Gilles de la Tourette Syndrome Clinical Trial
Official title:
Treatment of Gilles de la Tourette Syndrome by Bilateral Stimulation of the Internal Part of the Globus PALLIDUS
The aim of this study is to evaluate the efficacy and safety of bilateral pallidal stimulation in patients with a severe form of Gilles de la Tourette syndrome.
It acts of a randomized study, in parallel, double group blind, multi-centric relating to 14
patients.
The interest of this multicentric study, which will be carried out in centers specialized in
the field of major cerebral stimulation with for each one a multidisciplinary team, is to
carry out a homogeneous protocol which should make it possible to give a clear response in
term of effectiveness for this treatment in this pathology.
The evaluation will be:
1. neurological (YGTSS, video scale of the tics);
2. psychiatric, with in particular of the specific psychopathological evaluations centered
on mood;
3. neuropsychological, centered on impulsiveness;
4. functional calculus evaluating total operation and the social adaptation;
5. neurophysiological (recording of the neuronal activities).
Calculations of the number of subjects necessary showed, by laying down the principal
objective at an improvement of at least 60 % of the score of the YGTSS under treatment,
which 14 subjects will make it possible to show a significant difference with the procedure
placebo.
Study in Tomography by Emission of Positrons (Mtoe) carried out on 8 of the 14 operated
patients having had at least 3 months of stimulation, in comparison on 8 pilot subjects
(paired for the sex and the age), should make it possible to determine, at the time of the
improvement of the driving symptoms, modifications of cerebral activation induced by the
high frequency stimulation of GPI among patients.
The association of this study to the comparison of the improvement of the neurological
symptoms with the precise localization of the therapeutic stud of the electrode reformatted
on the post-operative TDM (8), carried out for all the patients, should make it possible to
specify the anatomy-physiological bases to specify the anatomy-physiological bases of the
MGT The duration of the study will be 14 month for each patient, that is to say one 2 months
preoperative period intended for inclusion; one 3 months post-operative period without
stimulation; one period randomized with stimulation either "one" (3 months), or "off" (3
months), then an open study for all the patients with stimulation "one" for one 6 months
duration.
It is envisaged to include 14 patients reached of the MGT (of which 8 will take part in
study Mtoe) and 8 subjects controls for study Mtoe is 22 subjects.
An observational follow-up at 30 and 48 months is added.
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