Ten years ago deep brain stimulation (DBS) has been introduced as an alternative and promising treatment option for patients suffering from severe Tourette syndrome (TS). It seemed timely to develop a European guideline on DBS by a working group of the European Society for the Study of Tourette Syndrome (ESSTS). For a narrative review a systematic literature search was conducted and expert opinions of the guidelines group contributed also to the suggestions. Of 63 patients reported so far in the literature 59 had a beneficial outcome following DBS with moderate to marked tic improvement. However, randomized controlled studies including a larger number of patients are still lacking. Although persistent serious adverse effects (AEs) have hardly been reported, surgery-related (e.g., bleeding, infection) as well as stimulation-related AEs (e.g., sedation, anxiety, altered mood, changes in sexual function) may occur. At present time, DBS in TS is still in its infancy. Due to both different legality and practical facilities in different European countries these guidelines, therefore, have to be understood as recommendations of experts. However, among the ESSTS working group on DBS in TS there is general agreement that, at present time, DBS should only be used in adult, treatment resistant, and severely affected patients. It is highly recommended to perform DBS in the context of controlled trials.
European clinical guidelines for Tourette syndrome and other tic disorders. Part IV: deep brain stimulation / Muller Vahl, K. r.; Danielle C., Cath; Andrea E., Cavanna; Sandra, Dehning; Mauro, Porta; Mary M., Robertson; Veerle Visser, Vandewalle; C., Essts Guidelines Group Androutsos; H., Aschauer; G., Baird; N., Bos Veneman; A., Brambilla; Cardona, Francesco Carmelo Giovanni; D. c., Cath; A. e., Cavanna; V., Czernecki; S., Dehning; A., Eapter; L., Farkas; J., Gadaros; A., Hartmann; E., Hauser; I., Heyman; T., Hedderly; P. j., Hoekstra; A., Korsgaard; G. m., Jackson; L., Larsson; A. g., Ludolph; D., Martino; C., Menghetti; N., Mol Debes; N., Muller; K., Muller Vahl; A., Munchau; T., Murphy; R., Musil; P., Nagy; J., Nurnberger; B., Oostra; P., Paschou; M., Pasquini; K. j., Plessen; M., Porta; H., Rickards; R., Rizzo; M. m., Robertson; V., Roessner; A., Rothenberger; D., Servello; L., Skov; J. s., Stern; G., Strand; Z., Tarnok; C., Termine; J., Van Der Griendt; C., Verdellen; V., Visser Vandewalle; E., Wannag; T., Wolanczyck. - In: EUROPEAN CHILD & ADOLESCENT PSYCHIATRY. - ISSN 1018-8827. - ELETTRONICO. - 20:4(2011), pp. 209-217. [10.1007/s00787-011-0166-4]
European clinical guidelines for Tourette syndrome and other tic disorders. Part IV: deep brain stimulation
K. r. Muller Vahl;CARDONA, Francesco Carmelo Giovanni;
2011
Abstract
Ten years ago deep brain stimulation (DBS) has been introduced as an alternative and promising treatment option for patients suffering from severe Tourette syndrome (TS). It seemed timely to develop a European guideline on DBS by a working group of the European Society for the Study of Tourette Syndrome (ESSTS). For a narrative review a systematic literature search was conducted and expert opinions of the guidelines group contributed also to the suggestions. Of 63 patients reported so far in the literature 59 had a beneficial outcome following DBS with moderate to marked tic improvement. However, randomized controlled studies including a larger number of patients are still lacking. Although persistent serious adverse effects (AEs) have hardly been reported, surgery-related (e.g., bleeding, infection) as well as stimulation-related AEs (e.g., sedation, anxiety, altered mood, changes in sexual function) may occur. At present time, DBS in TS is still in its infancy. Due to both different legality and practical facilities in different European countries these guidelines, therefore, have to be understood as recommendations of experts. However, among the ESSTS working group on DBS in TS there is general agreement that, at present time, DBS should only be used in adult, treatment resistant, and severely affected patients. It is highly recommended to perform DBS in the context of controlled trials.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
