title: Subthreshold rTMS over pre-motor cortex has no effect on tics in patients with Gilles de la Tourette syndrome.
abstract: OBJECTIVE
  A previous study showed no effect of 1Hz repetitive transcranial magnetic stimulation (rTMS) on tics in Gilles de la Tourette Syndrome (GTS). We modified the rTMS protocol in order to investigate some of the possible methodological reasons for the negative outcome in that study.
  
  
  METHODS
  In a single blinded 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 severity rating scale, the MOVES self-rating scale and video analysis.
  
  
  RESULTS
  We found no significant effect of either left pre-motor cortex stimulation alone, or left pre-motor followed by right pre-motor cortex stimulation.
  
  
  CONCLUSIONS
  These results suggest that the rTMS protocol used in this study is not useful for the treatment of tics in GTS.
  
  
  CONCLUSIONS
  rTMS protocols need to be modified substantially in order to explore their potential for the treatment of tics in GTS.
authors.affiliation: Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, The National Hospital for Neurology and Neurosurgery, Royal Free and University College Medical School, Box 77, Queen Square, London WC1N 3BG, UK. m.orth@ion.ucl.ac.uk
authors.forename: M
authors.initials: M
authors.lastname: Orth
authors.forename: R
authors.initials: R
authors.lastname: Kirby
authors.forename: M P
authors.initials: MP
authors.lastname: Richardson
authors.forename: A H
authors.initials: AH
authors.lastname: Snijders
authors.forename: J C
authors.initials: JC
authors.lastname: Rothwell
authors.forename: M R
authors.initials: MR
authors.lastname: Trimble
authors.forename: M M
authors.initials: MM
authors.lastname: Robertson
authors.forename: A
authors.initials: A
authors.lastname: Münchau
mesh_terms: D000328:Adult; D018592:Cross-Over Studies; D046690:Deep Brain Stimulation / Q000379:methods; D004574:Electromagnetic Fields; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000502:physiology*; D016037:Single-Blind Method; D020323:Tics / Q000503:physiopathology / Q000628:therapy*; D005879:Tourette Syndrome / Q000503:physiopathology / Q000628:therapy*