Abstract
Tourette syndrome is a neurodevelopmental disorder characterised by motor and phonic tics. For some, tics can be managed using medication and/or forms of behavioural therapy; however, adverse side effects and access to specialist resources can be barriers to treatment. In this sham-controlled brain stimulation study, we investigated the effects of transcranial direct current stimulation (tDCS) on the occurrence of tics and motor cortical excitability in individuals aged 16–33 years with Tourette syndrome. Changes in tics were measured using video recordings scored using the RUSH method (Goetz et al. in Mov Disord 14:502–506, 1999) and changes in cortical excitability were measured using single-pulse transcranial magnetic stimulation (spTMS) over the primary motor cortex (M1). Video recordings and spTMS measures were taken before and after 20 min of sham or active tDCS: during which cathodal current was delivered to an electrode placed above the supplementary motor area (SMA). Tic impairment scores, calculated from the video data, were significantly lower post-cathodal stimulation in comparison with post-sham stimulation; however, the interaction between time (pre/post) and stimulation (cathodal/sham) was not significant. There was no indication of a statistically significant change in M1 cortical excitability following SMA stimulation. This study presents tentative evidence that tDCS may be helpful in reducing tics for some individuals, and provides a foundation for larger scale explorations of the use of tDCS as a treatment for reducing tics.
Highlights
Tourette syndrome (TS) is a childhood onset disorder, characterized by the presence of brief stereotyped behaviours of a limited duration known as tics
The effects of 1 mA cathodal stimulation of the supplementary motor area (SMA) were compared with sham stimulation in individuals with Tourette syndrome
A small but significant difference between post-sham and post-cathodal conditions was found, with the predicted larger reduction in tics being observed after cathodal transcranial direct current stimulation (tDCS)
Summary
Tourette syndrome (TS) is a childhood onset disorder, characterized by the presence of brief stereotyped behaviours of a limited duration known as tics. The treatment options available for individuals with TS are limited, and while behavioural interventions such as habit reversal training (HRT) are effective (Bate et al 2011; Dutta and Cavanna 2013), they may not be readily accessible or suitable for all. One of the most common treatment options is medication, including forms of antipsychotics, which can have a number of undesirable side effects (Kurlan 2014). This makes it pertinent that alternative avenues of treatment are explored, one of which may involve the use of non-invasive brain stimulation techniques such as transcranial magnetic stimulation (TMS) or transcranial direct current stimulation (tDCS).
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