Mahjoub Yasamin, Szejko Natalia, Gan Liu Shi, Adeoti Janet Adesewa, Nitsche Michael A, Vicario Carmelo M, Pringsheim Tamara M, Martino Davide
Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Canada.
Department of Bioethics, Medical University of Warsaw, Warsaw, Poland.
Mov Disord Clin Pract. 2025 Mar;12(3):313-324. doi: 10.1002/mdc3.14285. Epub 2024 Nov 29.
Transcranial direct current stimulation (tDCS) over the supplementary motor area (SMA) has shown promise in Tourette syndrome (TS), but previous studies were limited in size and stimulation duration.
The aim was to explore the efficacy and safety of multiple sessions of cathodal tDCS over the bilateral SMA on tic severity in TS.
A double-blind, randomized, sham-controlled trial 1 mA cathodal tDCS over bilateral SMA was performed in participants with TS older than 16 years. The intervention involved two 20-min periods of stimulation with either sham or active tDCS per day, over 5 consecutive days, during which participants actively suppressed tics. Tic severity was measured using the Yale Global Tic Severity Scale Total Tic Severity (YGTSS-TTS, primary outcome) score at baseline, day 5 (visit 5), and 1 week later (visit 6). Questionnaires focusing on comorbidities were performed at baseline and visit 6.
Twenty-four participants were randomly assigned (12 active, 12 sham; 8 women; median age: 26). We observed a significant effect of visit on YGTSS-TSS, but no significant effect of treatment or treatment × visit interaction emerged. In contrast, a statistically significant effect of the treatment × visit interaction was observed for the motor tic subscore, with significantly larger improvement in the active arm. Furthermore, we detected a significantly larger decrease in premonitory urge intensity at visit 6 after active stimulation. No effect was detected on severity of comorbidities.
This preliminary study suggests that bilateral tDCS over the SMA provides small, but significant benefits in reducing motor tic severity in TS.
经颅直流电刺激（tDCS）作用于辅助运动区（SMA）在治疗抽动秽语综合征（TS）方面已显示出前景，但以往研究在样本量和刺激持续时间上存在局限性。
探讨对双侧SMA进行多次阴极tDCS治疗对TS患者抽动严重程度的疗效和安全性。
对16岁以上的TS患者进行一项双盲、随机、假对照试验，采用1毫安阴极tDCS作用于双侧SMA。干预措施包括每天进行两个20分钟的刺激时段，采用假刺激或真刺激，连续进行5天，在此期间参与者积极抑制抽动。在基线、第5天（访视5）和1周后（访视6），使用耶鲁全球抽动严重程度量表总抽动严重程度（YGTSS-TTS，主要结局）评分来测量抽动严重程度。在基线和访视6时进行关于共病情况的问卷调查。
24名参与者被随机分配（12名真刺激组，12名假刺激组；8名女性；年龄中位数：26岁）。我们观察到访视对YGTSS-TSS有显著影响，但未发现治疗或治疗×访视交互作用有显著影响。相比之下，在运动性抽动子评分方面观察到治疗×访视交互作用具有统计学意义，真刺激组的改善明显更大。此外，我们检测到真刺激后在访视6时预感冲动强度有显著更大程度的降低。未发现对共病严重程度有影响。
这项初步研究表明，对SMA进行双侧tDCS在降低TS患者的运动性抽动严重程度方面有微小但显著的益处。
