Affiliations: Tourette Centre, IRCCS Galeazzi Hospital, Milan,
Italy | The Michael Trimble Neuropsychiatry Research Group,
Department of Neuropsychiatry, BSMHFT and University of Birmingham, Birmingham,
UK | Sobell Department of Motor Neuroscience and Movement
Disorders, UCL and Institute of Neurology, London, UK | Functional Neurosurgery Unit, IRCCS Galeazzi Hospital,
Milan, Italy
Note: [] Corresponding author: Mauro Porta, Tourette Centre, IRCCS
Galeazzi Hospital, Via R. Galeazzi 4, 20161 Milan, Italy. Tel.: +39
02/66214933; Fax: +39 02/66214916; E-mail: portamilano@libero.it
Abstract: Deep brain stimulation (DBS) is an emerging therapeutic option for
severe resistant Tourette syndrome (TS). To date, about 100~cases have been
reported in the scientific literature. Different clinical guidelines have been
proposed for this procedure from both USA and European centres. A number of
issues remain unresolved, mainly in relation to eligibility criteria of
patients with TS. We highlight the need for a comprehensive assessment of
associated co-morbidities, which are not considered integral part of the
syndrome and are not sufficiently evaluated in relation to DBS. The concept of
refractoriness, the minimum age of candidates, and the optimal targets for DBS
are also controversial.
Keywords: Deep brain stimulation, Tourette syndrome, tics, co-morbidities, selection criteria
