Why so many deep brain stimulation targets in Tourette’s syndrome? Toward a broadening of the definition of the syndrome

Excerpt

Tourette’s syndrome (TS) is a neuro-developmental disorder characterized by simple or complex motor and sound tics starting before age 18 and that last for more than 1 year (TSA definition). TS can be considered as a sensory-sensitive-motor circuit dysfunction along with a strong behavioural component (Zapparoli et al. 2015a, b). It typically affects males more frequently than females (Khalifa and von Knorring 2003). The prevalence of tic disorder is about 0.85–1 % in the adults and up to 20 % in children according to (Robertson 2015). In the whole spectrum 90 % of patients present with at least one co-morbidity, such as obsessive–compulsive disorder (OCD), learning difficulty, poor impulse control, self-injury behaviour (SIB), attention-deficit-hyperactive-disorder (ADHD), non-obscene socially inappropriate behaviour (NOSI) and autistic spectrum disorder (Eapen et al. 2015; Robertson et al. 2015). Coexisting diseases are depression and anxiety symptoms (Robertson 2015). Tics are the main components in childhood, whereas OCD and other psychopathological traits are encountered more frequently in adolescence. …