European clinical guidelines for Tourette syndrome and other tic disorders. Part IV: Deep brain stimulation

Kirsten R. Müller-Vahl, Danielle C. Cath, Andrea E. Cavanna, Sandra Dehning, Mauro Porta, Mary M. Robertson, Veerle Visser-Vandewalle, Christos Androutsos, Harald Aschauer, Gillian Baird, Netty Bos-Veneman, Ariana Brambilla, Francesco Cardona, Virginie Czernecki, Alan Eapter, Luca Farkas, Julia Gadaros, Andreas Hartmann, Elizabeth Hauser, Isabel HeymanTammy Hedderly, Pieter J. Hoekstra, Anne Korsgaard, Georgina M. Jackson, Linnea Larsson, Andrea G. Ludolph, Davide Martino, Claudia Menghetti, Nanette Mol Debes, Norbert Muller, Alexander Munchau, Tara Murphy, Richard Musil, Peter Nagy, Judith Nurnberger, Ben Oostra, Perry Paschou, Massimo Pasquini, Kerstin J. Plessen, Hugh Rickards, Renata Rizzo, Veit Roessner, Aribert Rothenberger, Domenico Servello, Liselotte Skov, Jeremy S. Stern, Gerd Strand, Zsannett Tarnok, Cristiano Termine, Jolande Van Der Griendt, Cara Verdellen, Ebba Wannag, Tomas Wolanczyck

Research output: Contribution to journalArticlepeer-review


Ten years ago deep brain stimulation (DBS) has been introduced as an alternative and promising treatment option for patients suffering from severe Tourette syndrome (TS). It seemed timely to develop a European guideline on DBS by a working group of the European Society for the Study of Tourette Syndrome (ESSTS). For a narrative review a systematic literature search was conducted and expert opinions of the guidelines group contributed also to the suggestions. Of 63 patients reported so far in the literature 59 had a beneficial outcome following DBS with moderate to marked tic improvement. However, randomized controlled studies including a larger number of patients are still lacking. Although persistent serious adverse effects (AEs) have hardly been reported, surgery-related (e.g., bleeding, infection) as well as stimulation-related AEs (e.g., sedation, anxiety, altered mood, changes in sexual function) may occur. At present time, DBS in TS is still in its infancy. Due to both different legality and practical facilities in different European countries these guidelines, therefore, have to be understood as recommendations of experts. However, among the ESSTS working group on DBS in TS there is general agreement that, at present time, DBS should only be used in adult, treatment resistant, and severely affected patients. It is highly recommended to perform DBS in the context of controlled trials.

Original languageEnglish
Pages (from-to)209-217
Number of pages9
JournalEuropean Child and Adolescent Psychiatry
Issue number4
Publication statusPublished - Apr 2011


  • Deep brain stimulation
  • Guidelines
  • Tics
  • Tourette
  • Treatment

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pediatrics, Perinatology, and Child Health


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