IMR Press / JIN / Volume 21 / Issue 3 / DOI: 10.31083/j.jin2103089
Open Access Original Research
Comprehensive behavioural intervention for tics: a neurophysiological intervention
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1 School of Psychiatry, University of New South Wales, 2052 Sydney, Australia
2 Academic Unit of Child Psychiatry, South Western Sydney Local Health District and Ingham Institute, 2170 Sydney, Australia
3 Pnerith Therapy Centre, Penrith, 2750 Sydney, Australia
4 Faculty of Medicine, University of New South Wales, 2052 Sydney, Australia
5 Sydney Children's Hospital, Randwick, 2031 Sydney, Australia
6 School of Psychological Sciences, Macquarie University Australia, 2113 Sydney, Australia
*Correspondence: (Valsamma Eapen)
Academic Editors: Jesús Pastor and Min Zhou
J. Integr. Neurosci. 2022, 21(3), 089;
Submitted: 8 November 2021 | Revised: 6 December 2021 | Accepted: 27 December 2021 | Published: 10 May 2022
(This article belongs to the Special Issue Brain Stimulation and Neuroimaging)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Background: 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. Methods: To investigate the clinical effectiveness of CBIT in reducing tic severity in young people with GTS and explore neurophysiological mechanisms associated with clinical change. Results: 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. Conclusions: 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.

Comprehensive Behavioural Intervention for Tics (CBIT)
Transcranial magnetic stimulation
Tourette Syndrome
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