European clinical guidelines for Tourette syndrome and other tic disorders-version 2.0. Part IV: deep brain stimulation

N. Szejko*, Y. Worbe, A. Hartmann, V. Visser-Vandewalle, L. Ackermans, C. Ganos, M. Porta, A.F.G. Leentjens, J.H. Mehrkens, D. Huys, J.C. Baldermann, J. Kuhn, C. Karachi, C. Delorme, T. Foltynie, A.E. Cavanna, D. Cath, K. Muller-Vahl

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

5 Citations (Web of Science)

Abstract

In 2011 the European Society for the Study of Tourette Syndrome (ESSTS) published its first European clinical guidelines for the treatment of Tourette Syndrome (TS) with part IV on deep brain stimulation (DBS). Here, we present a revised version of these guidelines with updated recommendations based on the current literature covering the last decade as well as a survey among ESSTS experts. Currently, data from the International Tourette DBS Registry and Database, two meta-analyses, and eight randomized controlled trials (RCTs) are available. Interpretation of outcomes is limited by small sample sizes and short follow-up periods. Compared to open uncontrolled case studies, RCTs report less favorable outcomes with conflicting results. This could be related to several different aspects including methodological issues, but also substantial placebo effects. These guidelines, therefore, not only present currently available data from open and controlled studies, but also include expert knowledge. Although the overall database has increased in size since 2011, definite conclusions regarding the efficacy and tolerability of DBS in TS are still open to debate. Therefore, we continue to consider DBS for TS as an experimental treatment that should be used only in carefully selected, severely affected and otherwise treatment-resistant patients.
Original languageEnglish
Pages (from-to)443-461
Number of pages19
JournalEuropean Child & Adolescent Psychiatry
Volume31
Issue number3
Early online date4 Oct 2021
DOIs
Publication statusPublished - Mar 2022

Keywords

  • Tics
  • Tourette syndrome
  • Deep brain stimulation
  • Treatment
  • Guidelines
  • European Society for the Study of Tourette Syndrome (ESSTS)
  • GLOBUS-PALLIDUS INTERNUS
  • QUALITY-OF-LIFE
  • TERM-FOLLOW-UP
  • LONG-TERM
  • DOUBLE-BLIND
  • THALAMIC-STIMULATION
  • PATIENT SELECTION
  • NUCLEUS-ACCUMBENS
  • ASSESSMENT RECOMMENDATIONS
  • TRIAL

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