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A cranially contained constant-current device delivering stimulation on a scheduled duty cycle, as opposed to the standard continuous DBS paradigm was utilized. 24-month outcomes were collected and analyzed, and a responder analysis was performed.

A 40% improvement in the Modified Rush Tic Rating Scale (MRTRS) total score or Yale Global Tic Severity Scale (YGTSS) total score defined a full responder.

The trait intensity of premonitory urges is not a prerequisite of voluntary tic inhibition, a distinct form of motor control.

The prefrontal cortex is associated with the capacity to inhibit tics.The management of tics includes behavioral, pharmacological and surgical interventions.Indian Journal of Psychological Medicine, on line publication 2016 May-Jun; doi: 10.4103/0253-7176.183084 The cortico-basal ganglia-thalamo-cortical loops are implicated in generation of tics.Disruption of GABAergic inhibition lies at the core of tic pathophysiology, but novel animal models also implicate cholinergic and histaminergic neurotransmission.The patient was treated with haloperidol, sertraline, and clonidine when he developed mixed switch that necessitated us to stop sertraline.

Hence, he was treated with a mood stabilizer and he remitted.RESULTS: Three of the 4 patients followed to 24 months reached full responder criteria and had a mean stimulation time of 1.85 h per day.One patient lost to follow-up evaluated at the last time point (month 18) was a non-responder.In addition, the effect of premonitory urges on assessment of tic expression was evaluated.The associations between the subjective and objective measures of tic expression were moderate to low.Treatment recommendations differ based on patients' age.