Tic Disorders, Tourette Syndrome
Conditions
Keywords
continuous theta burst stimulation (cTBS), fMRI
Brief summary
continuous theta burst stimulation (cTBS) is a safe and effective device for Gilles de la Tourette's syndrome treatment. GPi is an agreed curative target of deep brain stimulation. GPi-based functional connectivity peak voxel in the SMA can be the cTBS target.
Detailed description
Tic disorder is a common neuropsychiatric disorder in children and adolescents. Medication is not effective and has side effect. Exploring new treatment methods is one of the research pathway of this disease.Continuous theta burst stimulation (cTBS) is relatively safe and effective, and its efficacy in psychiatric diseases has been gradually recognized. However, the results of current researches of tic disorder treatment are varied, and the evaluation method is relatively single. This project intends to adopt fmri-guided stimulation target and navigated cTBS to intervene patients with tics and explore individualized cTBS treatment parameters of tics, including stimulation frequency, intensity, type, time and stimulation target. Previous studies for deep brain stimulation reported that the medial globus pallidus (GPi) showed an obvious curative effect. And a deep brain area can be modulated indirectly by a superficial target via functional connectivity. Therefore, the present study attempts to stimulate the superficial target in supplementary motor area (SMA), lateral motor area (M1) which functionally connected with GPi or thalamus since the thalamus also a commonly reported abnormal brain area of Tic. Combined with clinical symptoms and neuroimaging, the therapeutic effect of cTBS in children with tic disorder was comprehensively evaluated in order to provide a new therapeutic method and a better therapeutic effect for the disease.
Interventions
DEVICEtraditional stimulation site continuous theta burst stimulation (cTBS)
before cTBS treatment, MRI was used to confirm the stimulation site
DEVICEprecise stimulation site cTBS
before cTBS treatment, rs-fMRI was used to confirm the stimulation site
Sponsors
Hangzhou Normal University
Second Affiliated Hospital, School of Medicine, Zhejiang University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Investigator)
Intervention model description
first group is traditional stimulation site group ,second group is precise position stimulation group .
Eligibility
Sex/Gender
ALL
Age
6 Years to 20 Years
Healthy volunteers
No
Inclusion criteria
1. meet the diagnostic criteria of chronic tic disorder or tourette syndrome; 2. Yale Global Tic Severity Scale (YGTSS) score is greater than 20; 3. the symptoms lasted more than 1 year, and the drug regimen was not adjusted within one month; 4. right-handedness; 5. age 6-20 years; 6. able to receive continuous theta burst stimulation (cTBS) therapy, participants and their guardians agree to receive treatment and observation.
Exclusion criteria
1. age is under 6-year old; 2. can not tolerate MRI or cTBS treatment; 3. adjust medication during treatment.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Yale Global Tic Severity Scale score | 5 days | to evaluate clinical change |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| fMRI | 1 day, 5 days | local neural activity; functional connectivity |
Countries
China
Outcome results
None listed