Indian Journal of Psychological Medicine
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CASE REPORT
Year : 2018  |  Volume : 40  |  Issue : 5  |  Page : 482-486

Low-frequency repetitive transcranial magnetic stimulation for treatment of tourette syndrome: a naturalistic study with 3 months of follow-up


Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
Dr. Nand Kumar
Department of Psychiatry, 4th Floor, Teaching Block, All India Institute of Medical Sciences, Ansari Nagar, NCT-Delhi, New Delhi - 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/IJPSYM.IJPSYM_332_17

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The objective of this study is to report the effects of low-frequency repetitive transcranial magnetic stimulation (rTMS) in three patients with medication-refractory Tourette syndrome (TS) and over 3-month follow-up. A review of literature on the use of rTMS for the treatment of TS is also presented. Three patients with severe, medication-refractory TS and comorbid obsessive-compulsive disorder (OCD) in two of them, received an open-label trial of rTMS at 1 Hz frequency for 4-week duration. The first two cases of TS-OCD showed, on average, around 57% improvement in Yale Global Tic Severity Scale (YGTSS) scores (65% and 50%) and 45% improvement in Yale-Brown Obsessive-compulsive Scale (Y-BOCS) scores; however, the third case of pure-TS showed marginal improvement of 10% only. The improvement in TS-OCD patients with rTMS treatment was maintained at the end of 3-month follow-up, with an average reduction of about 49% (58% and 40%) and 36% observed in YGTSS and Y-BOCS scores, respectively. The present study supports the use of low-frequency rTMS to improve tics and OCD symptoms in patients with severe, medication-refractory TS-OCD. Further, the beneficial effects of rTMS treatment were maintained substantially over 3-month follow-up period.


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