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Commentary| Volume 79, ISSUE 5, P343-344, March 01, 2016

Deep Brain Stimulation for Tourette Syndrome: Lessons Learned and Future Directions

  • James F. Leckman
    Correspondence
    Address correspondence to: James F. Leckman, M.D., Ph.D., Child Study Center, Yale University School of Medicine, 230 South Frontage Road, New Haven, CT 06520-7900.
    Affiliations
    Child Study Center and Departments of Psychiatry, Pediatrics, and Psychology, Yale University, New Haven, Connecticut
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      Tourette syndrome (TS) is a childhood-onset neuropsychiatric disorder that affects neural circuits involved in sensory and motor processing as well as cognitive control. Tics consist of repetitive, unwanted, non–goal-directed muscle contractions involving discrete muscle groups, which are associated with preceding sensory phenomena (urges) and are variably suppressible by volition (
      ). Most individuals with TS experience improvement of their tics in late adolescence or early adulthood. However, a few individuals have severe and self-injurious tics that are refractory to currently available behavioral and pharmacologic interventions. Untreated, severe tics can lead to permanent disability and injury (e.g., severe head snapping tics leading to permanent injury to the cervical spinal cord or persistent eye-poking tics leading to blindness).
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      References

      1. Martino D. Leckman J.F. Tourette Syndrome. Oxford University Press, New York2013
        • Schrock L.E.
        • Mink J.W.
        • Woods D.W.
        • Porta M.
        • Servello D.
        • Visser-Vandewalle V.
        • et al.
        Tourette syndrome deep brain stimulation: A review and updated recommendations.
        Mov Disord. 2015; 30: 448-471
      2. Motlagh MG, Smith ME, Landeros-Weisenberger A, Kobets AJ, King RA, Miravite J, et al. (2013): Lessons learned from open-label deep brain stimulation for Tourette syndrome: Eight cases over 7 years [published online ahead of print Nov 1]. Tremor Other Hyperkinet Mov. 2013 Nov 1;3. pii: tre-03-170-4428-1. eCollection 2013.

        • Huys D.
        • Bartsch C.
        • Koester P.
        • Lenartz D.
        • Maarouf M.
        • Daumann J.
        • et al.
        Motor improvement and emotional stabilization in patients with Tourette syndrome after deep brain stimulation of the ventral anterior and ventrolateral motor part of the thalamus.
        Biol Psychiatry. 2016; 79: 392-401
        • Krishnan C.
        • Santos L.
        • Peterson M.D.
        • Ehinger M.
        Safety of noninvasive brain stimulation in children and adolescents.
        Brain Stimul. 2015; 8: 76-87
        • Landeros-Weisenberger A.
        • Mantovani A.
        • Motlagh M.G.
        • de Alvarenga P.G.
        • Katsovich L.
        • Leckman J.F.
        • Lisanby S.H.
        Randomized sham controlled double-blind trial of repetitive transcranial magnetic stimulation for adults with severe Tourette syndrome.
        Brain Stimul. 2015; 8: 574-581
        • Almeida L.
        • Martinez-Ramirez D.
        • Rossi P.J.
        • Peng Z.
        • Gunduz A.
        • Okun M.S.
        Chasing tics in the human brain: Development of open, scheduled and closed loop responsive approaches to deep brain stimulation for Tourette syndrome.
        J Clin Neurol. 2015; 11: 122-131
        • Martino D.
        • Zis P.
        • Buttiglione M.
        The role of immune mechanisms in Tourette syndrome.
        Brain Res. 2015; 1617: 126-143
        • Wu Y.
        • Dissing-Olesen L.
        • MacVicar B.A.
        • Stevens B.
        Microglia: Dynamic mediators of synapse development and plasticity.
        Trends Immunol. 2015; 36: 605-613
        • Lennington J.B.
        • Coppola G.
        • Kataoka-Sasaki Y.
        • Fernandez T.V.
        • Palejev D.
        • Li Y.
        • et al.
        Transcriptome analysis of the human striatum in Tourette syndrome.
        Biol Psychiatry. 2016; 79: 372-382

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