SHORT REPORT

Tourette’s syndrome and deep brain stimulation

J L Houeto¹, C Karachi¹, L Mallet³, B Pillon², J Yelnik¹, V Mesnage¹, M L Welter¹, S Navarro⁶, A Pelissolo³, P Damier⁷, B Pidoux⁴, D Dormont⁵, P Cornu⁶ and Y Agid¹

¹ Centre d’Investigation Clinique, INSERM U289, IFR 70, Hôpital de la Salpêtrière, Paris, France
² INSERM EPI 007, Hôpital de la Salpêtrière
³ CNRS UMR7593, Hôpital de la Salpêtrière
⁴ Fédération de Neurophysiologie Clinique, Hôpital de la Salpêtrière
⁵ Service de Neuroradiologie, Hôpital de la Salpêtrière
⁶ Service de Neurochirurgie, Hôpital de la Salpêtrière
⁷ Service de Neurologie, Hôpital Laennec, Nantes, France

Correspondence to:
Correspondence to:
Dr Y Agid
Centre d’Investigation Clinique, Hôpital de la Salpêtrière, 47 boulevard de l’Hôpital, 75013 Paris, France; agid{at}ccr.jussieu.fr

In this prospective double blind randomised "N of 1" study, a patient with a severe form of Tourette’s syndrome was treated with bilateral high frequency stimulation of the centromedian-parafascicular complex (Ce-Pf) of the thalamus, the internal part of the globus pallidus (GPi), or both. Stimulation of either target improved tic severity by 70%, markedly ameliorated coprolalia, and eliminated self injuries. Severe forms of Tourette’s syndrome may benefit from stimulation of neuronal circuits within the basal ganglia, thus confirming the role of the dysfunction of limbic striato-pallido-thalamo-cortical systems in this disorder.

Abbreviations: DBS, deep brain stimulation; GPi, internal part of the globus pallidus; RVBTS, Rush video based tic scale; YGTSS, Yale global tic severity scale

Keywords: Tourette’s syndrome; deep brain stimulation

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