An experimental technique reduces the tics, or involuntary movements and vocal outbursts, associated with severe Tourette's syndrome in young adults, a study published Friday found.
The surgical technique, called thalamic deep brain stimulation (DBS), sends electrical impulses to a specific area of the brain that reduces the tics, according to the study published in the Journal of Neurosurgery. The finding adds to the growing body of evidence about the safety and effectiveness of deep brain stimulation, which might eventually lead the Food and Drug Administration to approve the treatment for Tourette's syndrome, according to the researchers.
“Our study shows that deep brain stimulation is a safe, effective treatment for young adults with severe Tourette syndrome that cannot be managed with current therapies,” said Alon Mogilner, an associate professor in the departments of neurosurgery and anesthesiology at New York University Langone and director of its Center for Neuromodulation, in a news release. “This treatment has the potential to improve the quality of life for patients who are debilitated through their teenage years and young adulthood.”
Tourette's syndrome, a type of neurological disorder, according to various studies afflicts from 0.3 to 0.6 percent of children in the United States, with around 138,000 ages 6 to 17 being diagnosed with the condition. The causes for the syndrome are not well known and are thought to be largely genetic, with unidentified environmental factors increasing the likelihood of the condition. Usually the syndrome begins in childhood and the condition improves with age for some people, but for others the symptoms become more severe to the point that people become socially isolated and unable to work or attend school.
Researchers from the New York University Langone Medical Center followed 13 patients, ages 16 to 33, with at least six months of follow-up visits. Researchers measured the severity of the tics before and after the surgery. Patients with severe Tourette's syndrome who underwent DBS initially showed an average decrease of 37 percent in their total tic severity, the study found.
The surgery is a multistage procedure in which two electrodes are initially inserted into a region of the brain that seems to function abnormally in people with Tourette's syndrome. During the second surgery, usually performed the following day or a few days later, a device like a pacemaker, called a neurostimulator, is connected to the electrodes so electrical impulses can be emitted in the medial thalamus. Adjustments are made to the electrical impulses during follow-up visits to find the best combination of settings that control the symptoms.
“I think we are really still in the area of the basic circuitry because with diseases like Parkinson’s, you can create models in animals to study the disease, but Tourette’s is a uniquely human condition,” Mogilner said in an interview.
Future research would likely involve looking into new types of imaging techniques to better understand how Tourette syndrome affects the brain and to improve effectiveness of treatments, he said.
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