Cannabis and cannabis-derived products are being considered for the treatment of tics – and a variety of other movement disorders – with great interest over the past years. Milosev et al. \cite{Milosev2019} present results from a retrospective data analysis and an online survey on the use of cannabis-based medicine for tics and comorbidities in TS. Patients (n= 98 and 40) expressed a preference for medical cannabis (rich in THC) over dronabinol and nabiximols. However, results from large randomized trials are still awaited and will help guide therapeutic decisions. These will also depend, obviously, on the availability of different cannabis-based medications across countries.
Blocking tics by CBT or botulinum toxin has been hypothesized to interrupt the sensory-motor feedforward loop likely operating in TS, i.e. premonitory sensations triggering tics which then re-inforce premonitory sensations.

Neurosurgery

Kimura et al. \cite{Kimura2019} report on four patients who had undergone thalamic DBS for severe TS. In two, DBS could be completely withdrawn four and seven years after surgery, respectively, without re-increase in tics. This is intriguing and confirms unpublished reports from other centers, including our own (Paris). One major question in this regard is, of course, if the tics observed pre-op were purely organic of if some functional tics were also present. On this topic, Ganos et al. \cite{Ganos2019} have published a landmark review which should be compulsory reading in the field.
Welter et al. 2019 \cite{Welter2019}
Image-based analysis and long-term clinical outcomes of deep brain stimulation for Tourette syndrome: a multisite study \cite{Johnson2019}