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EPA-1587 - Functional Outcome and Quality of Life in Tourette’ s Syndrome after Deep Brain Stimulation of the Posteroventrolateral Globus Pallidus Internus: Long-term follow-up

Published online by Cambridge University Press:  15 April 2020

B. Leitner
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, München, Germany
S. Dehning
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, München, Germany
R. Schennach
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, München, Germany
N. Müller
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, München, Germany
K. Bötzel
Affiliation:
Department of Neurology, Ludwig- Maximilians-University, München, Germany
M. Obermeier
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, München, Germany
J.H. Mehrkens
Affiliation:
Department of Neurosurgery, Ludwig-Maximilians-University, München, Germany

Abstract

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Introduction

Deep brain stimulation (DBS) for Tourette’ s syndrome (TS) in various targets has been in the focus for some years. However, there are hardly any data on ‘psychosocial’ outcome after DBS for TS.

Objectives

The aim of the present study therefore was to focus on the functional outcome and ‘psychosocial changes’ in TS patients after DBS.

Methods

Six patients with treatment-refractory TS underwent GPi-DBS. The Yale Global Tic Severity Scale (YGTSS) was used to evaluate symptomatic outcome. Psychosocial changes were assessed applying the Global Assessment of Functioning Scale (GAF) and the Gilles-de-la- Tourette-Syndrome Quality-of-Life scale (GTS-QOL) with additionally documenting psychosocial changes. Follow-up ranged between 12 and 72 months.

Results

In all symptomatic responders (4 of 6) we found a significant functional improvement (mean GAF increasing from 53.75 (± 7.5) preoperatively to 83.75 (± 7.5) at last follow-up) along with a positive correlation with the course of GTS-QOL (R2 = 0.62).

Conclusions

Treatment success should not only be assessed with the classic ‘tic-scales’, but also with the GAF and GTS-QOL. Although improvement of tics seems to be positively correlated with improved functional outcome, symptomatic improvement may lead to unexpected major psychosocial changes – which both the patient and the clinicians in charge – should be prepared for.

Type
E04 - e-Poster Oral Session 04: Therapy and Consultant liaison psychiatry, miscellaneous
Copyright
Copyright © European Psychiatric Association 2014
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