TY - JOUR
T1 - Deep brain stimulation lead removal in Tourette syndrome
AU - Deeb, Wissam
AU - Leentjens, Albert F. G.
AU - Mogilner, Alon Y.
AU - Servello, Domenico
AU - Meng, Fangang
AU - Zhang, Jianguo
AU - Galbiati, Tommaso Francesco
AU - Okun, Michael S.
N1 - Funding Information:
Fangang Meng reports receiving the following supports: National Natural Science Foundation of China ( 81971070 ), Beijing Natural Science Foundation Program and Scientific Research Key Program of Beijing Municipal Commission of Education ( KZ201910025036 ).
Funding Information:
Wissam Deeb received research funding from the American Brain Foundation and Tourette Association of America , royalties from Rose Publishing, Inc., and consultation fee from Medtronic.
Funding Information:
This study has been supported by a grant from the Tourette Association of America.Wissam Deeb received research funding from the American Brain Foundation and Tourette Association of America, royalties from Rose Publishing, Inc., and consultation fee from Medtronic.Albert F.G. Leentjens received research funding from the Michael J Fox Foundation and royalties from Springer media.Fangang Meng reports receiving the following supports: National Natural Science Foundation of China (81971070), Beijing Natural Science Foundation Program and Scientific Research Key Program of Beijing Municipal Commission of Education (KZ201910025036).Jianguo Zhang reports receiving funds from the National Natural Science Foundation of China.Michael S. Okun serves as a consultant for the Parkinson's Foundation, and has received research grants from NIH, Parkinson's Foundation, the Michael J. Fox Foundation, the Parkinson Alliance, Smallwood Foundation, the Bachmann-Strauss Foundation, the Tourette Syndrome Association, and the UF Foundation. Dr. Okun's DBS research is supported by: R01 NR014852 and R01NS096008. Dr. Okun has received royalties for publications with Demos, Manson, Amazon, Smashwords, Books4Patients, Perseus, Robert Rose, Oxford Public Affairs and Cambridge (movement disorders books). Dr. Okun is an associate editor for New England Journal of Medicine Journal Watch Neurology. Dr. Okun has participated in CME and educational activities on movement disorders sponsored by the Academy for Healthcare Learning, PeerView, Prime, QuantiaMD, WebMD/Medscape, Medicus, MedNet, Einstein, MedNet, Henry Stewart, American Academy of Neurology, Movement Disorders Society and by Vanderbilt University. The institution and not Dr. Okun receives grants from Medtronic, Abbvie, Abbott and Allergan and the PI has no financial interest in these grants. Dr. Okun has participated as a site PI and/or co-I for several NIH, foundation, and industry sponsored trials over the years but has not received honoraria. Research projects at the University of Florida receive device and drug donations.
Funding Information:
WD and MSO received grant support from the Tourette Association of America.
Funding Information:
Michael S. Okun serves as a consultant for the Parkinson's Foundation, and has received research grants from NIH, Parkinson's Foundation, the Michael J. Fox Foundation, the Parkinson Alliance, Smallwood Foundation, the Bachmann-Strauss Foundation, the Tourette Syndrome Association , and the UF Foundation . Dr. Okun's DBS research is supported by: R01 NR014852 and R01NS096008 . Dr. Okun has received royalties for publications with Demos, Manson, Amazon, Smashwords, Books4Patients, Perseus, Robert Rose, Oxford Public Affairs and Cambridge (movement disorders books). Dr. Okun is an associate editor for New England Journal of Medicine Journal Watch Neurology. Dr. Okun has participated in CME and educational activities on movement disorders sponsored by the Academy for Healthcare Learning, PeerView, Prime, QuantiaMD, WebMD/Medscape, Medicus, MedNet, Einstein, MedNet, Henry Stewart, American Academy of Neurology, Movement Disorders Society and by Vanderbilt University. The institution and not Dr. Okun receives grants from Medtronic, Abbvie, Abbott and Allergan and the PI has no financial interest in these grants. Dr. Okun has participated as a site PI and/or co-I for several NIH, foundation, and industry sponsored trials over the years but has not received honoraria. Research projects at the University of Florida receive device and drug donations.
Funding Information:
Albert F.G. Leentjens received research funding from the Michael J Fox Foundation and royalties from Springer media.
Funding Information:
Jianguo Zhang reports receiving funds from the National Natural Science Foundation of China .
Publisher Copyright:
© 2020 Elsevier Ltd
PY - 2020/8
Y1 - 2020/8
N2 - Introduction: Tourette syndrome (TS) is a complex neuropsychiatric disorder. A small percentage of individuals with TS can experience persistent severe, refractory, and impairing tics. Deep brain stimulation (DBS) has been increasingly used for symptom management, especially in these settings. In this article, we aim to evaluate the rate and the reasons for removal of DBS hardware in TS patients.Methods: Data was analyzed from patients enrolled in the Tourette Association of America's International Tourette Syndrome Registry and Database.Results: Fifteen of 269 (5.6%) patients required removal of their DBS systems. The mean age at explantation was 33.8 years. In these cases we observed a rate of 1.9 explantations per year of follow up from implantation. None of the removals took place in the immediate post-operative period. Infection was the most common cause (46.7%). Only one patient received explantation for tic resolution. There were no significant associations between explantation and the presence of specific psychiatric comorbidities, including OCD, depression, anxiety, or ADHD.Discussion: The rate of removal of 5.6% was lower than the previously reported rate in the TS DBS literature. Infections accounted for nearly half of the TS DBS explantations in this cohort. There was no relationship to psychiatric comorbidities.
AB - Introduction: Tourette syndrome (TS) is a complex neuropsychiatric disorder. A small percentage of individuals with TS can experience persistent severe, refractory, and impairing tics. Deep brain stimulation (DBS) has been increasingly used for symptom management, especially in these settings. In this article, we aim to evaluate the rate and the reasons for removal of DBS hardware in TS patients.Methods: Data was analyzed from patients enrolled in the Tourette Association of America's International Tourette Syndrome Registry and Database.Results: Fifteen of 269 (5.6%) patients required removal of their DBS systems. The mean age at explantation was 33.8 years. In these cases we observed a rate of 1.9 explantations per year of follow up from implantation. None of the removals took place in the immediate post-operative period. Infection was the most common cause (46.7%). Only one patient received explantation for tic resolution. There were no significant associations between explantation and the presence of specific psychiatric comorbidities, including OCD, depression, anxiety, or ADHD.Discussion: The rate of removal of 5.6% was lower than the previously reported rate in the TS DBS literature. Infections accounted for nearly half of the TS DBS explantations in this cohort. There was no relationship to psychiatric comorbidities.
KW - Deep brain stimulation
KW - Tourette syndrome
KW - Complications
U2 - 10.1016/j.parkreldis.2020.06.025
DO - 10.1016/j.parkreldis.2020.06.025
M3 - Article
C2 - 32712563
SN - 1353-8020
VL - 77
SP - 89
EP - 93
JO - Parkinsonism & Related Disorders
JF - Parkinsonism & Related Disorders
ER -