Comprehensive behavioural intervention for tics: a neurophysiological intervention

J Integr Neurosci. 2022 May 10;21(3):89. doi: 10.31083/j.jin2103089.

Abstract

Background: Gilles de la Tourette Syndrome (GTS) is a childhood-onset neuropsychiatric disorder characterised by motor and vocal tics. While Comprehensive Behavioural Intervention for Tics (CBIT) is an effective, non-pharmacological treatment for patients with GTS, the underlying neurophysiological basis of this intervention has not been investigated.

Methods: To investigate the clinical effectiveness of CBIT in reducing tic severity in young people with GTS and explore neurophysiological mechanisms associated with clinical change.

Results: There was a significant overall improvement in tic severity of large effect size. The Cortical Silent Period (CSP) to motor evoked potential (MEP) ratio (CSP/MEP ratio) increased after the intervention with a small effect size. Other neurophysiological measures of inhibition were not significantly related to the change in tic severity.

Conclusions: Alongside significant clinical improvements, these results suggest a role for motor cortical Gamma-aminobutyric acid (GABA)-ergic inhibitory circuitry in the neurophysiological changes underlying CBIT treatment. These findings need to be replicated in larger studies using control samples.

Keywords: Comprehensive Behavioural Intervention for Tics (CBIT); Neurophysiology; Tourette Syndrome; Transcranial magnetic stimulation.

MeSH terms

  • Adolescent
  • Child
  • Evoked Potentials, Motor
  • Humans
  • Inhibition, Psychological
  • Tics* / complications
  • Tics* / therapy
  • Tourette Syndrome* / complications
  • Tourette Syndrome* / drug therapy
  • Treatment Outcome