Table 1.
Non-invasive brain stimulation parameters used in Tourette patients.
| References | Design, population characteristics | Stimulation details | Stimulation site | Results/Outcome measures |
|---|---|---|---|---|
| Munchau et al. (71) | rTMS, RCT, single blinded, crossover, N = 16 GTS (adults) Comorbidities: N = 7 OCD |
1,200 pulses in 1 session per day for 2 days, 1 Hz, 80% AMT 2 week interval between sites |
Left motor cortex Left premotor cortex Sham |
No significant clinical improvement in: MOVES HDS-D |
| Orth et al. (72) | rTMS, RCT, single blinded, crossover, N = 5 GTS (adults) Comorbidities: N = 2 ADHD |
1,800 pulses in 1 session per day for 2 days, 1Hz, 80% AMT 4 week interval between sites |
Left + right premotor cortex Left premotor cortex + right premotor cortex sham Right + left premotor cortex sham |
No significant clinical improvement in: YGTSS MOVES MRVS |
| Mantovani et al. (76) | rTMS, open-label, N = 3 GTS, N = 5 OCD, N = 2 OCD+GTS (adults) | 1,200 pulses divided in 4 sessions per day over 10 days, 1 Hz, 100% RMT | SMA (bilateral) | Significant clinical improvement in: YGTSS YBOCS HDRS-24 HARS-14 CGI SCL-90 BDI SAD SASS |
| Kwon et al. (78) | rTMS, open-label, N = 10 GTS (children 11.2 ± 2.0 years) Comorbidities: N = 3ADHD, N = 2 Depression, N = 1 OCD |
1,200 pulses divided in 4 sessions per day for 10 days, 1 Hz, 100% RMT | SMA (bilateral) | Significant clinical improvement in: YGTSS CGI No significant clinical improvement in: Conner's ADHD Scale K-ARS CDI STAI Computerized ADS |
| Le et al. (79) | rTMS, open-label, N = 25 GTS (children 10.6 ± 2.2 years) | 1,200 pulses divided in 20 sessions over 20 days, 1 Hz, 110% RMT | SMA (bilateral) | Significant clinical improvement in YGTSS CGI SNAP IV CDI SCAS |
| Landeros-Weisenberger et al. (102) | rTMS, RCT (phase 1)/open-label (phase 2), N = 20 GTS (adults) | Phase 1: 1,800 pulses in 1 session per day over 15 days, 1 Hz, 110% RMT Phase 2: 1,800 pulses in 1 session per day over 30 days, 1 Hz, 110% RMT |
SMA (bilateral) | Phase 1: No significant clinical improvement in YGTSS YBOCS PUTS ASRS Phase 2: Significant clinical improvement in YGTSS |
| Mrakic-Sposta et al. (103) | tDCS, RCT, single blinded, crossover, N = 2 GTS (adults) | 2 sessions a day: 2 mA for 15 min, five consecutive days 2 weeks interval between sites |
Left premotor cortex Sham |
Significant clinical improvement in YGTSS VAS for general well-being |
| Carvalho et al. (104) | tDCS, open-label, N = 1 GTS (boy, 16 years) | 1 sessions a day: 1.4 mA for 30 min, over 10 days | Pre-SMA (bilateral) | Significant clinical improvement in YGTSS |
| Eapen et al. (105) | tDCS, double blinded, crossover, N = 2 GTS (adults) | 1 session a day: 2.4 mA for 20 min, three times a week, over 6 weeks three weeks active cathodal followed by sham or vice versa |
SMA (bilateral) Sham |
Significant clinical improvement in ATQ PUTS |
| Dyke et al. (106) | tDCS, single blinded, crossover, N = 10 GTS (adults) | 1 session: 4.5 mA for 20 min and 1 session sham 1 week interval between sessions |
SMA (bilateral) Sham |
Significant clinical improvement in YGTSS MRVS |
| Wu et al. (107) | cTBS, double blinded, N = 12 GTS (children and adults) | 2,400 pulses per day over 2 days, 90% RMT, 30 Hz | SMA (bilateral) Sham |
No significant clinical improvement in YGTSS |
ADHD, Attention deficit hyperactivity disorder; AMT, Active motor threshold; ASRS, Adult ADHD self-report scale; ATQ, Adult tic questionnaire; BDI, Beck depression inventory; CDI, Children's' depression inventory; CGI, Clinical global impression; Computerized ADS, Computerized ADHD diagnostic system; cTBS, continuous theta burst stimulation; GTS, Gilles de la Tourette syndrome; HARS-14, Hamilton anxiety rating scale; HDRS-24, Hamilton depression rating scale; HDS-D, Hospital anxiety and depression scale; K-ARS, Korean ADHD rating scale; mA, Milliampere; MOVES, Motor tic, obsessions and compulsions, vocal tic evaluation survey; MRVS, Modified Rush video scale; OCD, Obsessive-compulsive disorder; PUTS, Premonitory Urge for Tic Scale; RCT, Randomized controlled trial; RMT, Resting motor threshold; rTMS, repetitive transcranial magnetic stimulation; SAD, Scale for auto-evaluation of depression; SASS, Social adaptation self-evaluation scale; SCAS, Spence children‘s anxiety scale; SCL-90, Symptoms check list; SMA, Supplementary motor area; SNAP IV, Swanson, Nolan and Pelham rating scale; STAI, State/trait anxiety inventory; tDCS, transcranial direct current stimulation; VAS, Visual analog scale; YBOCS, Yale-Brown obsessive-compulsive scale; YGTSS, Yale Global tic severity scale.