Neuropsychiatric Outcome of an Adolescent Who Received Deep Brain Stimulation for Tourette's Syndrome

Table 1

Results of neurologic examination, neurocognitive testing, and psychotropic medication load pre- and postelectrode implantation.

Electrode placement	Bilateral centromedian parafascicular complex (CM-Pf)	Preimplantation	Postimplantation
Neurologic testing	YGTSS Scores^a	Date of testing; 12-22-2009	Date of testing; 08-05-2010
	Number motor	2	1
	Number phonic	1	0
	Frequency motor	5	1
	Frequency phonic	2	0
	Intensity motor	5	2
	Intensity phonic	2	0
	Complexity motor	2	0
	Complexity phonic	1	0
	Interference motor	5	0
	Interference phonic	2	0
	Overall impairment	50	10
	Global severity	77	14
Neurocognitive testing	WAIS-III/IV^b	Date of testing; 12-23-2009	Date of testing; 08-02-2010
	Full scale IQ	76	74
	Verbal comprehension	84	78
	Perceptual organization	76	73
	Working memory	80	86
	Processing speed	76	81
Psychosocial testing	BASC^c	Date of testing; 12-23-2009	Date of testing; 08-02-2010
Clinical scales	Hyperactivity	68	59
	Aggression	52	45
	Conduct problems	56	56
	Anxiety	79	59
	Depression	78	52
	Somatization	69	54
	Atypicality	69	49
	Withdrawal	53	42
	Attention problems	63	55
Adaptive scales	Adaptability	33	49
	Social skills	52	62
	Leadership	40	53
	Activities daily living	32	45
	Functional communication	39	53
Composite scales	Externalizing problems	60	54
	Internalizing problems	81	56
	Behavioral symptoms index	68	50
	Adaptive skills	37	53
Psychiatric evaluation	Psychotropic medications^d	Date of evaluation; 12-22-2009	Date of evaluation; 08-05-2010
		Aripiprazole 30 mg; Diazepam 20 mg; Divalproex sodium 3000 mg; Guanfacine 2.5 mg; Quetiapine 400 mg; Risperidone 1.5 mg	Risperidone 6 mg; Guanfacine 2 mg

^aYGTSS:Yale Global Tic Severity Scale.
^bWAIS-III/IV: Wechsler Adult Intelligence Scale-III/IV—Standard scores with a general population mean of 100 and a standard deviation of 15 are reported here. The WAIS III was administered preimplantation. The WAIS IV was administered postimplantation.
^cBASC: Behavior Assessment System for Children, Second Edition Ages 12–21; raw test scores reported here. A score reduction on items within clinical scales reflects relative improvement in the different measures of psychiatric symptomatology, whereas a score increase on items within adaptive scales reflects a relative improvement on different measures of adaptive functioning. Within the composite scales, a score reduction in the domains of externalizing symptoms, internalizing symptoms, and behavioral symptoms reflects relative improvement, whereas a score increase in the adaptive skills domain reflects relative improvement.
^dPsychotropic medications reported as maximum daily dosages prescribed to patient.