Effects of stereotactic radiofrequency thermocoagulation in the globus pallidus internus on refractory tic disorders

Figures & data

Figure 1. Seventeen-year-old man with refractory tic disorders treated with stereotactic radiofrequency thermocoagulation. A. Magnetic resonance imaging (MRI) scan performed for localization of the globus pallidus internus on the axial plane. B. Localization of the globus pallidus internus on the coronal plane of MRI. C. Targeted globus pallidus internus on both sides of the brain. D. Head MRI scan one year after the thermocoagulation, revealing the lesion of thermocoagulation in the right globus pallidus internus. The patient exhibited excellent improvement with no tic symptoms. The arrow indicates the damaged right globus pallidus internus.

Table 1. YGTSS scores before and after surgery (mean ± SD).

Variables	Before surgery	6m after surgery	12m after surgery	p
Motor tic score (range)	23.02 ± 2.21 (20.30–28.65)	7.36 ± 2.15 (5.53–10.38)	6.45 ± 1.68 (2.55–9.26)	<0.05
Vocal tic score (range)	20.26 ± 2.58 (16.82–25.74)	6.63 ± 2.82 (4.96–8.52)	5.52 ± 1.71 (3.15–8.11)	<0.05
Total severity score (range)	75.68 ± 5.71 (68.35–83.18)	21.28 ± 6.92 (12.22–25.68)	19.05 ± 2.32 (15.29–23.34)	<0.05

Note: YGTSS: Yale Global Tic Severity Scale; SD: standard deviation; p < 0.05 indicates a significant difference in the data at 6 m or 12 m after surgery compared with those before surgery.

Table 2. SDA and 5-HT before and after surgery (mean ± SD, ng/ml).

Variables	Before surgery	6 m after surgery	12 m after surgery	p
SDA (range)	125.63 ± 35.26 (88.60–178.85)	80.78 ± 18.82 (62.35–102.87)	75.65 ± 15.23 (55.62–92.91)	<0.05
5-HT (range)	35.62 ± 3.41 (29.33–41.78)	58.93 ± 16.88 (38.96–65.56)	62.63 ± 15.21 (40.95–85.49)	<0.05

Note: SDA: serum dopamine; 5-HT: 5- hydroxytryptamine; SD: standard deviation; p < 0.05 indicates a significant difference in the data at 6 m or 12 m after surgery compared with those before surgery.