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Deep brain stimulation eases tics in Tourette's syndrome

October 26, 2009 |  2:59 pm

Deep brain stimulation, already used for treating Parkinson's disease, essential tremor and dystonia, can ease the tics and other symptoms associated with Tourette's syndrome, British researchers reported today in the journal Neurology. Tourette's is a congenital neuropsychiatric disease affecting an estimated 1% of the population. It is characterized by physical tics, such as eye blinking, shoulder shrugging and head-and-shoulder jerking. It is also marked by vocal outbursts, many of which are obscene, providing great embarrassment. Sufferers often also have obsessive-compulsive disorder, depression, anxiety or attention deficit hyperactivity disorder. There is no cure for Tourette's and no medication that works in all patients.

Deep brain stimulation involves embedding electrodes deep in the brain--often called a brain pacemaker--and applying a minute electrical current to specific areas of the brain, depending on the condition being treated. Its underlying mechanisms are still not fully understood.

Isolated case reports have suggested that the technique might be useful in Tourette's, so Dr. Andrea Cavanna of the University of Birmingham and her colleagues decided to perform a formal study. They treated 18 patients, with an average age of 30, who also had obsessive-compulsive disorder and who did not respond to other forms of therapy.

Three of the patients were lost to follow-up. But the other 15, who were followed for two years, had an average of 52% fewer tics and a 26% to 33% improvement in the symptoms of OCD, depression and anxiety. The treatment did not interfere with their cognitive abilities. "Our findings hold promise for helping people with severe Tourette syndrome, who are in need of new treatment options to improve their quality of life," Cavanna said.

The study was funded by the Italian Tourette Syndrome Assn., the National Hospital Research and Development Fund and Tourettes Action-UK.

-- Thomas H. Maugh II

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