Repetitive Transcranial Magnetic Stimulation as a Treatment for Patients with Gilles de la Tourette Syndrome

Grant Type
Clinical
Grant Year
2001-2002
Institution Location
Foreign
Institution Organization Name
University College of London UK
Investigators Name
Robertson, Mary, MD

Symptoms of Gilles de la Tourette syndrome (TS) can often be improved by drugs, but these can have troublesome side effects. Alternative treatment options are therefore desirable. We are currently studying the effects of transcranial magnetic stimulation (TMS) as a treatment for TS. TMS is an established, safe method that has been used for a number of years to study the function of the brain. The principle of this method is that brief, painless magnetic pulses are applied to certain areas of the scalp by means of an insulated wire coil. The magnetic pulses cause small electrical currents in the outer part of the brain, and thereby affect the function of these brain areas. Repetitive TMS (rTMS), i.e. applying a series of magnetic pulses for several minutes, produces effects that outlast the period of stimulation for days or weeks. We have recently carried out a controlled trial in TS using rTMS. We found that slow frequency rTMS over the left motor and pre-motor cortex reduced tics in a subgroup of TS patients who do not have associated obsessive compulsive disorder. Although 1Hz rTMS appears capable of reducing TS tics, so far effects have been short-lasting with tic ratings returning to baseline levels approximately 10 days after the treatment. We are therefore conducting a second controlled trial aiming at further improving and prolonging the effects of rTMS by stimulating larger areas of the brain, and by increasing the number and intensity of applied rTMS pulses. We will compare left and right motor/pre-motor rTMS with placebo stimulation. Repetitive TMS will be applied for approximately 40 minutes daily on two consecutive days. As effects on the brain caused by magnetic stimulation outlast the stimulation, we hope to produce a longer lasting response. The results of the study will be determined using established rating scales including blinded video assessment. Prof. Mary Robertson, Dr. Alex Muenchau, Dr. J.C. Rothwell, Prof. Michael Trimble, Institute of Neurology University College, London, England Award: $40,000 IN TRIBUTE TO DONALD J. COHEN, M.D. (1940 – 2001) Tourette Association of America Inc. – Research Grant Award 2001-2002