Kevin J. Black non-breaking space?  over 7 years ago

Commit id: 6a815b9d65cad60f83568bb5d34292cfd3a0c7e3

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The Milan, Italy, center provided a progress report on their large sample of TS patients treated with DBS, mostly in the ventromedial thalamus \cite{26348012}. In 11 of 48 patients (23%), the device was removed after "inflammatory complications" or poor compliance with follow-up. In the remaining 37 patients, 29 had a more than 50% reduction in YGTSS scores (clinician-rated tic severity and impairment). In a separate publication, they argued that the patient's symptoms beyond tics should be considered when a DBS target is selected \cite{26739445}. Hartmann argued contrariwise that our current state of knowledge better supports a narrower focus on tic reduction in choosing a DBS target \cite{hartmann:2016:opinion}.   The TS group from Maastricht, The Netherlands, reported positive unblinded follow-up results in 5 patients with refractory TS treated with DBS in the anterior globus pallidus pars interna (GPi) \cite{26811866}, and a Chinese group reported unblinded 1-year follow-up of GPi DBS in 24 patients with TS, with improvement, on average, in both tics and OCD symptoms (50% reduction in mean YGTSS total tic score and 27% reduction in mean Y-BOCS score) \cite{27098785}. Interestingly, this latter report includes one patient whose tics continued improved after the DBS electrode was removed, consistent either with spontaneous improvement over time or with a micropallidotomy lesion effect (p.~1025). (p. 1025).  Given the current lack of consensus on DBS methods in TS, gathering data on all DBS patient outcomes in TS is crucial, and a recent collaborative report described the establishment of the International Deep Brain Stimulation Registry and Database for Gilles de la Tourette syndrome \cite{27199634}.