School of Psychiatry, University of New South Wales, 2052 Sydney, Australia.
Academic Unit of Child Psychiatry, South Western Sydney Local Health District and Ingham Institute, 2170 Sydney, Australia.
J Integr Neurosci. 2022 May 10;21(3):89. doi: 10.31083/j.jin2103089.
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.
To investigate the clinical effectiveness of CBIT in reducing tic severity in young people with GTS and explore neurophysiological mechanisms associated with clinical change.
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.
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.
妥瑞氏症候群（Gilles de la Tourette Syndrome，GTS）是一种儿童期发病的神经精神疾病，其特征为运动性和发声性抽搐。虽然全面行为干预治疗抽搐（Comprehensive Behavioural Intervention for Tics，CBIT）是 GTS 患者的一种有效、非药物治疗方法，但这种干预的潜在神经生理基础尚未得到研究。
为了研究 CBIT 在降低青少年 GTS 患者抽搐严重程度方面的临床效果，并探讨与临床变化相关的神经生理机制。
总抽搐严重程度有显著的整体改善，具有较大效果量。干预后运动诱发电位（motor evoked potential，MEP）的皮质静息期（Cortical Silent Period，CSP）与 MEP 的比值（CSP/MEP ratio）增加，效果量较小。其他抑制性神经生理测量与抽搐严重程度的变化没有显著相关。
除了显著的临床改善外，这些结果表明运动皮质γ-氨基丁酸（Gamma-aminobutyric acid，GABA）能抑制回路在 CBIT 治疗的神经生理变化中起作用。这些发现需要在更大的使用对照样本的研究中得到复制。
