Bilateral transcranial magnetic stimulation of the supplementary motor area in children with Tourette syndrome

Aim To explore the feasibility and possible effects of low-frequency repetitive transcranial magnetic stimulation (rTMS) delivered to supplementary motor area (SMA) on tic severity system neurophysiology in children with Tourette syndrome. Method Ten syndrome (eight males, two females; 9–15y) participated this open-label, phase 1 clinical trial. Treatment consisted 1800 (1Hz) neuronavigated robotic rTMS (100% resting threshold) SMA, bilaterally for 15 sessions. The primary outcome was a change Yale Global Tic Severity Scale (YGTSS) total score from baseline posttreatment. Secondary measures included changes resonance spectroscopy metabolite concentrations, TMS measures, maps, assessments (anxiety, depression) end treatment. Results YGTSS decreased after treatment (p<0.001; Cohen's d=2.9). All procedures were well-tolerated. Interpretation Robot-driven, bilateral SMA is feasible appears reduce severity. What paper adds Repetitive use tolerated by Precise targeting using functional imaging also these children.