Abstract
Therapy resistance of approximately one-third of patients with Gilles de la Tourette syndrome (GTS) requires consideration of alternative therapeutic interventions. This article provides a condensed review of the invasive and non-invasive stimulation techniques that have been applied, to date, for treatment and investigation of GTS. Through this perspective and short review, the article discusses potential novel applications for neurostimulation techniques based on a symptom-guided approach. The concept of considering the physiological basis of specific symptoms when using stimulation techniques will provide a platform for more effective non-pharmacological neuromodulation of symptoms in GTS.
Highlights
The use of non-invasive and invasive brain stimulation techniques for relief of specific symptomatology in neuropsychiatric disorders should be considered as a young therapeutic intervention
The motivation for such a proposal stems from the need for alternatives to current pharmaceutical neuromodulation for Gilles de la Tourette syndrome (GTS), as approximately one-third of patients with GTS demonstrate therapy resistance or side effects to conventional neuropharmaceuticals, with limited current alternatives for symptom management
When considering the role of circuit components in learning and plasticity processes, brain stimulation becomes a strategic and valuable technique for investigating potential treatment options for neuropsychiatric disorders, since particular neural circuits have demonstrated abnormal excitability related to symptom manifestation and have been linked to aberrations in plasticity-induced learning [1]
Summary
The use of non-invasive and invasive brain stimulation techniques for relief of specific symptomatology in neuropsychiatric disorders should be considered as a young therapeutic intervention. Current problems with stimulation can perhaps be considered to be rooted in the bottom-up approach to its application rather than the top-down proposal previously mentioned: that is, observing clinical manifestation of behavior in order to propose underlying circuits that have structures accessible for specific neurostimulation paradigms designed to modulate particular aberrant firing. The benefit of such a proposal is that it allows consideration of individual symptoms as guides to the physiology involved in their production. Tic reduction ranging from 72.2 to 90.1% reduction at long-term follow-up, specific tic persistence was reported for the 3 patients
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