Repetitive Transcranial Magnetic Stimulation for Adults with Severe Tourette Syndrome

Grant Type
Grant Year
Institution Location
Institution Organization Name
Yale University
Investigators Name
Leckman, James, MD

Transcranial Magnetic Stimulation (TMS) has been investigated as a TS treatment for the past decade and repetitive TMS (rTMS) has been used as an investigational treatment for severe TS for the last five years. In this technique an electromagnet that generates magnetic field pulses, roughly the strength of an MRI scan, is placed on the head. The magnetic pulses pass through the skull and stimulate the underlying brain tissue. Low frequency (once per second) TMS has been shown in multiple studies to induce sustained reductions in brain activity. While this procedure is safe, initial studies using rTMS for treating individuals with severe TS were unsuccessful. However, in a recent Italian study of five patients with TS, rTMS that targeted a brain region known as the “supplementary motor area” (known to be involved in the initiation of movement and speech) did show a positive effect. Improvements were maintained for three months, and no major side effects were noted during the course of treatment or over the subsequent three months. Investigators at Yale and Columbia Universities now plan to do a double blind study to rigorously test the value of rTMS for adults with severe TS. We anticipate screening 25 patients and selecting 16 of them to participate in a randomized clinical trial. Eight will receive the rTMS treatment, and the other eight will receive a sham treatment. An independent evaluator (who does not know whether the person was treated with rTMS or not) will monitor the benefits of these interventions. After the study, those patients who received the sham treatment will receive the rTMS treatment, free of charge. Booster sessions to sustain their clinical improvement may be necessary for some participants. James F. Leckman, M.D., Yale University School of Medicine New Haven, CT Sarah H. Lisanby, M.D,. Columbia College of Physicians and Surgeons New York, NY Rodolfo R. Llinas, M.D., Ph.D., New York University New York, NY Ralph E. Hoffman, M.D. Yale Medical School New Haven, CT Antonio Mantovani, M.D. Columbia College of Physicians and Surgeons New York, NY Award: $73,590 Tourette Association of America Inc. – Research Grant Award 2007-2008