New Brain Stimulation Target Identified for Tourette’s Syndrome
Reported by new study in Biological Psychiatry
Reported by new study in Biological Psychiatry
Gilles de la Tourette syndrome, often just called Tourette’s, is best known for the vocal and motor tics that are the most common symptoms of the disorder. Usually, these symptoms respond to a growing array of medications. However, some patients experience severe tics that do not respond to medications and may be disabling or even life-threatening. In these rare cases, deep brain stimulation may provide relief.
Deep brain stimulation is a neurosurgical technique that involves implanting a neurostimulator into the brain to deliver electrical signals. It is most commonly used to treat symptoms of Parkinson’s disease and other movement disorders. It was first used an experimental treatment for severe Tourette’s in 1999 and has since shown therapeutic promise, but the optimal neural targets have remained unclear.
For this study, researchers at the University of Cologne conducted an open-label trial to treat eight patients with severe Tourette syndrome for whom medication was not beneficial.
Over a one year period, deep brain stimulation targeted at the thalamus significantly improved patients’ Tourette-related symptoms, quality of life, and overall functioning. It was also generally well-tolerated. The thalamus is a complex structure deep in the brain that relays sensory and motor signals and is part of the brain network responsible for motor control.
“Tourette syndrome is most commonly associated with the basal ganglia, but the thalamus receives the output from the basal ganglia. It appears that stimulating the thalamus may be helpful when medications have failed,” commented Dr. John Krystal, Editor of Biological Psychiatry. “This study suggests that when the basal ganglia are dysfunctional, that one may intervene by altering the activity of a target of the basal ganglia output, such as the thalamus.”
Although more research is still necessary, these findings suggest that, despite the risks, thalamic deep brain stimulation may be beneficial for patients with severe Tourette’s.
The article is “Motor Improvement and Emotional Stabilization in Patients with Tourette Syndrome After Deep Brain Stimulation of the Ventral Anterior and Ventrolateral Motor Part of the Thalamus” by Daniel Huys, Christina Bartsch, Philip Koester, Doris Lenartz, Mohammad Maarouf, Jörg Daumann, Jürgen K. Mai, Joachim Klosterkötter, Stefan Hunsche, Veerle Visser-Vandewalle, Christiane Woopen, Lars Timmermann, Volker Sturm, and Jens Kuhn (doi: 10.1016/j.biopsych.2014.05.014). The article appears in Biological Psychiatry, Volume 79, Issue 5 (March 1, 2016), published by Elsevier.
Notes for editors
Full text of the article is available to credentialed journalists upon request; contact Rhiannon Bugno at +1 214 648 0880 or Biol.Psych@utsouthwestern.edu. Journalists wishing to interview the authors may contact Dr. Daniel Huys at Daniel.Huys@uk-koeln.de.
The authors’ affiliations, and disclosures of financial and conflicts of interests are available in the article.
John H. Krystal, M.D., is Chairman of the Department of Psychiatry at the Yale University School of Medicine, Chief of Psychiatry at Yale-New Haven Hospital, and a research psychiatrist at the VA Connecticut Healthcare System. His disclosures of financial and conflicts of interests are available here.
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Biological Psychiatry is the official journal of the Society of Biological Psychiatry, whose purpose is to promote excellence in scientific research and education in fields that investigate the nature, causes, mechanisms and treatments of disorders of thought, emotion, or behavior. In accord with this mission, this peer-reviewed, rapid-publication, international journal publishes both basic and clinical contributions from all disciplines and research areas relevant to the pathophysiology and treatment of major psychiatric disorders.
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