Tourette Deep Brain Stimulation (DBS) Target Detection & Suppression

Inclusion Criteria: * The diagnosis of TS must be made by both a fellowship-trained movement disorders neurologist and a psychiatrist and must meet Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria for a diagnosis of TS. * Yale Global Tic Severity Scale (YGTSS; 100) must be \>35/50 and the motor tic sub score \>15. The TS must be causing incapacitation with severe distress, self-injurious behavior, and/or quality of life disruption. OCD, Depression, and ADHD are not exclusionary provided tics are the major difficulty requiring surgical intervention. * There are no gender criteria for this study. * The subject's TS symptoms must be medication refractory. To meet the medication refractory criteria, subjects must have been treated by a psychiatrist or neurologist experienced in TS with therapeutic doses (doses adapted from Scahill's recommendations of at least three dopamine blocking drugs) \[either 1-4 mg/day of haloperidol, 2-8 mg/day of pimozide, risperidone (1-3 mg/day), or aripiprazole (2.5-5 mg/day)\]. There must be at a minimum7 single trial with an alpha-2 adrenergic agonist (0.1-0.3 mg/day). * Clinically relevant depression if present must be pharmacologically treated and deemed stable (by the study psychiatrist). * Must have been stabilized for one month on TS medication without a dose change prior to surgical intervention. If medication trials resulted in discontinuation of TS medications, the subject must be stabilized for three months off TS me…