Tourette syndrome (TS) bears a higher rate of inflammatory complications at the implanted hardware in deep brain stimulation (DBS)

• Published in: Acta neurochirurgica 2011-03, Vol.153 (3), p.629-632
• Main Authors: Servello, Domenico, Sassi, Marco, Gaeta, Maddalena, Ricci, Cristian, Porta, Mauro
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Brain Mapping; Clinical Article; Deep Brain Stimulation - instrumentation; Device Removal; Disability Evaluation; Dominance, Cerebral - physiology; Electrodes, Implanted - adverse effects; Equipment Failure; Female; Foreign-Body Reaction - etiology; Globus Pallidus - physiopathology; Humans; Interventional Radiology; Intralaminar Thalamic Nuclei - physiopathology; Magnetic Resonance Imaging; Male; Medicine; Medicine & Public Health; Middle Aged; Minimally Invasive Surgery; Neurology; Neuroradiology; Neurosurgery; Nucleus Accumbens - physiopathology; Outcome and Process Assessment (Health Care); Quality of Life; Social Behavior; Surgical Orthopedics; Tomography, X-Ray Computed; Tourette Syndrome - diagnosis; Tourette Syndrome - physiopathology; Tourette Syndrome - therapy; Young Adult
• ISSN: 0001-6268; 0942-0940
• DOI: 10.1007/s00701-010-0851-y

Background Deep brain stimulation (DBS) is a commonly performed surgical technique for the treatment of movement disorders, and recent surgical trials concerning the treatment of a wider range of disorders have recently been published. Despite DBS being non-ablative and minimally invasive, numerous complications and side effects have been recorded. In particular, concerning the growing interest in novel indications for DBS, an enthusiastic approach has put neurosurgeons at risk of underestimating some of the complications that might be associated with specific characters of the treated disease. Objective Our objective was to evaluate hardware failures and rates of infective complications in correlation to the different indications to DBS, in order to ascertain whether DBS in Tourette syndrome (TS) is characterized by specific risks and pitfalls. Methods We retrospectively reviewed our experience of 531 procedures on 272 patients treated for various movement disorders, among which 39 patients were treated for conservative treatmentrefractory TS. Results A statistically significant association of infective complications was found with the TS subgroup. Conclusions It is our belief that specific behavioral characters of the TS patients may be put into association with this specific complication and need to be considered carefully when indicating DBS as treatment of choice for these patients.