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Objective: A previous study showed no effect of 1 Hz repetitive transcranial m agnetic stimulation (rTMS) on tics in Gilles de la Tourette Syndrome (GTS). We m odified the rTMS protocol in order to investigate some of the possible methodolo gical reasons for the negative outcome in that study. Methods: In a single blind ed placebo-controlled cross-over study in five GTS patients without obsessive compulsive disorder we probed whether longer trains (1800 stimuli) of 1 Hz pre- motor cortex rTMS at 80%of active motor threshold and application to both hemis pheres can improve tics in GTS. This was measured with the Yale Global Tic sever ity rating scale, the MOVES self-rating scale and video analysis. Results: We f ound no significant effect of either left pre-motor cortex stimulation alone, o r left pre-motor followed by right pre-motor cortex stimulation. Conclusions:T hese results suggest that the rTMS protocol used in this study is not useful for the treatment of tics in GTS. Significance: rTMS protocols need to be modified substantially in order to explore their potential for the treatment of tics in G TS.
Objective: A previous study showed no effect of 1 Hz repetitive transcranial m agnetic stimulation (rTMS) on tics in Gilles de la Tourette Syndrome (GTS). We m odified the rTMS protocol in order to investigate some of the possible methodolo gical reasons for the negative outcome in that study. Methods: In a single blind placebo-controlled cross-over study in five GTS patients without obsessive compulsive disorder we probed whether longer trains (1800 stimuli) of 1 Hz pre-motor cortex rTMS at 80% of active motor threshold and application to both hemispheres can improve tics in GTS. This was measured with the Yale Global Tic sever ity rating scale, the MOVES self-rating scale and video analysis. motor cortex stimulation alone, or left pre-motor followed by right pre-motor cortex stimulation. Conclusions: T hese results suggest that the rTMS protocol used in this study is not useful for the treatment of tics in GTS. Significa nce: rTMS protocols need to be modified substantially in order to explore their potential for the treatment of tics in G TS.