NEW YORK (Reuters Health) – Tourette’s syndrome patients had a reduction in tics and other psychological symptoms during a 2-year study of bilateral thalamic deep brain stimulation, investigators report.

Dr. Mary Robertson from University College London, UK, and co-investigators report findings of their prospective cohort study in the October 27 issue of Neurology.

The authors note that roughly 90% of patients with Tourette’s have comorbid disorders, including attention-deficit/hyperactivity disorder, obsessive-compulsive disorder, depression, anxiety, self-injurious behaviors, and nonobscene socially inappropriate behaviors. Few studies of deep brain stimulation in these patients have used standardized instruments to evaluate post-treatment changes in the “psychobehavioral spectrum.”

The study cohort included 12 men and 3 women, ages 17 to 46 years, with intractable Tourette’s syndrome and obsessive compulsive disorder whose symptoms were monitored before and for 2 years after implantation of electrodes.

Neuropsychiatric measures showed significant improvement in tics (change in mean Yale Global Tic Severity Scale 76.5 to 36.6, p = 0.001) and in Yale-Brown Obsessive Compulsive Scale (20.9 to 14.4, p = 0.009).

Significant improvements were also documented for depression and anxiety. Fourteen patients had significantly improved subjective perception of social impairment.

Neuropsychological testing revealed significant improvement in attention skills according to Trail Making Test scores. Other tests indicated no decline in cognitive function.

No serious neuropsychiatric adverse effects were noted.

Dr. Robertson’s team suggests that “formal neuropsychiatric and neuropsychological assessments be undertaken in deep brain stimulation protocols and in centers in which there are the appropriate disciplines for the assessment and treatment of patients with Tourette’s syndrome.”

Reference:
Neurology 2009;73:1375-1380.