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Video assessment of rTMS for Tourette syndrome
  1. A H Snijders1,
  2. B R Bloem2,
  3. M Orth3,
  4. J C Rothwell3,
  5. M R Trimble4,
  6. M M Robertson4,
  7. A Münchau5
  1. 1Sobell Department of Neurophysiology, Institute of Neurology, Queen Square, London, UK
  2. 2Department of Neurology, University Medical Centre St Radboud, Nijmegen, The Netherlands
  3. 3Sobell Department of Neurophysiology, Institute of Neurology, Queen Square, London, UK
  4. 4Department of Neuropsychiatry, The National Hospital for Neurology and Neurosurgery, London, UK
  5. 5Sobell Department of Neurophysiology, Institute of Neurology, Queen Square, London, UK
  1. Correspondence to:
 Dr Alexander Münchau
 Department of Neurology, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany;muenchauuke.uni-hamburg.de

https://doi.org/10.1136/jnnp.2004.058321

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    In a recent study, subthreshold 1 Hz repetitive transcranial magnetic stimulation (rTMS) over left motor or premotor cortex failed to improve tics in patients with Gilles de la Tourette syndrome (GTS) as determined by self assessment scores.1 However, video ratings of this study had not been analysed. Here, we present the results of blinded analysis of the video of GTS patients who participated in the previous study. We show that rTMS has a placebo effect and confirm that low intensity motor or premotor rTMS does not have a specific effect on tics in GTS.

    In a placebo controlled cross-over study of 16 patients with GTS, subthreshold 1 Hz rTMS (2400 stimuli delivered on 2 consecutive days) were applied under three conditions in random order: left motor, left premotor, and left motor sham stimulation. Videotapes were recorded before and after each rTMS intervention in eight patients. One of the authors (AHS) who did not know …

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    Footnotes

    • A Münchau and M Orth were supported by the Tourette Syndrome Association (USA) and the Raymond Way Unit, Institute of Neurology, Queen Square, London, UK. AH Snijders was supported by the Hersenstichting Nederland

    • Competing interests: none declared