Abstract

Objective: The pathophysiology of Tourette syndrome (TS), a chronic motor and vocal tic disorder remains unknown, however abnormalities in basal ganglia-thalamo-cortical circuits presumably play an important role. Repetitive transcranial magnetic stimulation (rTMS), a non-invasive method for modulation of cortical activity, has been applied in different ways in patients with TS.
Methods: Open-label pilot study of active rTMS. Four adolescents with TS participated in the pilot study, two females and two males. The patients fulfilled DSM IV criteria for TS, and had tried psychological and/or pharmacological therapy without effects on symptoms. The rTMS treatment consisted of 10 treatment sessions Monday to Friday during a two-week period. Follow-up was done one, three and six months after finishing the treatment with rTMS.
Results: There was clinically significant improvement in TS symptoms with benefits lasting up to 6 months in two of the patients. In addition, improvement in ADHD was seen in one patient, and improvement in OCD symptoms in another. There were no side effects.
Conclusions: Low-frequency rTMS may be effective in children with TS. Further studies using rTMS in TS are warranted. Careful consideration of target regions and stimulation parameters, longer follow-up, and use of a double-blind, sham-controlled design may allow us to draw founded conclusions in the future.

Keywords: Gilles de la Tourette Syndrome; rTMS; Children