Deep Brain Stimulation Treatment for Tourettes

published on 04 January 2021
Screen shot 2021 01 04 at 2.17.13 pm

For decades, doctors have been consistently trying to cure Tourettes - they have found many medications and therapy, however, these are only used to lessen the effect of the syndrome. In today's day and age, technology has advanced and various techniques are used to completely cure Tourettes, one of these include Deep Brain Stimulation. Deep Brain Stimulation, also known as DBS, is a relatively new procedure that utilises an implantable electrode to alter the activity of the brain circuitry. The procedure is also used for Parkinson’s disease, essential tremor, dystonia and OCD.  In this procedure, there are two electrons feeding new impulses into the brain from devices implanted in his chest. Tourettes is believed to be caused by a misfiring of the brain signal. Dr Alon Mogilner from North Shore university hospital says, “The electrode provides continuous electrical stimulation to that part of the brain to hopefully correct the abnormal activity. DBS can be exceptionally challenging as you have to choose the right target in the brain to make the procedure successful.’

BDS has the potential to neuromodulate abnormal communication that occurs deep within the brains of people with Tourettes Syndrome. So far researchers have probed into several areas in the brain of people with Tourettes syndrome (the centromedian thalamus, the internal globus pallidus ect..) and have had mixed success. The best target for neuromodulation is yet to be found however it appears that DBS has positive results in patients. 

University Hospital in North America was the first hospital in the world to perform Deep Brain Stimulation on a patient. The patient, Adam, says he used to get alot of motor skill tics so it used to get hard to walk and function sometimes as his arms start to lock up. He also gets alot of neck tics which causes a lot of neck pain sometimes. During his surgery, neurosurgeons implanted electrodes to block faulty signals that cause tics or tremors. This procedure completely cured his tourettes and now many patients are beginning to believe in its effects. 

Authors of a research report done on DBS have reported that DBS significantly decreased motor tics in 18 patients but the therapy was less effective for phonic tics. Furthermore, there are short and long term ‘potential’ complications with the process. The DBS device is a forgein body in the brain and under the skin so infection is a primary worry, and it can occur in 5% or more of implanted patients. One of the biggest worries is that during the placement of the DBS electrodes there will be bleeding or alternatively a stroke that may lead to weakness, numbness, changes in vision, and changes in speech. 

What is needed for DBS to move forward as a viable therapy for severe TS are carefully controlled studies. These studies should be undertaken by experienced multidisciplinary teams and should be guided by experts in performing clinical trials. Despite the positive results of some Tourette's patients, we must learn the lessons which have resulted in the DBS failure in other disorders and make serious early attempts to avoid them in TS. 

Written by Sarah Ali

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