Investigating Responsive Neurostimulation (RNS) Therapy for Adults with Treatment-resistant Tourette's Syndrome Using Stereoelectroencephalography (SEEG) to Guide Personalized Brain Stimulation

What this Trial Is About

Researchers are evaluating the effect of personalized responsive neurostimulation (RNS) therapy guided by stereoelectroencephalography (SEEG) in adults with treatment-resistant Tourette's Syndrome (TR-TS). Tourette's Syndrome is a neurodevelopmental disorder causing repetitive, involuntary movements and vocalizations called tics, often starting in childhood and sometimes persisting into adulthood. This study focuses on patients whose symptoms have not improved with standard treatments like behavioral therapy and medications and aims to understand how SEEG-guided RNS can help manage these severe symptoms. It also explores neuronal activity in several brain targets including GPi, amGPi, pvGPi, Cm-Spv-Voi, Cm-Voi, and NA-ALIC, and optionally involves cognitive tasks and unexpected reward tests. The study involves implanting an RNS device where a lead is stereotactically placed into specific brain targets and connected to a neurostimulator implanted under the skin near the collarbone. This device delivers responsive stimulation tailored to the individual's brain activity to address their tics. Some participants may also take part in an optional related study using positron emission tomography (PET) scans to observe how brain activity changes in response to the stimulation. Participants will be involved in assessments over 12 months, including evaluation of tic severity using the Yale Global Tic Severity Scale (YGTSS) to measure changes from baseline to one year after surgery. Researchers will monitor neuronal activity, cognitive responses, and safety throughout the study. The total duration includes the implantation procedure, follow-up visits, and ongoing monitoring, with optional PET scanning for additional brain activity data.

Effect of RNS in Treatment-refractory Tourette's Syndrome