Deep brain stimulation in Gilles de la Tourette syndrome: killing

In patients with severe, treatment-refractory Gilles de la Tourette syndrome (GTS), deep brain stimulation (DBS) of various targets has been increasingly explored over the past 15 years. The multiplicity of surgical targets is intriguing and may be partly due to the complexity of GTS, specifically the various and frequent associated psychiatric comorbidities in this disorder. Thus, the target choice may not only be aimed at reducing tics but also comorbidities. While this approach is laudable, it also carries the risk to increase confounding factors in DBS trials and patient evaluation. Moreover, I question whether DBS should really be expected to alleviate multiple symptoms at a time. Rather, I argue that tic reduction should remain our primary objective in severe GTS patients and that this intervention may subsequently allow an improved psychotherapeutic and/or pharmacological treatment of comorbidities. Thus, I consider DBS in GTS not as a single solution for all our patients’ ailments but as a stepping stone to improved holistic care made possible by tic reduction. This article is included in the collection. Tics Andreas Hartmann ( ) Corresponding author: [email protected] Competing interests: No competing interests were disclosed. Hartmann A. How to cite this article: Deep brain stimulation in Gilles de la Tourette syndrome: killing several birds with one stone? 2016, :2255 (doi: ) [version 1; referees: 3 approved] F1000Research 5 10.12688/f1000research.9521.1 © 2016 Hartmann A. This is an open access article distributed under the terms of the , which Copyright: Creative Commons Attribution Licence permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The author(s) is/are employees of the US Government and therefore domestic copyright protection in USA does not apply to this work. The work may be protected under the copyright laws of other jurisdictions when used in those jurisdictions. The author(s) declared that no grants were involved in supporting this work. Grant information: 07 Sep 2016, :2255 (doi: ) First published: 5 10.12688/f1000research.9521.1 1 2 3