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Here, we present a revised version of these guidelines with updated recommendations based on the current literature covering the last decade as well as a survey among ESSTS experts. Currently, data from the International Tourette DBS Registry and Database, two meta-analyses, and eight randomized controlled trials (RCTs) are available. Interpretation of outcomes is limited by small sample sizes and short follow-up periods. Compared to open uncontrolled case studies, RCTs report less favorable outcomes with conflicting results. This could be related to several different aspects including methodological issues, but also substantial placebo effects. These guidelines, therefore, not only present currently available data from open and controlled studies, but also include expert knowledge. Although the overall database has increased in size since 2011, definite conclusions regarding the efficacy and tolerability of DBS in TS are still open to debate. Therefore, we continue to consider DBS for TS as an experimental treatment that should be used only in carefully selected, severely affected and otherwise treatment-resistant patients.<\/jats:p>","DOI":"10.1007\/s00787-021-01881-9","type":"journal-article","created":{"date-parts":[[2021,10,4]],"date-time":"2021-10-04T22:20:44Z","timestamp":1633386044000},"page":"443-461","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":60,"title":["European clinical guidelines for Tourette syndrome and other tic disorders\u2014version 2.0. 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CG received research grants from the\u00a0VolkswagenStiftung\u00a0(Freigeist\u00a0Fellowship) and the German Parkinson Society and was also supported by the Deutsche\u00a0Forschungsgemeinschaft\u00a0(GA2031\/1-1 and GA2031\/1-2) and Actelion Pharmaceuticals. He also received financial support\/honoraria to speak at meetings by Actelion pharmaceuticals and as ad hoc advisory board for Lundbeck. CD has been awarded travel grants from Medtronic, Boston Scientific and Merz Pharma. AFGL\u00a0received\u00a0a research grant from the Michael J Fox Foundation and royalties from Springer media. TF\u00a0received honoraria for talks sponsored by Boston scientific,\u00a0Bial\u00a0and Profile Pharma.\u00a0He also was funded with grants from NIHR, Innovate UK, Cure Parkinson\u2019s trust, Michael J Fox foundation, John Black Charitable Foundation, Van\u00a0Andel\u00a0Institute and Defeat MSA. JK\u00a0has received financial support for Investigator initiated trials from Medtronic GmbH and grants from the German Research Foundation (KU2665\/1-2) and the\u00a0Marga\u00a0and Walter Boll Foundation. KMV has received financial or material research support from EU (FP7-HEALTH-2011 No. 278367, FP7-PEOPLE-2012-ITN No. 316978) DFG: GZ MU 1527\/3-1 and GZ MU 1527\/3-2, BMBF: 01KG1421, National Institute of Mental Health (NIMH), Tourette Gesellschaft Deutschland e.V. Else-Kr\u00f6ner-Fresenius-Stiftung, GW pharmaceuticals, Almirall Hermal GmbH, Abide Therapeutics, and Therapix Biosiences. She has received consultant's honoraria from Abide Therapeutics, Boehringer Ingelheim International GmbH, Bionorica Ethics GmbH, CannaMedical Pharma GmbH, Canopy Grouth, Columbia Care, CTC Communications Corp., Demecan, Eurox Deutschland GmbH, Global Praxis Group Limited, IMC Germany, Lundbeck, Sanity Group, Stadapharm GmbH, Synendos Therapeutics AG, and Tilray. She is an advisory\/scientific board member for CannaMedical Pharma GmbH, Bionorica Ethics GmbH, CannaXan GmbH, Canopy Growth, Columbia Care, IMC Germany, Leafly Deutschland GmbH, Sanity Group, Syqe Medical Ltd., Therapix Biosciences Ltd., and Wayland Group. She has received speaker\u2019s fees from Aphria Deutschland GmbH, Almirall, Cogitando GmbH, Emalex, Eurox Deutschland GmbH, Ever pharma GmbH, Meinhardt Congress GmbH, PR Berater, Spectrum Therapeutics GmbH, Takeda GmbH, Tilray, Wayland Group. She has received royalties fromDeutsches \u00c4rzteblatt, Der Neurologie und Psychiater, Elsevier, Medizinisch Wissenschaftliche Verlagsgesellschaft Berlin, and Kohlhammer. She served as a guest editor for Frontiers in Neurology on the research topic \u201cThe neurobiology and genetics of Gilles de la Tourette syndrome: new avenues through large-scale collaborative projects\u201d, is an associate editor for \u201cCannabis and Cannabinoid Research\u201d and an Editorial Board Member of \u201cMedical Cannabis and Cannabinoids\u201d und \u201cMDPI-Reports\u201d and a Scientific board member for \u201cZeitschrift f\u00fcr Allgemeinmedizin\u201d. AH has received consultancy honoraria from Lundbeck and Noema\u00a0Pharma.\u00a0He has received research grants from the Association Fran\u00e7aise pour le Syndrome Gilles de la Tourette (AFSGT).\u00a0DC received grant from the EU (TS EUROTRAIN), grant nr. 316978),\u00a0several\u00a0grants from ZONMW and MAGW (the Netherlands), from TSA-USA (2008), from Sunovion (DS028 (2019). From\u00a0Espria\u00a0fonds, Drenthe, the Netherlands.\u00a0She has received\u00a0speakers\u2019\u00a0fees from ECNP,\u00a0Psyfar,\u00a0Benecke, Pfizer. JCB and VVV area funded by the Deutsche Forschungsgemeinschaft, German Research Foundation (Project-ID: 431549029\u2013SFB 1451). All other authors have no conflicts to declare.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}