The team of Vilela Filho and colleagues has previously suggested that clinical symptoms of TS may be linked to hyperactivity of the globus pallidus externus (GPe), based on animal models and theoretical models of the basal ganglia. In this recent paper, they report for the first time the results of an open clinical trial of GPe stimulation in TS patients \citep{Vilela_Filho_2023}. They found that 10 of the 13 patients responded to surgery (mean global improvement in tics of 64%, mean improvement of OCB 57.8%). They also found significant improvements in depression and anxiety scores. These promising results of GPe DBS remain to be replicated in future studies. Interestingly, they also reported on 2 patients who continued to have excellent tic improvement despite battery depletion, while another patient experienced severe rebound effect. Another case report of a patient with Centromedian/Parafascicular (Cm/Pf) stimulation who experienced severe tic status following battery depletion was published this year \citep{Parmera_2023}. The mechanisms of these ongoing responses or rebound effects remain to be deciphered.