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Martinez-Ramirez D, Jimenez-Shahed J, Leckman JF, Porta M, Servello D, Meng FG, Kuhn J, Huys D, Baldermann JC, Foltynie T, Hariz MI, Joyce EM, Zrinzo L, Kefalopoulou Z, Silburn P, Coyne T, Mogilner AY, Pourfar MH, Khandhar SM, Auyeung M, Ostrem JL, Visser-Vandewalle V, Welter ML, Mallet L, Karachi C, Houeto JL, Klassen BT, Ackermans L, Kaido T, Temel Y, Gross RE, Walker HC, Lozano AM, Walter BL, Mari Z, Anderson WS, Changizi BK, Moro E, Zauber SE, Schrock LE, Zhang JG, Hu W, Rizer K, Monari EH, Foote KD, Malaty IA, Deeb W, Gunduz A, Okun MS. Efficacy and Safety of Deep Brain Stimulation in Tourette Syndrome: The International Tourette Syndrome Deep Brain Stimulation Public Database and Registry. JAMA Neurol 2019; 75:353-359. [PMID: 29340590 DOI: 10.1001/jamaneurol.2017.4317] [Citation(s) in RCA: 137] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Importance Collective evidence has strongly suggested that deep brain stimulation (DBS) is a promising therapy for Tourette syndrome. Objective To assess the efficacy and safety of DBS in a multinational cohort of patients with Tourette syndrome. Design, Setting, and Participants The prospective International Deep Brain Stimulation Database and Registry included 185 patients with medically refractory Tourette syndrome who underwent DBS implantation from January 1, 2012, to December 31, 2016, at 31 institutions in 10 countries worldwide. Exposures Patients with medically refractory symptoms received DBS implantation in the centromedian thalamic region (93 of 163 [57.1%]), the anterior globus pallidus internus (41 of 163 [25.2%]), the posterior globus pallidus internus (25 of 163 [15.3%]), and the anterior limb of the internal capsule (4 of 163 [2.5%]). Main Outcomes and Measures Scores on the Yale Global Tic Severity Scale and adverse events. Results The International Deep Brain Stimulation Database and Registry enrolled 185 patients (of 171 with available data, 37 females and 134 males; mean [SD] age at surgery, 29.1 [10.8] years [range, 13-58 years]). Symptoms of obsessive-compulsive disorder were present in 97 of 151 patients (64.2%) and 32 of 148 (21.6%) had a history of self-injurious behavior. The mean (SD) total Yale Global Tic Severity Scale score improved from 75.01 (18.36) at baseline to 41.19 (20.00) at 1 year after DBS implantation (P < .001). The mean (SD) motor tic subscore improved from 21.00 (3.72) at baseline to 12.91 (5.78) after 1 year (P < .001), and the mean (SD) phonic tic subscore improved from 16.82 (6.56) at baseline to 9.63 (6.99) at 1 year (P < .001). The overall adverse event rate was 35.4% (56 of 158 patients), with intracranial hemorrhage occurring in 2 patients (1.3%), infection in 4 patients with 5 events (3.2%), and lead explantation in 1 patient (0.6%). The most common stimulation-induced adverse effects were dysarthria (10 [6.3%]) and paresthesia (13 [8.2%]). Conclusions and Relevance Deep brain stimulation was associated with symptomatic improvement in patients with Tourette syndrome but also with important adverse events. A publicly available website on outcomes of DBS in patients with Tourette syndrome has been provided.
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Affiliation(s)
- Daniel Martinez-Ramirez
- Center for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville
| | - Joohi Jimenez-Shahed
- Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Houston, Texas
| | | | - Mauro Porta
- Tourette's Syndrome and Movement Disorders Center, Galeazzi Hospital, Milan, Italy
| | | | - Fan-Gang Meng
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Jens Kuhn
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany.,Department of Psychiatry, Psychotherapy, and Psychosomatic Medicine, Johanniter Hospital Oberhausen, Oberhausen, Germany
| | - Daniel Huys
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | | | - Thomas Foltynie
- Sobell Department of Motor Neuroscience, University College London Institute of Neurology, London, United Kingdom
| | - Marwan I Hariz
- Sobell Department of Motor Neuroscience, University College London Institute of Neurology, London, United Kingdom.,Department of Clinical Neuroscience, Umeå University, Umeå, Sweden
| | - Eileen M Joyce
- Sobell Department of Motor Neuroscience, University College London Institute of Neurology, London, United Kingdom
| | - Ludvic Zrinzo
- Sobell Department of Motor Neuroscience, University College London Institute of Neurology, London, United Kingdom
| | - Zinovia Kefalopoulou
- Sobell Department of Motor Neuroscience, University College London Institute of Neurology, London, United Kingdom
| | - Peter Silburn
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Terry Coyne
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Alon Y Mogilner
- Department of Neurosurgery, Center for Neuromodulation, New York University Langone Medical Center, New York
| | - Michael H Pourfar
- Department of Neurosurgery, Center for Neuromodulation, New York University Langone Medical Center, New York
| | - Suketu M Khandhar
- Department of Neurology, The Permanente Medical Group (Kaiser Permanente Northern California), Comprehensive Movement Disorders Program, Sacramento, California
| | - Man Auyeung
- Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong, SAR China
| | | | - Veerle Visser-Vandewalle
- Department of Stereotaxy and Functional Neurosurgery, University Hospital Cologne, Cologne, Germany
| | - Marie-Laure Welter
- The French National Institute of Health and Medical Research U 1127, The National Center for Scientific Research 7225, Sorbonne Universités, University of Pierre and Marie Curie University of Paris 06 UMR S 1127, Institut du Cerveau et de la Moëlle Epinière, The Brain and Spinal Cord Institute, Paris, France
| | - Luc Mallet
- Assistance Publique-Hôpitaux de Paris, Personalised Neurology and Psychiatry University Department, Hôpitaux Universitaires Henri Mondor-Albert Chenevier, Université Paris-Est Créteil, Créteil, France.,Sorbonne Universités, University of Pierre and Marie Curie University of Paris 06, CNRS, INSERM, Institut du Cerveau et de la Moëlle épinière, Paris, France.,Department of Mental Health and Psychiatry, Global Health Institute, University of Geneva, Geneva, Switzerland
| | - Carine Karachi
- Institut du Cerveau et de la Moëlle Epinière, The French National Institute of Health and Medical Research U 1127, The National Center for Scientific Research 7225, Sorbonne Universités, University of Paris 06, UMR S 1127 Paris, France; Department of Neurosurgery, Pitié-Salpêtrière Hospital, Paris, France
| | - Jean Luc Houeto
- Service de Neurologie, Centers for Clinical Investigation 1402, Centre Hospitalier Universitaire de Poitiers, Poitiers, France.,Université de Poitiers, Poitiers, France
| | | | - Linda Ackermans
- Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Takanobu Kaido
- Department of Neurosurgery, National Hospital Organization Nara Medical Center, Nara, Japan.,Anatomy and Physiology Laboratory, Department of Health and Nutrition, Osaka Shoin Women's University, Osaka, Japan
| | - Yasin Temel
- Maastricht University Medical Center, Maastricht, the Netherlands; MHeNs, Experimental Neurosurgery, Maastricht University, Maastricht, the Netherlands
| | | | - Harrison C Walker
- Division of Movement Disorders, Department of Neurology, University of Alabama at Birmingham.,Department of Biomedical Engineering, University of Alabama at Birmingham
| | - Andres M Lozano
- Toronto Western Hospital, Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada
| | - Benjamin L Walter
- School of Medicine, Case Western Reserve University, Cleveland, Ohio.,US Department of Veterans Affairs, Louis Stokes Cleveland Veterans Affairs Medical Center, Functional Electrical Stimulation Center of Excellence, Rehabilitation R&D Service, Cleveland, Ohio.,Department of Neurology, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Zoltan Mari
- Department of Neurology and Neurosurgery, Johns Hopkins University, Baltimore, Maryland
| | - William S Anderson
- Department of Neurology and Neurosurgery, Johns Hopkins University, Baltimore, Maryland
| | | | - Elena Moro
- Division of Neurology, Centre Hospitalier Universitaire de Grenoble, Grenoble, France.,Grenoble Alpes University, Grenoble, France
| | | | - Lauren E Schrock
- Neuromodulation Research Center, Department of Neurology, University of Minnesota, Minneapolis
| | - Jian-Guo Zhang
- Department of Functional Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wei Hu
- Center for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville
| | - Kyle Rizer
- Center for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville
| | - Erin H Monari
- Center for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville
| | - Kelly D Foote
- Center for Movement Disorders and Neurorestoration, Department of Neurosurgery, University of Florida, Gainesville.,Fixel Center for Neurological Diseases, Gainesville, Florida
| | - Irene A Malaty
- Center for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville
| | - Wissam Deeb
- Center for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville
| | - Aysegul Gunduz
- Brain Map Lab, Center for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville
| | - Michael S Okun
- Center for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville.,Fixel Center for Neurological Diseases, Gainesville, Florida
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Korn RE, Wagle Shukla A, Katz M, Keenan HT, Goldenthal S, Auinger P, Zhu W, Dodge M, Rizer K, Achey MA, Byrd E, Barbano R, Richard I, Andrzejewski KL, Schwarz HB, Dorsey ER, Biglan KM, Kang G, Kanchana S, Rodriguez R, Tanner CM, Galifianakis NB. Virtual visits for Parkinson disease: A multicenter noncontrolled cohort. Neurol Clin Pract 2017; 7:283-295. [PMID: 28840919 DOI: 10.1212/cpj.0000000000000371] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 03/31/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Previous small-scale studies have demonstrated the feasibility of providing remote specialty care via virtual visits. We assessed the feasibility and benefits of a one-time consultation between a remote Parkinson Disease (PD) specialist and an individual with PD at home on a larger scale. METHODS We conducted a multicenter noncontrolled cohort of virtual visits administered over videoconferencing between remote PD specialists and individuals with PD in their home. Specialists performed a patient history and a PD-specific physical examination and provided recommendations to patients and their local physicians. The primary outcome measures were feasibility, as measured by the proportion of visits completed as scheduled, and the 6-month change in quality of life, as measured by the Parkinson's Disease Questionnaire 39. Additional outcomes included satisfaction with visits and interest in future virtual visits. RESULTS A total of 277 participants from 5 states enrolled, 258 participants completed virtual visits with 14 different physicians, and 91% of visits were completed as scheduled. No improvement in quality of life was observed at 6 months (0.4-point improvement; 95% confidence interval -1.5 to 0.6; p = 0.39). Overall satisfaction with virtual visits was high among physicians (94% satisfied or very satisfied) and patients (94% satisfied or very satisfied), and 74% of participants were interested in receiving future care via virtual visits. CONCLUSIONS Providing specialty care remotely into the homes of individuals with PD is feasible, but a one-time visit did not improve quality of life. Satisfaction with the visits was high among physicians and patients, who were interested in receiving such care in the future. CLASSIFICATION OF EVIDENCE This study provides Class IV evidence that for patients with PD, remote specialty care is feasible but does not improve quality of life. CLINICALTRIALSGOV IDENTIFIER NCT02144220.
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Affiliation(s)
- Ryan E Korn
- University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL
| | - Aparna Wagle Shukla
- University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL
| | - Maya Katz
- University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL
| | - H Tait Keenan
- University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL
| | - Steven Goldenthal
- University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL
| | - Peggy Auinger
- University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL
| | - William Zhu
- University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL
| | - Michael Dodge
- University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL
| | - Kyle Rizer
- University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL
| | - Meredith A Achey
- University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL
| | - Erica Byrd
- University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL
| | - Richard Barbano
- University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL
| | - Irene Richard
- University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL
| | - Kelly L Andrzejewski
- University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL
| | - Heidi B Schwarz
- University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL
| | - E Ray Dorsey
- University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL
| | - Kevin M Biglan
- University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL
| | - Gail Kang
- University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL
| | - Sulada Kanchana
- University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL
| | - Ramon Rodriguez
- University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL
| | - Caroline M Tanner
- University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL
| | - Nicholas B Galifianakis
- University of Rochester School of Medicine and Dentistry (REK, HTK); Center for Human Experimental Therapeutics (REK, HTK, SG, PA, WZ, MAA, ERD, KMB) and Department of Neurology (PA, RB, IR, KLA, HBS, ERD, KMB, SK), University of Rochester, NY; Center for Movement Disorders and Neurorestoration (AWS, KR), Department of Neurology, University of Florida, Gainesville; Department of Neurology (MK, MD, EB, CMT, NBG), University of California-San Francisco; Parkinson's Disease Research, Education and Clinical Center (MK, MD, EB, CMT, NBG), San Francisco Veterans Affairs Medical Center, CA; University of Michigan Medical School (WZ), Ann Arbor; Department of Neurology (KLA), University at Buffalo, NY; Neurology Private Practice (GK), Berkeley, CA; and Department of Internal Medicine (RR), University of Central Florida College of Medicine, Orlando, FL
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3
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Frank S, Testa CM, Stamler D, Kayson E, Davis C, Edmondson MC, Kinel S, Leavitt B, Oakes D, O'Neill C, Vaughan C, Goldstein J, Herzog M, Snively V, Whaley J, Wong C, Suter G, Jankovic J, Jimenez-Shahed J, Hunter C, Claassen DO, Roman OC, Sung V, Smith J, Janicki S, Clouse R, Saint-Hilaire M, Hohler A, Turpin D, James RC, Rodriguez R, Rizer K, Anderson KE, Heller H, Carlson A, Criswell S, Racette BA, Revilla FJ, Nucifora F, Margolis RL, Ong M, Mendis T, Mendis N, Singer C, Quesada M, Paulsen JS, Brashers-Krug T, Miller A, Kerr J, Dubinsky RM, Gray C, Factor SA, Sperin E, Molho E, Eglow M, Evans S, Kumar R, Reeves C, Samii A, Chouinard S, Beland M, Scott BL, Hickey PT, Esmail S, Fung WLA, Gibbons C, Qi L, Colcher A, Hackmyer C, McGarry A, Klos K, Gudesblatt M, Fafard L, Graffitti L, Schneider DP, Dhall R, Wojcieszek JM, LaFaver K, Duker A, Neefus E, Wilson-Perez H, Shprecher D, Wall P, Blindauer KA, Wheeler L, Boyd JT, Houston E, Farbman ES, Agarwal P, Eberly SW, Watts A, Tariot PN, Feigin A, Evans S, Beck C, Orme C, Edicola J, Christopher E. Effect of Deutetrabenazine on Chorea Among Patients With Huntington Disease: A Randomized Clinical Trial. JAMA 2016; 316:40-50. [PMID: 27380342 DOI: 10.1001/jama.2016.8655] [Citation(s) in RCA: 132] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
IMPORTANCE Deutetrabenazine is a novel molecule containing deuterium, which attenuates CYP2D6 metabolism and increases active metabolite half-lives and may therefore lead to stable systemic exposure while preserving key pharmacological activity. OBJECTIVE To evaluate efficacy and safety of deutetrabenazine treatment to control chorea associated with Huntington disease. DESIGN, SETTING, AND PARTICIPANTS Ninety ambulatory adults diagnosed with manifest Huntington disease and a baseline total maximal chorea score of 8 or higher (range, 0-28; lower score indicates less chorea) were enrolled from August 2013 to August 2014 and randomized to receive deutetrabenazine (n = 45) or placebo (n = 45) in a double-blind fashion at 34 Huntington Study Group sites. INTERVENTIONS Deutetrabenazine or placebo was titrated to optimal dose level over 8 weeks and maintained for 4 weeks, followed by a 1-week washout. MAIN OUTCOMES AND MEASURES Primary end point was the total maximal chorea score change from baseline (the average of values from the screening and day-0 visits) to maintenance therapy (the average of values from the week 9 and 12 visits) obtained by in-person visits. This study was designed to detect a 2.7-unit treatment difference in scores. The secondary end points, assessed hierarchically, were the proportion of patients who achieved treatment success on the Patient Global Impression of Change (PGIC) and on the Clinical Global Impression of Change (CGIC), the change in 36-Item Short Form- physical functioning subscale score (SF-36), and the change in the Berg Balance Test. RESULTS Ninety patients with Huntington disease (mean age, 53.7 years; 40 women [44.4%]) were enrolled. In the deutetrabenazine group, the mean total maximal chorea scores improved from 12.1 (95% CI, 11.2-12.9) to 7.7 (95% CI, 6.5-8.9), whereas in the placebo group, scores improved from 13.2 (95% CI, 12.2-14.3) to 11.3 (95% CI, 10.0-12.5); the mean between-group difference was -2.5 units (95% CI, -3.7 to -1.3) (P < .001). Treatment success, as measured by the PGIC, occurred in 23 patients (51%) in the deutetrabenazine group vs 9 (20%) in the placebo group (P = .002). As measured by the CGIC, treatment success occurred in 19 patients (42%) in the deutetrabenazine group vs 6 (13%) in the placebo group (P = .002). In the deutetrabenazine group, the mean SF-36 physical functioning subscale scores decreased from 47.5 (95% CI, 44.3-50.8) to 47.4 (44.3-50.5), whereas in the placebo group, scores decreased from 43.2 (95% CI, 40.2-46.3) to 39.9 (95% CI, 36.2-43.6), for a treatment benefit of 4.3 (95% CI, 0.4 to 8.3) (P = .03). There was no difference between groups (mean difference of 1.0 unit; 95% CI, -0.3 to 2.3; P = .14), for improvement in the Berg Balance Test, which improved by 2.2 units (95% CI, 1.3-3.1) in the deutetrabenazine group and by 1.3 units (95% CI, 0.4-2.2) in the placebo group. Adverse event rates were similar for deutetrabenazine and placebo, including depression, anxiety, and akathisia. CONCLUSIONS AND RELEVANCE Among patients with chorea associated with Huntington disease, the use of deutetrabenazine compared with placebo resulted in improved motor signs at 12 weeks. Further research is needed to assess the clinical importance of the effect size and to determine longer-term efficacy and safety. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01795859.
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Affiliation(s)
| | | | | | | | - Elise Kayson
- Center for Human Experimental Therapeutics, University of Rochester, Rochester, New York
| | | | | | | | - Blair Leavitt
- Centre of Molecular Medicine and Therapeutics, University of British Columbia, Vancouver, Canada
| | - David Oakes
- University of Rochester, Rochester, New York
| | | | | | - Jody Goldstein
- Center for Human Experimental Therapeutics, University of Rochester, Rochester, New York
| | - Margaret Herzog
- Center for Human Experimental Therapeutics, University of Rochester, Rochester, New York
| | - Victoria Snively
- Center for Human Experimental Therapeutics, University of Rochester, Rochester, New York
| | - Jacquelyn Whaley
- Center for Human Experimental Therapeutics, University of Rochester, Rochester, New York
| | | | - Greg Suter
- Hereditary Neurological Disease Centre, Wichita, Kansas
| | | | | | | | | | - Olivia C Roman
- Vanderbilt University Medical Center, Nashville, Tennessee
| | - Victor Sung
- University of Alabama School of Medicine, Birmingham, Alabama
| | - Jenna Smith
- University of Alabama School of Medicine, Birmingham, Alabama
| | | | | | | | - Anna Hohler
- Boston University Medical Campus, Boston, Massachusetts
| | - Denyse Turpin
- Boston University Medical Campus, Boston, Massachusetts
| | | | - Ramon Rodriguez
- University of Florida College of Medicine, Gainesville, Florida
| | - Kyle Rizer
- University of Florida College of Medicine, Gainesville, Florida
| | | | | | | | - Susan Criswell
- Washington University School of Medicine, St Louis, Missouri
| | - Brad A Racette
- Washington University School of Medicine, St Louis, Missouri
| | - Fredy J Revilla
- Greenville Health System, Greenville, South Carolina22University of South Carolina Medical School, Greenville, South Carolina
| | | | | | - MaryJane Ong
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Tilak Mendis
- Ottowa Parkinson's and Neurodegenerative Disorders Clinic, Ottawa, Canada
| | - Neila Mendis
- Ottowa Parkinson's and Neurodegenerative Disorders Clinic, Ottawa, Canada
| | | | | | - Jane S Paulsen
- University of Iowa Carver College of Medicine, Iowa City, Iowa
| | | | - Amanda Miller
- University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Jane Kerr
- University of Iowa Carver College of Medicine, Iowa City, Iowa
| | | | - Carolyn Gray
- University of Kansas Medical Center, Kansas City
| | | | | | - Eric Molho
- Albany Medical College, Albany, New York
| | - Mary Eglow
- Albany Medical College, Albany, New York
| | | | - Rajeev Kumar
- Rocky Mountain Movement Disorders Center, Englewood, Colorado
| | | | - Ali Samii
- University of Washington, Seattle, Washington
| | - Sylvain Chouinard
- Centre hospitalier de l'Université de Montréal, Montreal, Québec, Canada
| | | | | | | | | | - Wai Lun Alan Fung
- North York General Hospital, Toronto, Canada35University of Toronto, Toronto, Ontario, Canada36Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Clare Gibbons
- North York General Hospital, Toronto, Canada35University of Toronto, Toronto, Ontario, Canada
| | - Lina Qi
- North York General Hospital, Toronto, Canada
| | - Amy Colcher
- Cooper University Hospital, Camden, New Jersey
| | | | | | - Kevin Klos
- The Movement Disorders Clinic Oklahoma, Tulsa
| | | | - Lori Fafard
- South Shore Neurologic Associates, Islip, New York
| | | | | | - Rohit Dhall
- Parkinson's Institute and Clinical Center, Sunnyvale, California
| | | | | | | | | | | | - David Shprecher
- University of Utah Health Care, Salt Lake City, Utah46Banner Sun Health Research Institute, Sun City, Arizona
| | - Paola Wall
- Medical College of Wisconsin, Milwaukee, Wisconsin
| | | | - Lynn Wheeler
- Medical College of Wisconsin, Milwaukee, Wisconsin
| | - James T Boyd
- University of Vermont Medical Center, Burlington, Vermont
| | - Emily Houston
- University of Vermont Medical Center, Burlington, Vermont
| | | | - Pinky Agarwal
- Evergreen Neuroscience Institute, Kirkland, Washington
| | | | | | | | - Andrew Feigin
- Feinstein Institute for Medical Research, Manhasset, New York
| | | | - Chris Beck
- University of Rochester, Rochester, New York
| | | | - Jon Edicola
- University of Rochester, Rochester, New York
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4
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Deeb W, Rossi PJ, Porta M, Visser-Vandewalle V, Servello D, Silburn P, Coyne T, Leckman JF, Foltynie T, Hariz M, Joyce EM, Zrinzo L, Kefalopoulou Z, Welter ML, Karachi C, Mallet L, Houeto JL, Shahed-Jimenez J, Meng FG, Klassen BT, Mogilner AY, Pourfar MH, Kuhn J, Ackermans L, Kaido T, Temel Y, Gross RE, Walker HC, Lozano AM, Khandhar SM, Walter BL, Walter E, Mari Z, Changizi BK, Moro E, Baldermann JC, Huys D, Zauber SE, Schrock LE, Zhang JG, Hu W, Foote KD, Rizer K, Mink JW, Woods DW, Gunduz A, Okun MS. The International Deep Brain Stimulation Registry and Database for Gilles de la Tourette Syndrome: How Does It Work? Front Neurosci 2016; 10:170. [PMID: 27199634 PMCID: PMC4842757 DOI: 10.3389/fnins.2016.00170] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Accepted: 04/04/2016] [Indexed: 12/24/2022] Open
Abstract
Tourette Syndrome (TS) is a neuropsychiatric disease characterized by a combination of motor and vocal tics. Deep brain stimulation (DBS), already widely utilized for Parkinson's disease and other movement disorders, is an emerging therapy for select and severe cases of TS that are resistant to medication and behavioral therapy. Over the last two decades, DBS has been used experimentally to manage severe TS cases. The results of case reports and small case series have been variable but in general positive. The reported interventions have, however, been variable, and there remain non-standardized selection criteria, various brain targets, differences in hardware, as well as variability in the programming parameters utilized. DBS centers perform only a handful of TS DBS cases each year, making large-scale outcomes difficult to study and to interpret. These limitations, coupled with the variable effect of surgery, and the overall small numbers of TS patients with DBS worldwide, have delayed regulatory agency approval (e.g., FDA and equivalent agencies around the world). The Tourette Association of America, in response to the worldwide need for a more organized and collaborative effort, launched an international TS DBS registry and database. The main goal of the project has been to share data, uncover best practices, improve outcomes, and to provide critical information to regulatory agencies. The international registry and database has improved the communication and collaboration among TS DBS centers worldwide. In this paper we will review some of the key operation details for the international TS DBS database and registry.
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Affiliation(s)
- Wissam Deeb
- Department of Neurology, University of Florida and Center for Movement Disorders and Neurorestoration Gainesville, FL, USA
| | - Peter J Rossi
- Department of Neurology, University of Florida and Center for Movement Disorders and Neurorestoration Gainesville, FL, USA
| | - Mauro Porta
- Tourette's Syndrome and Movement Disorders Center, Galeazzi Hospital Milan, Italy
| | | | | | - Peter Silburn
- Asia-Pacific Centre for Neuromodulation, Queensland Brain InstituteBrisbane, Queensland, Australia; University of Queensland Centre for Clinical Research, The University of QueenslandBrisbane, Queensland, Australia
| | - Terry Coyne
- University of Queensland Centre for Clinical Research, The University of QueenslandBrisbane, Queensland, Australia; BrizBrain&SpineBrisbane, QLD, Australia
| | - James F Leckman
- Departments of Psychiatry, Pediatrics and Psychology, Child Study Center, Yale University New Haven, CT, USA
| | - Thomas Foltynie
- Sobell Department of Motor Neuroscience, University College London Institute of Neurology London, UK
| | - Marwan Hariz
- Sobell Department of Motor Neuroscience, University College London Institute of Neurology London, UK
| | - Eileen M Joyce
- Sobell Department of Motor Neuroscience, University College London Institute of Neurology London, UK
| | - Ludvic Zrinzo
- Sobell Department of Motor Neuroscience, University College London Institute of Neurology London, UK
| | - Zinovia Kefalopoulou
- Sobell Department of Motor Neuroscience, University College London Institute of Neurology London, UK
| | - Marie-Laure Welter
- Assistance publique - Hôpitaux de Paris, Institut du Cerveau et de la Moelle Epiniere, Institut National de la Santé et de la Recherche Médicale 1127, Pitié-Salpêtrière Hospital, Sorbonne Universités, UPMC Univ Paris 06, Unité Mixte de Recherche 1127, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 7225 Paris, France
| | - Carine Karachi
- Institut National de la Santé et de la Recherche Médicale U 1127, Centre National de la Recherche Scientifique UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinièreParis, France; Department of Neurosurgery, Assistance Publique - Hôpitaux de Paris, Hôpital de la Pitié-SalpêtrièreParis, France
| | - Luc Mallet
- Institut National de la Santé et de la Recherche Médicale U 1127, Centre National de la Recherche Scientifique UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinièreParis, France; Assistance publique - Hôpitaux de Paris, DHU Pe-PSY, Pôle de Psychiatrie et d'addictologie des Hôpitaux Universitaires H Mondor, Université Paris Est CréteilCréteil, France; Department of Mental Health and Psychiatry, Geneva University HospitalGeneva, Switzerland
| | - Jean-Luc Houeto
- Service de Neurologie, Institut National de la Santé et de la Recherche Médicale-Centres d'Investigation Clinique 1402, Centre Hospitalier Universitaire de Grenoble de Poitiers, Université de Poitiers Poitiers, France
| | - Joohi Shahed-Jimenez
- Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine Houston, TX, USA
| | - Fan-Gang Meng
- Beijing Neurosurgical Institute, Capital Medical University Beijing, China
| | - Bryan T Klassen
- Department of Neurology, Mayo Clinic College of Medicine Rochester, MN, USA
| | - Alon Y Mogilner
- Department of Neurosurgery, Center for Neuromodulation, NYU Langone Medical Center New York, NY, USA
| | - Michael H Pourfar
- Department of Neurosurgery, Center for Neuromodulation, NYU Langone Medical Center New York, NY, USA
| | - Jens Kuhn
- Department of Psychiatry and Psychotherapy, University of Cologne Cologne, Germany
| | - L Ackermans
- Department of Neurosurgery, Maastricht University Medical Centre Maastricht, Netherlands
| | - Takanobu Kaido
- Department of Neurosurgery, National Center Hospital, National Center of Neurology and Psychiatry Kodaira, Japan
| | - Yasin Temel
- Department of Neurosurgery, Maastricht University Medical CenterMaastricht, Netherlands; Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht UniversityMaastricht, Netherlands
| | - Robert E Gross
- Department of Neurosurgery, Emory University Atlanta, GA, USA
| | - Harrison C Walker
- Department of Neurology, Department of Biomedical Engineering, University of Alabama at Birmingham Birmingham, AL, USA
| | - Andres M Lozano
- Division of Neurosurgery, University of Toronto Toronto, Canada
| | - Suketu M Khandhar
- Department of Neurology, The Permanente Medical Group (Tidewater Physicians Multispecialty Group), Movement Disorders Program Sacramento, CA, USA
| | - Benjamin L Walter
- University Hospitals, Case Western Reserve University School of Medicine Cleveland, OH, USA
| | - Ellen Walter
- Department of Neurology, University Hospitals Case Medical Center, Neurological Institute Cleveland, OH, USA
| | - Zoltan Mari
- Parkinson's & Movement Disorder Center/Division, Johns Hopkins University, School of Medicine Baltimore, MD, USA
| | - Barbara K Changizi
- Department of Neurology, The Ohio State University Wexner Medical Center Columbus, OH, USA
| | - Elena Moro
- Division of Neurology, Centre Hospitalier Universitaire de Grenoble Grenoble, Grenoble Alpes University Grenoble, France
| | - Juan C Baldermann
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Köln Köln, Germany
| | - Daniel Huys
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Köln Köln, Germany
| | - S Elizabeth Zauber
- Department of Neurology, Indiana University School of Medicine Indianapolis, IN, USA
| | - Lauren E Schrock
- Department of Neurology, University of Utah Salt Lake City, UT, USA
| | - Jian-Guo Zhang
- Department of Functional Neurosurgery, Beijing Tiantan Hospital, Capital Medical University Beijing, China
| | - Wei Hu
- Department of Neurology, University of Florida and Center for Movement Disorders and Neurorestoration Gainesville, FL, USA
| | - Kelly D Foote
- Department of Neurology, University of Florida and Center for Movement Disorders and NeurorestorationGainesville, FL, USA; Department of Neurological Surgery, University of FloridaGainesville, FL, USA
| | - Kyle Rizer
- Department of Neurology, University of Florida and Center for Movement Disorders and Neurorestoration Gainesville, FL, USA
| | - Jonathan W Mink
- Department of Neurology, University of Rochester Medical Center Rochester, NY, USA
| | - Douglas W Woods
- Department of Psychology, Marquette University Milwaukee, WI, USA
| | - Aysegul Gunduz
- Department of Neurology, University of Florida and Center for Movement Disorders and NeurorestorationGainesville, FL, USA; J. Crayton Pruitt Family Department of Biomedical Engineering, University of FloridaGainesville, FL, USA
| | - Michael S Okun
- Department of Neurology, University of Florida and Center for Movement Disorders and Neurorestoration Gainesville, FL, USA
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5
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Deeb W, Rossi PJ, Porta M, Visser-Vandewalle V, Servello D, Silburn P, Coyne T, Leckman JF, Foltynie T, Hariz M, Joyce EM, Zrinzo L, Kefalopoulou Z, Welter ML, Karachi C, Mallet L, Houeto JL, Shahed-Jimenez J, Meng FG, Klassen BT, Mogilner AY, Pourfar MH, Kuhn J, Ackermans L, Kaido T, Temel Y, Gross RE, Walker HC, Lozano AM, Khandhar SM, Walter BL, Walter E, Mari Z, Changizi BK, Moro E, Baldermann JC, Huys D, Zauber SE, Schrock LE, Zhang JG, Hu W, Foote KD, Rizer K, Mink JW, Woods DW, Gunduz A, Okun MS. The International Deep Brain Stimulation Registry and Database for Gilles de la Tourette Syndrome: How Does It Work? Front Neurosci 2016. [PMID: 27199634 DOI: 10.3389/fnins.2016.00170/abstract] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
Tourette Syndrome (TS) is a neuropsychiatric disease characterized by a combination of motor and vocal tics. Deep brain stimulation (DBS), already widely utilized for Parkinson's disease and other movement disorders, is an emerging therapy for select and severe cases of TS that are resistant to medication and behavioral therapy. Over the last two decades, DBS has been used experimentally to manage severe TS cases. The results of case reports and small case series have been variable but in general positive. The reported interventions have, however, been variable, and there remain non-standardized selection criteria, various brain targets, differences in hardware, as well as variability in the programming parameters utilized. DBS centers perform only a handful of TS DBS cases each year, making large-scale outcomes difficult to study and to interpret. These limitations, coupled with the variable effect of surgery, and the overall small numbers of TS patients with DBS worldwide, have delayed regulatory agency approval (e.g., FDA and equivalent agencies around the world). The Tourette Association of America, in response to the worldwide need for a more organized and collaborative effort, launched an international TS DBS registry and database. The main goal of the project has been to share data, uncover best practices, improve outcomes, and to provide critical information to regulatory agencies. The international registry and database has improved the communication and collaboration among TS DBS centers worldwide. In this paper we will review some of the key operation details for the international TS DBS database and registry.
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Affiliation(s)
- Wissam Deeb
- Department of Neurology, University of Florida and Center for Movement Disorders and Neurorestoration Gainesville, FL, USA
| | - Peter J Rossi
- Department of Neurology, University of Florida and Center for Movement Disorders and Neurorestoration Gainesville, FL, USA
| | - Mauro Porta
- Tourette's Syndrome and Movement Disorders Center, Galeazzi Hospital Milan, Italy
| | | | | | - Peter Silburn
- Asia-Pacific Centre for Neuromodulation, Queensland Brain InstituteBrisbane, Queensland, Australia; University of Queensland Centre for Clinical Research, The University of QueenslandBrisbane, Queensland, Australia
| | - Terry Coyne
- University of Queensland Centre for Clinical Research, The University of QueenslandBrisbane, Queensland, Australia; BrizBrain&SpineBrisbane, QLD, Australia
| | - James F Leckman
- Departments of Psychiatry, Pediatrics and Psychology, Child Study Center, Yale University New Haven, CT, USA
| | - Thomas Foltynie
- Sobell Department of Motor Neuroscience, University College London Institute of Neurology London, UK
| | - Marwan Hariz
- Sobell Department of Motor Neuroscience, University College London Institute of Neurology London, UK
| | - Eileen M Joyce
- Sobell Department of Motor Neuroscience, University College London Institute of Neurology London, UK
| | - Ludvic Zrinzo
- Sobell Department of Motor Neuroscience, University College London Institute of Neurology London, UK
| | - Zinovia Kefalopoulou
- Sobell Department of Motor Neuroscience, University College London Institute of Neurology London, UK
| | - Marie-Laure Welter
- Assistance publique - Hôpitaux de Paris, Institut du Cerveau et de la Moelle Epiniere, Institut National de la Santé et de la Recherche Médicale 1127, Pitié-Salpêtrière Hospital, Sorbonne Universités, UPMC Univ Paris 06, Unité Mixte de Recherche 1127, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 7225 Paris, France
| | - Carine Karachi
- Institut National de la Santé et de la Recherche Médicale U 1127, Centre National de la Recherche Scientifique UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinièreParis, France; Department of Neurosurgery, Assistance Publique - Hôpitaux de Paris, Hôpital de la Pitié-SalpêtrièreParis, France
| | - Luc Mallet
- Institut National de la Santé et de la Recherche Médicale U 1127, Centre National de la Recherche Scientifique UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinièreParis, France; Assistance publique - Hôpitaux de Paris, DHU Pe-PSY, Pôle de Psychiatrie et d'addictologie des Hôpitaux Universitaires H Mondor, Université Paris Est CréteilCréteil, France; Department of Mental Health and Psychiatry, Geneva University HospitalGeneva, Switzerland
| | - Jean-Luc Houeto
- Service de Neurologie, Institut National de la Santé et de la Recherche Médicale-Centres d'Investigation Clinique 1402, Centre Hospitalier Universitaire de Grenoble de Poitiers, Université de Poitiers Poitiers, France
| | - Joohi Shahed-Jimenez
- Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine Houston, TX, USA
| | - Fan-Gang Meng
- Beijing Neurosurgical Institute, Capital Medical University Beijing, China
| | - Bryan T Klassen
- Department of Neurology, Mayo Clinic College of Medicine Rochester, MN, USA
| | - Alon Y Mogilner
- Department of Neurosurgery, Center for Neuromodulation, NYU Langone Medical Center New York, NY, USA
| | - Michael H Pourfar
- Department of Neurosurgery, Center for Neuromodulation, NYU Langone Medical Center New York, NY, USA
| | - Jens Kuhn
- Department of Psychiatry and Psychotherapy, University of Cologne Cologne, Germany
| | - L Ackermans
- Department of Neurosurgery, Maastricht University Medical Centre Maastricht, Netherlands
| | - Takanobu Kaido
- Department of Neurosurgery, National Center Hospital, National Center of Neurology and Psychiatry Kodaira, Japan
| | - Yasin Temel
- Department of Neurosurgery, Maastricht University Medical CenterMaastricht, Netherlands; Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht UniversityMaastricht, Netherlands
| | - Robert E Gross
- Department of Neurosurgery, Emory University Atlanta, GA, USA
| | - Harrison C Walker
- Department of Neurology, Department of Biomedical Engineering, University of Alabama at Birmingham Birmingham, AL, USA
| | - Andres M Lozano
- Division of Neurosurgery, University of Toronto Toronto, Canada
| | - Suketu M Khandhar
- Department of Neurology, The Permanente Medical Group (Tidewater Physicians Multispecialty Group), Movement Disorders Program Sacramento, CA, USA
| | - Benjamin L Walter
- University Hospitals, Case Western Reserve University School of Medicine Cleveland, OH, USA
| | - Ellen Walter
- Department of Neurology, University Hospitals Case Medical Center, Neurological Institute Cleveland, OH, USA
| | - Zoltan Mari
- Parkinson's & Movement Disorder Center/Division, Johns Hopkins University, School of Medicine Baltimore, MD, USA
| | - Barbara K Changizi
- Department of Neurology, The Ohio State University Wexner Medical Center Columbus, OH, USA
| | - Elena Moro
- Division of Neurology, Centre Hospitalier Universitaire de Grenoble Grenoble, Grenoble Alpes University Grenoble, France
| | - Juan C Baldermann
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Köln Köln, Germany
| | - Daniel Huys
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Köln Köln, Germany
| | - S Elizabeth Zauber
- Department of Neurology, Indiana University School of Medicine Indianapolis, IN, USA
| | - Lauren E Schrock
- Department of Neurology, University of Utah Salt Lake City, UT, USA
| | - Jian-Guo Zhang
- Department of Functional Neurosurgery, Beijing Tiantan Hospital, Capital Medical University Beijing, China
| | - Wei Hu
- Department of Neurology, University of Florida and Center for Movement Disorders and Neurorestoration Gainesville, FL, USA
| | - Kelly D Foote
- Department of Neurology, University of Florida and Center for Movement Disorders and NeurorestorationGainesville, FL, USA; Department of Neurological Surgery, University of FloridaGainesville, FL, USA
| | - Kyle Rizer
- Department of Neurology, University of Florida and Center for Movement Disorders and Neurorestoration Gainesville, FL, USA
| | - Jonathan W Mink
- Department of Neurology, University of Rochester Medical Center Rochester, NY, USA
| | - Douglas W Woods
- Department of Psychology, Marquette University Milwaukee, WI, USA
| | - Aysegul Gunduz
- Department of Neurology, University of Florida and Center for Movement Disorders and NeurorestorationGainesville, FL, USA; J. Crayton Pruitt Family Department of Biomedical Engineering, University of FloridaGainesville, FL, USA
| | - Michael S Okun
- Department of Neurology, University of Florida and Center for Movement Disorders and Neurorestoration Gainesville, FL, USA
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