures stand out as the most frequently used DBS targets: the centromedian/parafascicular (CM‐Pf) complex of the intralaminar thalamus and the globus pallidus internus (GPi) . An international prospective, multicenter registry including data from 185 patients has recently reported a robust improvement of TS symptoms, highlighting the therapeutic potential of neuromodulation approaches for medically refractory TS patients .…”

mentioning

confidence: 99%

Pallidal and thalamic neural oscillatory patterns in tourette's syndrome

Neumann

Huebl

Brücke

et al. 2018

Annals of Neurology

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Anterior pallidal deep brain stimulation for Tourette's syndrome: a randomised, double-blind, controlled trial

Cited by 81 publications

References 28 publications

Comprehensive systematic review summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders

Comprehensive systematic review summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders

Long‐term effects of anterior pallidal deep brain stimulation for tourette's syndrome

Pallidal and thalamic neural oscillatory patterns in tourette's syndrome

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