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5 results on '"Movement Disorders and Tourette Centre"'

1. 135 A Comparison of Outcomes Between Deep Brain Stimulation Under General Anesthesia Versus Conscious Sedation With Awake Evaluation

Author

Marc Vérin, M. Maarouf, Roshini Jain, Domenico Servello, Mauro Porta, Michael T. Barbe, Steven S. Gill, Claire Haegelen, Lilly Chen, François Alesch, Alan L Whone, Esther Suarez San Martin, Thomas Brucke, Lars Timmermann, Fernando Seijo, Department of Neurology, Medizinische Universität Wien = Medical University of Vienna, Service de neurochirurgie [Rennes] = Neurosurgery [Rennes], CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Comportement et noyaux gris centraux = Behavior and Basal Ganglia [Rennes], Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université européenne de Bretagne - European University of Brittany (UEB)-CHU Pontchaillou [Rennes]-Institut des Neurosciences Cliniques de Rennes (INCR), Service de Neurologie [Rennes] = Neurology [Rennes], Frenchay Hospital, Movement Disorders and Tourette Centre, Heinrich Heine Universität Düsseldorf = Heinrich Heine University [Düsseldorf], Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Rennes (UR)-Université européenne de Bretagne - European University of Brittany (UEB)-CHU Pontchaillou [Rennes]-Institut des Neurosciences Cliniques de Rennes = Institute of Clinical Neurosciences of Rennes (INCR)

Subjects
0301 basic medicine, medicine.medical_specialty, Deep brain stimulation, business.industry, medicine.medical_treatment, Sedation, Significant difference, Motor symptoms, Motor function, Clinical trial, 03 medical and health sciences, Subthalamic nucleus, 030104 developmental biology, 0302 clinical medicine, Rating scale, Anesthesia, Physical therapy, medicine, Surgery, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery
Abstract

International audience; INTRODUCTION: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) for the management of motor symptoms of Parkinson disease (PD) is typically performed under conscious sedation with awake evaluation during intraoperative physiologic testing. However, developments in surgical techniques now allow for subjects to be asleep during the procedure using general anesthesia. Previously reported long-term outcomes of subjects who underwent STN-DBS under general anesthesia demonstrated postoperative safety and efficacy out to 1 year. In this study, we examine outcomes between subjects undergoing the STN-DBS procedure who used general anesthesia vs those using conscious sedation with awake evaluation as part of the ongoing VANTAGE clinical trial. METHODS: VANTAGE is a prospective, multicenter, nonrandomized, open-label interventional trial, sponsored by Boston Scientific Corporation. The trial assesses motor improvement in subjects with moderate-to-severe PD following bilateral STN-DBS. Assessments include motor scores such as Unified Parkinson's Disease Rating Scale (UPDRS) and quality-of-life measurements such as PDQ-39. Forty subjects were implanted bilaterally with the Vercise DBS System (Boston Scientific Corporation) at 6 European centers. Of these, 19 (47%) underwent the DBS procedure under general anesthesia. RESULTS: Analysis of both study groups did not indicate a statistically significant difference in motor function outcomes. However, subjects utilizing general anesthesia were found not to display motor function outcomes that were necessarily clinically inferior to those consciously sedated with awake evaluation. Sample size and variation in baseline differences in selected subjects may have contributed to these final results, because a tendency for subjects undergoing general anesthesia to report an improvement in motor function similar to or better than those consciously sedated (vs baseline) was observed. CONCLUSION: No inferiority in clinical outcomes was observed in subjects that underwent general anesthesia vs those that were consciously sedated with awake evaluation.

Published
2016

2. 134 VANTAGE Trial: Three-Year Outcomes of a Prospective, Multicenter Trial Evaluating Deep Brain Stimulation With a New Multiple-Source, Constant-Current Rechargeable System in Parkinson Disease

Author

Veerle Visser-Vandewalle, Domenico Servello, Esther Suarez San Martin, Lars Timmermann, Claire Haegelen, Thomas Brucke, Marc Vérin, Fernando Seijo, Alan L Whone, Mauro Porta, Michael T. Barbe, François Alesch, Roshini Jain, Lilly Chen, Steven S. Gill, Heinrich Heine Universität Düsseldorf = Heinrich Heine University [Düsseldorf], Department of Neurology, Medizinische Universität Wien = Medical University of Vienna, Service de neurochirurgie [Rennes] = Neurosurgery [Rennes], CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Comportement et noyaux gris centraux = Behavior and Basal Ganglia [Rennes], Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université européenne de Bretagne - European University of Brittany (UEB)-CHU Pontchaillou [Rennes]-Institut des Neurosciences Cliniques de Rennes (INCR), Service de Neurologie [Rennes] = Neurology [Rennes], Department of Neurosurgery, University Hospital Maastricht, Frenchay Hospital, Movement Disorders and Tourette Centre, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Rennes (UR)-Université européenne de Bretagne - European University of Brittany (UEB)-CHU Pontchaillou [Rennes]-Institut des Neurosciences Cliniques de Rennes = Institute of Clinical Neurosciences of Rennes (INCR)

Subjects
medicine.medical_specialty, Deep brain stimulation, business.industry, medicine.medical_treatment, 05 social sciences, Disease, 3. Good health, Clinical trial, 03 medical and health sciences, Subthalamic nucleus, 0302 clinical medicine, Dyskinesia, Rating scale, Multicenter trial, 0502 economics and business, medicine, Physical therapy, 050211 marketing, Surgery, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Neurology (clinical), medicine.symptom, business, Adverse effect, 030217 neurology & neurosurgery
Abstract

International audience; INTRODUCTION: Deep brain stimulation (DBS) has been demonstrated to be effective for Parkinson disease (PD) symptom relief. We sought to characterize the benefit of subthalamic nucleus (STN) DBS for PD patients using a recently CE-marked multiple-source, constant-current system that permits a well-defined distribution of applied current. We report the 3-year results of the first clinical trial using multiple independent current control (MICC) DBS in the management of symptoms of PD. METHODS: VANTAGE is a monitored, prospective, multicenter, nonrandomized, open-label interventional trial sponsored by Boston Scientific Corporation. Forty subjects with idiopathic PD were implanted bilaterally with a DBS system (Vercise) targeting the STN and followed up to 3 years after lead placement. Motor improvement was evaluated using Unified Parkinson's Disease Rating Scale (UPDRS) III scores in stim ON/meds OFF in comparison with preoperative scores. Other assessments such as CAPSIT motor tests, Tremor Rating Scale, Dyskinesia Rating Scale, PDQ-39, SF-36, Schwab and England, and resource utilization were administered. Patient motor diaries were collected over 3 days. Adverse events were also recorded. RESULTS: This study will report the safety and effectiveness outcomes of VANTAGE subjects at 3 years postimplantation as compared with baseline. CONCLUSION: The VANTAGE trial is the first reported trial of a multiple-source, constant-current rechargeable system for use in the management of PD symptoms. Study outcomes will inform clinicians on the use of this system and its flexibility to manage the symptoms of idiopathic PD.

Published
2016

3. Multiple-source current steering in subthalamic nucleus deep brain stimulation for Parkinson's disease (the VANTAGE study): a non-randomised, prospective, multicentre, open-label study

Author

Nic Van Dyck, Thomas Brucke, Claire Haegelen, Lilly Chen, Esther Suarez, Domenico Servello, Mauro Porta, Lars Timmermann, Michael T. Barbe, Iris Kaiser, Mohamed Maarouf, Sebastian Beirer, Fernando Sejio, Steven Gill, Alan L Whone, Roshini Jain, Niels Allert, Marc Vérin, François Alesch, Beatriz Lozano, Heinrich Heine Universität Düsseldorf = Heinrich Heine University [Düsseldorf], Department of Neurology, Medizinische Universität Wien = Medical University of Vienna, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de neurochirurgie [Rennes] = Neurosurgery [Rennes], CHU Pontchaillou [Rennes], Comportement et noyaux gris centraux = Behavior and Basal Ganglia [Rennes], Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université européenne de Bretagne - European University of Brittany (UEB)-CHU Pontchaillou [Rennes]-Institut des Neurosciences Cliniques de Rennes (INCR), Service de Neurologie [Rennes] = Neurology [Rennes], Movement Disorders and Tourette Centre, Heinrich-Heine-Universität Düsseldorf [Düsseldorf], Service de neurochirurgie [Rennes], Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Institut des Neurosciences Cliniques de Rennes (INCR)-CHU Pontchaillou [Rennes]-Université européenne de Bretagne - European University of Brittany (UEB)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Service de Neurologie [Rennes], Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Rennes (UR)-Université européenne de Bretagne - European University of Brittany (UEB)-CHU Pontchaillou [Rennes]-Institut des Neurosciences Cliniques de Rennes = Institute of Clinical Neurosciences of Rennes (INCR)

Subjects
Adult, Male, Levodopa, medicine.medical_specialty, Deep brain stimulation, Parkinson's disease, medicine.medical_treatment, Deep Brain Stimulation, [SDV]Life Sciences [q-bio], 03 medical and health sciences, 0302 clinical medicine, Rating scale, Subthalamic Nucleus, medicine, Clinical endpoint, Humans, Prospective Studies, Prospective cohort study, 030304 developmental biology, Aged, 0303 health sciences, business.industry, Parkinson Disease, Middle Aged, medicine.disease, 3. Good health, Electrodes, Implanted, Subthalamic nucleus, Treatment Outcome, Physical therapy, Female, Neurology (clinical), Implant, business, 030217 neurology & neurosurgery, medicine.drug
Abstract

International audience; Background High-frequency deep brain stimulation (DBS) with a single electrical source is effective for motor symptom relief in patients with Parkinson's disease. We postulated that a multiple-source, constant-current device that permits well defined distribution of current would lead to motor improvement in patients with Parkinson's disease. Methods We did a prospective, multicentre, non-randomised, open-label intervention study of an implantable DBS device (the VANTAGE study) at six specialist DBS centres at universities in six European countries. Patients were judged eligible if they were aged 21–75 years, had been diagnosed with bilateral idiopathic Parkinson's disease with motor symptoms for more than 5 years, had a Hoehn and Yahr score of 2 or greater, and had a Unified Parkinson's disease rating scale part III (UPDRS III) score in the medication-off state of more than 30, which improved by 33% or more after a levodopa challenge. Participants underwent bilateral implantation in the subthalamic nucleus of a multiple-source, constant-current, eight-contact, rechargeable DBS system, and were assessed 12, 26, and 52 weeks after implantation. The primary endpoint was the mean change in UPDRS III scores (assessed by site investigators who were aware of the treatment assignment) from baseline (medication-off state) to 26 weeks after first lead implantation (stimulation-on, medication-off state). This study is registered with ClinicalTrials.gov, number NCT01221948. Findings Of 53 patients enrolled in the study, 40 received a bilateral implant in the subthalamic nucleus and their data contributed to the primary endpoint analysis. Improvement was noted in the UPDRS III motor score 6 months after first lead implantation (mean 13·5 [SD 6·8], 95% CI 11·3–15·7) compared with baseline (37·4 [8·9], 34·5–40·2), with a mean difference of 23·8 (SD 10·6; 95% CI 20·3–27·3; p

Published
2015

4. IARC Monographs : 40 Years of Evaluating Carcinogenic Hazards to Humans

Author

Pearce, Neil E, Blair, Aaron, Vineis, Paolo, Ahrens, Wolfgang, Andersen, Aage, Anto, Josep M, Armstrong, Bruce K, Baccarelli, Andrea A, Beland, Frederick A, Berrington, Amy, Bertazzi, Pier A, Birnbaum, Linda S, Brownson, Ross C, Bucher, John R, Cantor, Kenneth P, Cardis, Elisabeth, Cherrie, John W, Christiani, David C, Cocco, Pierluigi, Coggon, David, Comba, Pietro, Demers, Paul A, Dement, John M, Douwes, Jeroen, Eisen, Ellen A, Engel, Lawrence S, Fenske, Richard A, Fleming, Lora E, Fletcher, Tony, Fontham, Elizabeth, Forastiere, Francesco, Frentzel-Beyme, Rainer, Fritschi, Lin, Gerin, Michel, Goldberg, Marcel, Grandjean, Philippe, Grimsrud, Tom K, Gustavsson, Per, Haines, Andy, Hartge, Patricia, Hansen, Johnni, Hauptmann, Michael, Heederik, Dick, Hemminki, Kari, Hemon, Denis, Hertz-Picciotto, Irva, Hoppin, Jane A, Huff, James, Jarvholm, Bengt, Kang, Daehee, Karagas, Margaret R, Kjaerheim, Kristina, Kjuus, Helge, Kogevinas, Manolis, Kriebel, David, Kristensen, Petter, Kromhout, Hans, Laden, Francine, Lebailly, Pierre, LeMasters, Grace, Lubin, Jay H, Lynch, Charles F, Lynge, Elsebeth, 't Mannetje, Andrea, McMichael, Anthony J, McLaughlin, John R, Marrett, Loraine, Martuzzi, Marco, Merchant, James A, Merler, Enzo, Merletti, Franco, Miller, Anthony, Mirer, Franklin E, Monson, Richard, Nordby, Karl-Kristian, Olshan, Andrew F, Parent, Marie-Elise, Perera, Frederica P, Perry, Melissa J, Pesatori, Angela C, Pirastu, Roberta, Porta, Miquel, Pukkala, Eero, Rice, Carol, Richardson, David B, Ritter, Leonard, Ritz, Beate, Ronckers, Cecile M, Rushton, Lesley, Rusiecki, Jennifer A, Rusyn, Ivan, Samet, Jonathan M, Sandler, Dale P, de Sanjose, Silvia, Schernhammer, Eva, Seniori Constantini, Adele, Seixas, Noah, Shy, Carl, Siemiatycki, Jack, Silvermann, Debra T, Simonato, Lorenzo, Smith, Allan H, Smith, Martyn T, Spinelli, John J, Spitz, Margaret R, Stallones, Lorann, Stayner, Leslie T, Steenland, Kyle, Stenzel, Mark, Stewart, Bernard W, Stewart, Patricia A, Symanski, Elaine, Terracini, Benedetto, Tolbert, Paige E, Vainio, Harri, Vena, John, Vermeulen, Roel, Victora, Cesar G, Ward, Elizabeth M, Weinberg, Clarice R, Weisenburger, Dennis, Wesseling, Catharina, Weiderpass, Elisabete, Zahm, Shelia H, Risk Assessment, Infection & Immunity, dIRAS RA-I&I RA, dIRAS RA-2, LS IRAS EEPI GRA (Gezh.risico-analyse), LS IRAS EEPI EXAS (Arb.hyg+bl.st.kar.), CCA -Cancer Center Amsterdam, APH - Amsterdam Public Health, Paediatric Oncology, The University of Sydney, CIBER de Epidemiología y Salud Pública (CIBERESP), Universita degli Studi di Cagliari [Cagliari], Cohortes épidémiologiques en population (CONSTANCES), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université de Paris (UP), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA), Center for Research in Environmental Epidemiology (CREAL), Universitat Pompeu Fabra [Barcelona] (UPF)-Catalunya ministerio de salud, Université de Caen Normandie (UNICAEN), Normandie Université (NU), Institut Armand Frappier (INRS-IAF), Réseau International des Instituts Pasteur (RIIP)-Institut National de la Recherche Scientifique [Québec] (INRS), Movement Disorders and Tourette Centre, Rockefeller University [New York], Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal (UdeM), Plymouth University, Siemens [New York], Siemens AG [Munich], Department of Medical Epidemiology and Biostatistics (MEB), Karolinska Institutet [Stockholm], Population-Based Epidemiological Cohorts, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital Paul Brousse, Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Universitat Pompeu Fabra [Barcelona]-Catalunya ministerio de salud, Institut National de la Recherche Scientifique [Québec] (INRS)-Réseau International des Instituts Pasteur (RIIP), Rockefeller University, Risk Assessment, Infection & Immunity, dIRAS RA-I&I RA, dIRAS RA-2, LS IRAS EEPI GRA (Gezh.risico-analyse), LS IRAS EEPI EXAS (Arb.hyg+bl.st.kar.), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC), The University of Sydney [Sydney], Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -AP-HP Hôpital Paul Brousse, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité ( CRESS (U1153 / UMR_A 1125) ), Institut National de la Recherche Agronomique ( INRA ) -Université Sorbonne Paris Cité ( USPC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Center for Research in Environmental Epidemiology ( CREAL ), Université de Caen Normandie ( UNICAEN ), Normandie Université ( NU ), Institut Armand Frappier ( INRS-IAF ), Institut National de la Recherche Scientifique [Québec] ( INRS ) -Réseau International des Instituts Pasteur ( RIIP ) -Institut Armand Frappier, Rockefeller University, New York, Centre de recherche du Centre Hospitalier de l'Université de Montréal ( CRCHUM ), and Department of Medical Epidemiology and Biostatistics ( MEB )

Subjects
Pathology, Biomedical Research, Health, Toxicology and Mutagenesis, [SDV]Life Sciences [q-bio], 05 Environmental Sciences, Toxicology, MESH: Carcinogens, Environmental, 0302 clinical medicine, CANCER-EPIDEMIOLOGY, Neoplasms, Epidemiology of cancer, PLEA, PROGRAM, Medicine, MESH: Neoplasms, Càncer, health care economics and organizations, Public, Environmental & Occupational Health, Cancer, 0303 health sciences, Publications, 11 Medical And Health Sciences, MESH : Publications, POLICY, 030220 oncology & carcinogenesis, PUBLIC-HEALTH, Public Health, MESH: Public Health, MESH : Biomedical Research, Life Sciences & Biomedicine, International agency, medicine.medical_specialty, MESH : Public Health, education, MESH : International Agencies, Environmental Sciences & Ecology, macromolecular substances, MESH: Publications, MESH : Carcinogens, Environmental, MESH: International Agencies, 03 medical and health sciences, Arbetsmedicin och miljömedicin, ADHERENCE, Environmental health, Humans, VDP::Medisinske Fag: 700, 030304 developmental biology, Science & Technology, MESH: Humans, [ SDV ] Life Sciences [q-bio], business.industry, MESH: Biomedical Research, MESH : Humans, Public Health, Environmental and Occupational Health, RECIPE, International Agencies, PRINCIPLES UNDERLYING SCIENCE, Occupational Health and Environmental Health, MESH : Neoplasms, Carcinogens, Environmental, VDP::Medical disciplines: 700, Commentary, business, FALSE, Cancerígens, Environmental Sciences, EPIDEMIOLOGIC ENTERPRISE
Abstract

BACKGROUND: Recently, the International Agency for Research on Cancer (IARC) Programme for the Evaluation of Carcinogenic Risks to Humans has been criticized for several of its evaluations, and also for the approach used to perform these evaluations. Some critics have claimed that failures of IARC Working Groups to recognize study weaknesses and biases of Working Group members have led to inappropriate classification of a number of agents as carcinogenic to humans.OBJECTIVES: The authors of this Commentary are scientists from various disciplines relevant to the identification and hazard evaluation of human carcinogens. We examined criticisms of the IARC classification process to determine the validity of these concerns. Here, we present the results of that examination, review the history of IARC evaluations, and describe how the IARC evaluations are performed.DISCUSSION: We concluded that these recent criticisms are unconvincing. The procedures employed by IARC to assemble Working Groups of scientists from the various disciplines and the techniques followed to review the literature and perform hazard assessment of various agents provide a balanced evaluation and an appropriate indication of the weight of the evidence. Some disagreement by individual scientists to some evaluations is not evidence of process failure. The review process has been modified over time and will undoubtedly be altered in the future to improve the process. Any process can in theory be improved, and we would support continued review and improvement of the IARC processes. This does not mean, however, that the current procedures are flawed.CONCLUSIONS: The IARC Monographs have made, and continue to make, major contributions to the scientific underpinning for societal actions to improve the public's health.CITATION: Pearce N, Blair A, Vineis P, Ahrens W, Andersen A, Anto JM, Armstrong BK, Baccarelli AA, Beland FA, Berrington A, Bertazzi PA, Birnbaum LS, Brownson RC, Bucher JR, Cantor KP, Cardis E, Cherrie JW, Christiani DC, Cocco P, Coggon D, Comba P, Demers PA, Dement JM, Douwes J, Eisen EA, Engel LS, Fenske RA, Fleming LE, Fletcher T, Fontham E, Forastiere F, Frentzel-Beyme R, Fritschi L, Gerin M, Goldberg M, Grandjean P, Grimsrud TK, Gustavsson P, Haines A, Hartge P, Hansen J, Hauptmann M, Heederik D, Hemminki K, Hemon D, Hertz-Picciotto I, Hoppin JA, Huff J, Jarvholm B, Kang D, Karagas MR, Kjaerheim K, Kjuus H, Kogevinas M, Kriebel D, Kristensen P, Kromhout H, Laden F, Lebailly P, LeMasters G, Lubin JH, Lynch CF, Lynge E, 't Mannetje A, McMichael AJ, McLaughlin JR, Marrett L, Martuzzi M, Merchant JA, Merler E, Merletti F, Miller A, Mirer FE, Monson R, Nordby KC, Olshan AF, Parent ME, Perera FP, Perry MJ, Pesatori AC, Pirastu R, Porta M, Pukkala E, Rice C, Richardson DB, Ritter L, Ritz B, Ronckers CM, Rushton L, Rusiecki JA, Rusyn I, Samet JM, Sandler DP, de Sanjose S, Schernhammer E, Seniori Costantini A, Seixas N, Shy C, Siemiatycki J, Silverman DT, Simonato L, Smith AH, Smith MT, Spinelli JJ, Spitz MR, Stallones L, Stayner LT, Steenland K, Stenzel M, Stewart BW, Stewart PA, Symanski E, Terracini B, Tolbert PE, Vainio H, Vena J, Vermeulen R, Victora CG, Ward EM, Weinberg CR, Weisenburger D, Wesseling C, Weiderpass E, Zahm SH. 2015. IARC Monographs: 40 years of evaluating carcinogenic hazards to humans. Environ Health Perspect 123:507-514; http://dx.doi.org/10.1289/ehp.1409149.

Published
2015

5. European clinical guidelines for Tourette syndrome and other tic disorders. Part IV: Deep brain stimulation

Author

Muller Vahl, K. r., Cath, Danielle C., Cavanna, Andrea E., Sandra, Dehning, Mauro, Porta, Robertson, Mary M., Veerle Visser Vandewalle, Essts Guidelines Group Androutsos, C., Aschauer, H., Baird, G., Bos Veneman, N., Brambilla, A., Cardona, Francesco Carmelo Giovanni, Cath, D. c., Cavanna, A. e., Czernecki, V., Dehning, S., Eapter, A., Farkas, L., Gadaros, J., Hartmann, A., Hauser, E., Heyman, I., Hedderly, T., Hoekstra, P. j., Korsgaard, A., Jackson, G. m., Larsson, L., Ludolph, A. g., Martino, D., Menghetti, C., Mol Debes, N., Muller, N., Muller Vahl, K., Munchau, A., Murphy, T., Musil, R., Nagy, P., Nurnberger, J., Oostra, B., Paschou, P., Pasquini, M., Plessen, K. j., Porta, M., Rickards, H., Rizzo, R., Robertson, M. m., Roessner, V., Rothenberger, A., Servello, D., Skov, L., Stern, J. s., Strand, G., Tarnok, Z., Termine, C., Van Der Griendt, J., Verdellen, C., Visser Vandewalle, V., Wannag, E., Wolanczyck, T., University of Groningen, Clinic of Psychiatry, Socialpsychiatry and Psychotherapy, Hannover Medical School [Hannover] (MHH), Department of Clinical and Health Psychology, Utrecht University/Altrecht Academic Anxiety Outpatient Services, Department of Neuropsychiatry, Birmingham and Solihull Mental Health NHS Foundation, Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München (LMU), Movement Disorders and Tourette Centre, Department of Mental Health Sciences, UCL, Department of Neurosurgery, University Hospital Maastricht, Neurochirurgie, RS: MHeNs School for Mental Health and Neuroscience, Muller-Vahl, K, Cath, D, Cavanna, A, Dehning, S, Porta, M, Robertson, M, Visser-Vandewalle, V, and the ESSTS Guidelines, G

Subjects
Pediatrics, Tic, Tourette, Deep Brain Stimulation, Treatment, ASSESSMENT RECOMMENDATIONS, SURGERY, medicine.medical_treatment, DBS, Guideline, Tourette syndrome, law.invention, 0302 clinical medicine, Randomized controlled trial, law, Developmental and Educational Psychology, Deep brain stimulation, THALAMIC-STIMULATION, General Medicine, 3. Good health, Europe, Psychiatry and Mental health, Tics, Anxiety, medicine.symptom, Psychology, medicine.medical_specialty, NUCLEUS-ACCUMBENS, Context (language use), IMPROVEMENT, Guidelines, PATIENT SELECTION, 03 medical and health sciences, medicine, Humans, Tourette, Psychiatry, GLOBUS-PALLIDUS INTERNUS, Tic, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, medicine.disease, 030227 psychiatry, GPI, Supportive psychotherapy, Tic Disorders, Pediatrics, Perinatology and Child Health, 030217 neurology & neurosurgery, Tourette Syndrome
Abstract

International audience; Ten years ago deep brain stimulation (DBS) has been introduced as an alternative and promising treatment option for patients suffering from severe Tourette syndrome (TS). It seemed timely to develop a European guideline on DBS by a working group of the European Society for the Study of Tourette Syndrome (ESSTS). For a narrative review a systematic literature search was conducted and expert opinions of the guidelines group contributed also to the suggestions. Of 63 patients reported so far in the literature 59 had a beneficial outcome following DBS with moderate to marked tic improvement. However, randomized controlled studies including a larger number of patients are still lacking. Although persistent serious adverse effects (AEs) have hardly been reported, surgery-related (e.g., bleeding, infection) as well as stimulation-related AEs (e.g., sedation, anxiety, altered mood, changes in sexual function) may occur. At present time, DBS in TS is still in its infancy. Due to both different legality and practical facilities in different European countries these guidelines, therefore, have to be understood as recommendations of experts. However, among the ESSTS working group on DBS in TS there is general agreement that, at present time, DBS should only be used in adult, treatment resistant, and severely affected patients. It is highly recommended to perform DBS in the context of controlled trials.

Published
2011

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