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This is a report of experience with deep brain stimulation (DBS) in 18 patients with severe Gilles de la Tourette syndrome that was refractory to medication and psychobehavioral therapy. The stimulation targets were the bilateral centromedian–parafascicular complex and ventral oral nuclei of the thalamus. The main assessment instrument was the Yale Global Tic Severity Rating Scale. The study was open-label except for one double-blind assessment of nine patients during “on,” “off,” and sham “off” periods.
Overall, the patients improved significantly on the vocal-tic, motor-tic, and social-impairment components of the scale. Improvement was greater in the “on” than the “off” parameter. Patients experienced anxiety during the sham “off” period.…