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Fourteen patients were randomly allocated to DBS on-stimulation or off-stimulation conditions for the first 3 months after DBS leads were placed in the GPi (globus pallidus, pars interna), followed by a switch to the other condition for another 3 months \citep{25882029}. Ratings were collected blind to stimulation status and thirteen patients completed assessments during both conditions. Total YGTSS scores were 15% lower at the end of the on-stimulation period compared with the off-stimulation period (p=0.048). Three serious adverse events occurred (two infections in the DBS hardware and one episode of hypomania). Further improvements were seen during the long-term open label treatment period. This study is important as it provides evidence of efficacy when using a design that involves on *vs* off stimulation with random assignment to initial condition.   A case study raised the issue of temporary DBS treatment \citep{26290773}. The patient started having simple motor tics at the age of 7 followed by vocal and complex motor tics two years later. The patient also had ADHD and learning difficulties. Thalamic DBS surgery was provided when he developed continuous motor and vocal tics that resulted in his leaving school at the age of 17. A year after surgery his YGTSS score had decreased by 58%. Three years after the surgery the tic severity increased and the IPG was replaced, again followed by improved tic severity. When the patient was 23 it was noticed that the IPG was not operational, yet there had not been any increase in the patient's symptoms. After the device was left off for 2 years and the patient remained stable clinically, the decision was made to remove the device and the patient was still stable 8 months later. This case raises important questions discussed in the consensus statement \citep{25476818}, but without adequate controls it is impossible to know whether DBS was the cause of tic improvement.\citet{26180116} reviewed electrophysiological data obtained in nonhuman primate models of TS and in Parkinson disease, with the hope of identifying possible mechanisms to account for the efficacy of high-frequency GPi DBS in both a hyper- and a hypokinetic movement disorder. This article focuses on the possibility that excessive synchrony and pathological low-frequency oscillations (LFO) impair activation in the motor regions that receive input from the basal ganglia. There is also some evidence that synchronous oscillatory activity and excess LFO contribute to TS. DBS effectiveness is considered to occur because population-scale firing rates are maintained allowing proper encoding of desired movement. When used with Parkinson patients, DBS suppresses excess LFO in the GPE in addition to the GPI. GPI-DBS is theorized to suppress the phasic activations in the GPe and phasic inhibitions in the GPi for TS patients. It is hypothesized that in both medical conditions aberrant output is minimized while the population-averaged firing rate is maintained.   \citet*{26110808} reviewed DBS for movement disorders generally and describe some recent technological advances (i.e., electrode design; rechargable implantable pulse generators; closed-loop, adaptive stimulation). \citet{25882028} discuss various obstacles to carrying out randomized, blinded studies of DBS with appropriate controls. \citet{25925326} summarize research describing the effects of DBS on neural abnormalities associated with TS, and discuss how the findings relate to models of cortico-basal ganglia function.  ### Other treatment