{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T21:11:42Z","timestamp":1784322702144,"version":"3.55.0"},"reference-count":38,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2017,12,23]],"date-time":"2017-12-23T00:00:00Z","timestamp":1513987200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Deep brain stimulation (DBS) has emerged as a novel therapy for the treatment of several movement and neuropsychiatric disorders, and may also be suitable for the treatment of Tourette syndrome (TS). The main DBS targets used to date in patients with TS are located within the basal ganglia-thalamo-cortical circuit involved in the pathophysiology of this syndrome. They include the ventralis oralis\/centromedian-parafascicular (Vo\/CM-Pf) nucleus of the thalamus and the nucleus accumbens. Current DBS treatments deliver continuous electrical stimulation and are not designed to adapt to the patient\u2019s symptoms, thereby contributing to unwanted side effects. Moreover, continuous DBS can lead to rapid battery depletion, which necessitates frequent battery replacement surgeries. Adaptive deep brain stimulation (aDBS), which is controlled based on neurophysiological biomarkers, is considered one of the most promising approaches to optimize clinical benefits and to limit the side effects of DBS. aDBS consists of a closed-loop system designed to measure and analyse a control variable reflecting the patient\u2019s clinical condition and to modify on-line stimulation settings to improve treatment efficacy. Local field potentials (LFPs), which are sums of pre- and post-synaptic activity arising from large neuronal populations, directly recorded from electrodes implanted for DBS can theoretically represent a reliable correlate of clinical status in patients with TS. The well-established LFP-clinical correlations in patients with Parkinson\u2019s disease reported in the last few years provide the rationale for developing and implementing new aDBS devices whose efficacies are under evaluation in humans. Only a few studies have investigated LFP activity recorded from DBS target structures and the relationship of this activity to clinical symptoms in TS. Here, we review the available literature supporting the feasibility of an LFP-based aDBS approach in patients with TS. In addition, to increase such knowledge, we report explorative findings regarding LFP data recently acquired and analysed in patients with TS after DBS electrode implantation at rest, during voluntary and involuntary movements (tics), and during ongoing DBS. Data available up to now suggest that patients with TS have oscillatory patterns specifically associated with the part of the brain they are recorded from, and thereby with clinical manifestations. The Vo\/CM-Pf nucleus of the thalamus is involved in movement execution and the pathophysiology of TS. Moreover, the oscillatory patterns in TS are specifically modulated by DBS treatment, as reflected by improvements in TS symptoms. These findings suggest that LFPs recorded from DBS targets may be used to control new aDBS devices capable of adaptive stimulation responsive to the symptoms of TS.<\/jats:p>","DOI":"10.3390\/brainsci8010004","type":"journal-article","created":{"date-parts":[[2017,12,26]],"date-time":"2017-12-26T03:06:38Z","timestamp":1514257598000},"page":"4","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Adaptive Deep Brain Stimulation (aDBS) for Tourette Syndrome"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0456-866X","authenticated-orcid":false,"given":"Sara","family":"Marceglia","sequence":"first","affiliation":[{"name":"Clinical Center for Neurostimulation, Neurotechnology and Movement Disorders, Fondazione Istituto Ricovero e Cura a Carattere Scientifico (IRCCS) Ca\u2019 Granda, Ospedale Maggiore Policlinico, Milan 20122, Italy"},{"name":"Dipartimento di Ingegneria e Architettura, Universit\u00e0 degli Studi di Trieste, Trieste 34127, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Rosa","sequence":"additional","affiliation":[{"name":"Clinical Center for Neurostimulation, Neurotechnology and Movement Disorders, Fondazione Istituto Ricovero e Cura a Carattere Scientifico (IRCCS) Ca\u2019 Granda, Ospedale Maggiore Policlinico, Milan 20122, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Servello","sequence":"additional","affiliation":[{"name":"Functional Neurosurgery Unit, Galeazzi Hospital and Tourette Center, Milan 20161, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Porta","sequence":"additional","affiliation":[{"name":"Functional Neurosurgery Unit, Galeazzi Hospital and Tourette Center, Milan 20161, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Barbieri","sequence":"additional","affiliation":[{"name":"Clinical Center for Neurostimulation, Neurotechnology and Movement Disorders, Fondazione Istituto Ricovero e Cura a Carattere Scientifico (IRCCS) Ca\u2019 Granda, Ospedale Maggiore Policlinico, Milan 20122, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Moro","sequence":"additional","affiliation":[{"name":"Division of Neurology, Centre Hospitalier Universitaire de Grenoble, CS 10217, 38043 Grenoble, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Priori","sequence":"additional","affiliation":[{"name":"\u201cAldo Ravelli\u201d Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Milan 20142 , Italy"},{"name":"Department of Health Sciences, University of Milan &amp; ASST Santi Paolo e Carlo, Milan 20142, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2017,12,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.pnpbp.2016.02.003","article-title":"Treatment-Refractory Tourette Syndrome","volume":"70","author":"Kious","year":"2016","journal-title":"Prog. Neuropsychopharmacol. Biol. Psychiatry"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1002\/mds.26094","article-title":"Tourette Syndrome Deep Brain Stimulation: A Review and Updated Recommendations","volume":"30","author":"Schrock","year":"2015","journal-title":"Mov. Disord. Off. J. Mov. Disord. Soc."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1002\/mds.26890","article-title":"Current Applications and Limitations of Surgical Treatments for Movement Disorders: Surgical Treatments For Movement Disorders","volume":"32","author":"Krack","year":"2017","journal-title":"Mov. Disord."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.nec.2013.08.009","article-title":"Deep Brain Stimulation for Tourette Syndrome","volume":"25","author":"Kim","year":"2014","journal-title":"Neurosurg. Clin. N. Am."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1016\/S1474-4422(17)30160-6","article-title":"Anterior Pallidal Deep Brain Stimulation for Tourette\u2019s Syndrome: A Randomised, Double-Blind, Controlled Trial","volume":"16","author":"Welter","year":"2017","journal-title":"Lancet Neurol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"308","DOI":"10.3389\/fnhum.2017.00308","article-title":"Deep Brain Stimulation of the H Fields of Forel Alleviates Tics in Tourette Syndrome","volume":"11","author":"Neudorfer","year":"2017","journal-title":"Front. Hum. Neurosci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2255","DOI":"10.12688\/f1000research.9521.1","article-title":"Deep Brain Stimulation in Gilles de La Tourette Syndrome: Killing Several Birds with One Stone?","volume":"5","author":"Hartmann","year":"2016","journal-title":"F1000Research"},{"key":"ref_8","first-page":"218","article-title":"Sixteen Years of Deep Brain Stimulation in Tourette\u2019s Syndrome: A Critical Review","volume":"60","author":"Servello","year":"2016","journal-title":"J. Neurosurg. Sci."},{"key":"ref_9","unstructured":"Dowd, R.S., Pourfar, M., and Mogilner, A.Y. (2017). Deep Brain Stimulation for Tourette Syndrome: A Single-Center Series. J. Neurosurg., 1\u20139."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"134","DOI":"10.4103\/sni.sni_15_17","article-title":"Deep Brain Stimulation for Psychiatric Disorders: Is There an Impact on Social Functioning?","volume":"8","author":"Saleh","year":"2017","journal-title":"Surg. Neurol. Int."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Smeets, A.Y.J.M., Duits, A.A., Leentjens, A.F.G., Schruers, K., van Kranen-Mastenbroek, V., Visser-Vandewalle, V., Temel, Y., and Ackermans, L. (2017). Thalamic Deep Brain Stimulation for Refractory Tourette Syndrome: Clinical Evidence for Increasing Disbalance of Therapeutic Effects and Side Effects at Long-Term Follow-Up. Neuromodulation J. Int. Neuromodulation Soc.","DOI":"10.1111\/ner.12556"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1002\/ana.23951","article-title":"Adaptive Deep Brain Stimulation in Advanced Parkinson Disease","volume":"74","author":"Little","year":"2013","journal-title":"Ann. Neurol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1002\/mds.26241","article-title":"Adaptive Deep Brain Stimulation in a Freely Moving Parkinsonian Patient","volume":"30","author":"Rosa","year":"2015","journal-title":"Mov. Disord. Off. J. Mov. Disord. Soc."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1002\/mds.26953","article-title":"Adaptive Deep Brain Stimulation Controls Levodopa-Induced Side Effects in Parkinsonian Patients","volume":"32","author":"Rosa","year":"2017","journal-title":"Mov. Disord. Off. J. Mov. Disord. Soc."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.parkreldis.2016.05.033","article-title":"Scheduled, Intermittent Stimulation of the Thalamus Reduces Tics in Tourette Syndrome","volume":"29","author":"Rossi","year":"2016","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1001\/jamaneurol.2013.580","article-title":"A Trial of Scheduled Deep Brain Stimulation for Tourette Syndrome: Moving Away From Continuous Deep Brain Stimulation Paradigms","volume":"70","author":"Okun","year":"2013","journal-title":"JAMA Neurol."},{"key":"ref_17","first-page":"436","article-title":"GPi Oscillatory Activity Differentiates Tics from the Resting State, Voluntary Movements, and the Unmedicated Parkinsonian State","volume":"10","author":"Telkes","year":"2016","journal-title":"Front. Neurosci."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1578","DOI":"10.1016\/j.clinph.2014.10.217","article-title":"Tic Related Local Field Potentials in the Thalamus and the Effect of Deep Brain Stimulation in Tourette Syndrome: Report of Three Cases","volume":"126","author":"Bour","year":"2015","journal-title":"Clin. Neurophysiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.nicl.2016.06.015","article-title":"Thalamocortical Network Activity Enables Chronic Tic Detection in Humans with Tourette Syndrome","volume":"12","author":"Shute","year":"2016","journal-title":"NeuroImage Clin."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1002\/mds.22982","article-title":"Thalamic Single-Unit and Local Field Potential Activity in Tourette Syndrome","volume":"25","author":"Marceglia","year":"2010","journal-title":"Mov. Disord. Off. J. Mov. Disord. Soc."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1016\/j.neubiorev.2013.01.011","article-title":"Deep Brain Electrophysiological Recordings Provide Clues to the Pathophysiology of Tourette Syndrome","volume":"37","author":"Priori","year":"2013","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.parkreldis.2016.03.020","article-title":"The Adaptive Deep Brain Stimulation Challenge","volume":"28","author":"Arlotti","year":"2016","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2510","DOI":"10.1016\/j.clinph.2005.05.009","article-title":"Basal Ganglia Local Field Potential Activity: Character and Functional Significance in the Human","volume":"116","author":"Brown","year":"2005","journal-title":"Clin. Neurophysiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1113\/jphysiol.2005.089722","article-title":"Movement-Related Frequency Modulation of Beta Oscillatory Activity in the Human Subthalamic Nucleus","volume":"568","author":"Foffani","year":"2005","journal-title":"J. Physiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1586\/ern.10.184","article-title":"What Neurophysiological Recordings Tell Us about Cognitive and Behavioral Functions of the Human Subthalamic Nucleus","volume":"11","author":"Marceglia","year":"2011","journal-title":"Expert Rev. Neurother."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1016\/j.expneurol.2012.06.012","article-title":"Subthalamic Local Field Potentials after Seven-Year Deep Brain Stimulation in Parkinson\u2019s Disease","volume":"237","author":"Giannicola","year":"2012","journal-title":"Exp. Neurol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"15222","DOI":"10.1073\/pnas.96.26.15222","article-title":"Thalamocortical Dysrhythmia: A Neurological and Neuropsychiatric Syndrome Characterized by Magnetoencephalography","volume":"96","author":"Ribary","year":"1999","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1109\/TNSRE.2007.907893","article-title":"Interaction between Rhythms in the Human Basal Ganglia: Application of Bispectral Analysis to Local Field Potentials","volume":"15","author":"Marceglia","year":"2007","journal-title":"IEEE Trans. Neural Syst. Rehabil. Eng."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1748","DOI":"10.1093\/brain\/awl103","article-title":"Slow Oscillatory Activity and Levodopa-Induced Dyskinesias in Parkinson\u2019s Disease","volume":"129","author":"Zamarbide","year":"2006","journal-title":"Brain J. Neurol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1136\/jnnp.2006.104067","article-title":"Deep Brain Stimulation in 18 Patients with Severe Gilles de La Tourette Syndrome Refractory to Treatment: The Surgery and Stimulation","volume":"79","author":"Servello","year":"2008","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1109\/TAU.1967.1161901","article-title":"The Use of Fast Fourier Transform for the Estimation of Power Spectra: A Method Based on Time Averaging over Short, Modified Periodograms","volume":"15","author":"Welch","year":"1967","journal-title":"IEEE Trans. Audio Electroacoustics"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1644","DOI":"10.1002\/mds.25427","article-title":"Pathological Gambling in Parkinson\u2019s Disease: Subthalamic Oscillations during Economics Decisions: STN Oscillations in Gambling","volume":"28","author":"Rosa","year":"2013","journal-title":"Mov. Disord."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1176\/appi.neuropsych.16070141","article-title":"Neurobiology of the Premonitory Urge in Tourette\u2019s Syndrome: Pathophysiology and Treatment Implications","volume":"29","author":"Cavanna","year":"2017","journal-title":"J. Neuropsychiatry Clin. Neurosci."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1979","DOI":"10.1212\/01.wnl.0000264417.18604.12","article-title":"Neuroimaging of Neuronal Circuits Involved in Tic Generation in Patients with Tourette Syndrome","volume":"68","author":"Lerner","year":"2007","journal-title":"Neurology"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1088\/1741-2560\/4\/2\/010","article-title":"An Electronic Device for Artefact Suppression in Human Local Field Potential Recordings during Deep Brain Stimulation","volume":"4","author":"Rossi","year":"2007","journal-title":"J. Neural Eng."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1016\/j.medengphy.2016.02.007","article-title":"An External Portable Device for Adaptive Deep Brain Stimulation (aDBS) Clinical Research in Advanced Parkinson\u2019s Disease","volume":"38","author":"Arlotti","year":"2016","journal-title":"Med. Eng. Phys."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"106","DOI":"10.3390\/brainsci7080106","article-title":"A Review of the Neuropsychological Dimensions of Tourette Syndrome","volume":"7","author":"Leclerc","year":"2017","journal-title":"Brain Sci."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1080\/13651501.2017.1291822","article-title":"Parsing the Phenotype of Obsessive-Compulsive Tic Disorder (OCTD): A Multidisciplinary Consensus","volume":"21","author":"Marazziti","year":"2017","journal-title":"Int. J. Psychiatry Clin. Pract."}],"container-title":["Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3425\/8\/1\/4\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T18:55:14Z","timestamp":1760208914000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3425\/8\/1\/4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,12,23]]},"references-count":38,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2018,1]]}},"alternative-id":["brainsci8010004"],"URL":"https:\/\/doi.org\/10.3390\/brainsci8010004","relation":{},"ISSN":["2076-3425"],"issn-type":[{"value":"2076-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,12,23]]}}}