{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:10:38Z","timestamp":1772169038319,"version":"3.50.1"},"reference-count":12,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2016,9,7]],"date-time":"2016-09-07T00:00:00Z","timestamp":1473206400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns4:p>In patients with severe, treatment-refractory Gilles de la Tourette syndrome (GTS), deep brain stimulation (DBS) of various targets has been increasingly explored over the past 15 years. The multiplicity of surgical targets is intriguing and may be partly due to the complexity of GTS, specifically the various and frequent associated psychiatric comorbidities in this disorder. Thus, the target choice may not only be aimed at reducing tics but also comorbidities. While this approach is laudable, it also carries the risk to increase confounding factors in DBS trials and patient evaluation. Moreover, I question whether DBS should really be expected to alleviate multiple symptoms at a time. Rather, I argue that tic reduction should remain our primary objective in severe GTS patients and that this intervention may subsequently allow an improved psychotherapeutic and\/or pharmacological treatment of comorbidities. Thus, I consider DBS in GTS not as a single solution for all our patients\u2019 ailments but as a stepping stone to improved holistic care made possible by tic reduction.<\/ns4:p>","DOI":"10.12688\/f1000research.9521.1","type":"journal-article","created":{"date-parts":[[2016,9,7]],"date-time":"2016-09-07T07:26:03Z","timestamp":1473233163000},"page":"2255","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Deep brain stimulation in Gilles de la Tourette syndrome: killing several birds with one stone?"],"prefix":"10.12688","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0335-984X","authenticated-orcid":false,"given":"Andreas","family":"Hartmann","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2016,9,7]]},"reference":[{"key":"ref-1","doi-asserted-by":"publisher","first-page":"325-33","DOI":"10.1001\/jamapsychiatry.2014.2650","article-title":"Lifetime prevalence, age of risk, and genetic relationships of comorbid psychiatric disorders in Tourette syndrome.","volume":"72","author":"M Hirschtritt","year":"2015","journal-title":"JAMA Psychiatry."},{"key":"ref-2","doi-asserted-by":"publisher","first-page":"992-5","DOI":"10.1136\/jnnp.2004.043273","article-title":"Tourette's syndrome and deep brain stimulation.","volume":"76","author":"J Houeto","year":"2005","journal-title":"J Neurol Neurosurg Psychiatry."},{"key":"ref-3","doi-asserted-by":"publisher","first-page":"595-605","DOI":"10.1016\/S1474-4422(15)00008-3","article-title":"Bilateral globus pallidus stimulation for severe Tourette's syndrome: a double-blind, randomised crossover trial.","volume":"14","author":"Z Kefalopoulou","year":"2015","journal-title":"Lancet Neurol."},{"key":"ref-4","doi-asserted-by":"publisher","first-page":"22-7","DOI":"10.1016\/j.jocn.2013.05.011","article-title":"The latest evidence on target selection in deep  brain stimulation for Parkinson's disease.","volume":"21","author":"T Lukins","year":"2014","journal-title":"J Clin Neurosci."},{"key":"ref-5","doi-asserted-by":"publisher","first-page":"2121-34","DOI":"10.1056\/NEJMoa0708514","article-title":"Subthalamic nucleus stimulation in severe obsessive-compulsive disorder.","volume":"359","author":"L Mallet","year":"2008","journal-title":"N Engl J Med."},{"key":"ref-6","doi-asserted-by":"publisher","first-page":"3515-22","DOI":"10.1017\/S0033291714000956","article-title":"Cognitive-behavioural therapy augments the effects of deep brain stimulation in obsessive-compulsive disorder.","volume":"44","author":"M Mantione","year":"2014","journal-title":"Psychol Med."},{"key":"ref-7","doi-asserted-by":"publisher","first-page":"125-31","DOI":"10.3233\/BEN-120288","article-title":"Selection of patients with Tourette syndrome for deep brain stimulation surgery.","volume":"27","author":"M Porta","year":"2013","journal-title":"Behav Neurol."},{"key":"ref-8","doi-asserted-by":"publisher","first-page":"68-87","DOI":"10.1016\/S2215-0366(14)00132-1","article-title":"A personal 35 year perspective on Gilles de la Tourette syndrome: prevalence, phenomenology, comorbidities, and coexistent psychopathologies.","volume":"2","author":"M Robertson","year":"2015","journal-title":"Lancet Psychiatry."},{"key":"ref-9","doi-asserted-by":"publisher","first-page":"106-13","DOI":"10.1016\/j.ajp.2014.05.010","article-title":"Tourette's: syndrome, disorder or spectrum? 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A Cohort of 48 Patients.","volume":"78","author":"D Servello","year":"2016","journal-title":"Neurosurgery."},{"key":"ref-12","doi-asserted-by":"publisher","first-page":"952-7","DOI":"10.1001\/archneur.65.7.952","article-title":"Internal pallidal and thalamic stimulation in patients with Tourette syndrome.","volume":"65","author":"M Welter","year":"2008","journal-title":"Arch Neurol."}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/5-2255\/v1\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/5-2255\/v1\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/5-2255\/v1\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,4,6]],"date-time":"2020-04-06T03:25:10Z","timestamp":1586143510000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/5-2255\/v1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,9,7]]},"references-count":12,"URL":"https:\/\/doi.org\/10.12688\/f1000research.9521.1","relation":{"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.10256.r16159","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.10256.r16164","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.10256.r16161","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.10256.r16159","asserted-by":"object"},{"id-type":"doi","id":"10.5256\/f1000research.10256.r16164","asserted-by":"object"},{"id-type":"doi","id":"10.5256\/f1000research.10256.r16161","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,9,7]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/5-2255\/v1#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.10256.r16164, Andrea Cavanna, Department of Neuropsychiatry, University of Birmingham, Birmingham, UK, 19 Sep 2016, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/5-2255\/v1#referee-response-16164","order":0,"name":"referee-response-16164","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.10256.r16161, Jeremy S. 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