Hassler and Dieckmann on stereotactic thalamotomy for Tourette syndrome: Italian translation and commentary

Gilles de la Tourette syndrome (GTS) is a neuropsychiatric disorder of childhood onset, characteristically composed of a concoction of both multiple motor and vocal tics, frequently accompanied by various behavioural disturbances. In instances the disorder is self-limiting; in many cases it may be treated by medication or behavioural therapy and in a minority with intractable symptoms neurosurgical procedures may be resorted to. Recent years have seen a revival of stereotactic neurosurgery as a management strategy for severe treatment-resistant GTS. Over the last decade, scientific literature has documented a cluster of thirty-eight patients with GTS undergoing deep brain stimulation (DBS) for the treatment of tics and tic-related symptoms; eighteen of which originate from Italy. Amidst a diverse set of historically reported neurosurgical sites, two principal brain targets have emerged: the centromedial parafascicular complex of the thalamus (CMPfC) and the globus pallidus internum. Authors who targeted the CMPfC for insertion of DBS devices have frequently cited the work of R. Hassler and G. Dieckmann published in 1970 in French. In this paper the authors illustrated three successful cases of thalamotomy for GTS. We provide the first Italian translation of the original paper, in association with a critical commentary.