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Behavioural Neurology
Volume 27, Issue 1, Pages 125-131
http://dx.doi.org/10.3233/BEN-120288

Selection of Patients with Tourette Syndrome for Deep Brain Stimulation Surgery

Mauro Porta,1 Andrea E. Cavanna,2,3 Edvin Zekaj,4 Francesca D'Adda,1 and Domenico Servello4

1Tourette Centre, IRCCS Galeazzi Hospital, Milan, Italy
2The Michael Trimble Neuropsychiatry Research Group, Department of Neuropsychiatry, BSMHFT and University of Birmingham, Birmingham, UK
3Sobell Department of Motor Neuroscience and Movement Disorders, UCL and Institute of Neurology, London, UK
4Functional Neurosurgery Unit, IRCCS Galeazzi Hospital, Milan, Italy

Received 23 November 2012; Accepted 23 November 2012

Copyright © 2013 Hindawi Publishing Corporation and the authors. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.