Overview
Tourette syndrome (TS) is a neurological disorder that is characterized by repetitive, involuntary tics that may appear in the form of vocalizations or other motor movements. Neurofeedback has been suggested as an alternative treatment for TS, and recent evidence supports its viability as a beneficial therapeutic option.
Neurofeedback for Tourette syndrome
Research suggests that the appearance and maintenance of symptoms in TS may be impacted by cognitive control, which regulates sensory and motor processes (1). Specifically, impairments in TS have been seen in the prefrontal cortex and its related functions of attention and overall executive control (1). The goal of neurofeedback is to train individuals with TS to improve these weaknesses through a protocol designed to enhance neural functioning specifically in the sensory-motor cortex (SMR). Research has found that increased self-regulation and motor control are common treatment outcomes of this protocol (1).
Empirical Evidence
Randomized clinical trials (RCTs) investigating the efficacy of neurofeedback for TS are lacking. Most empirical evidence for the technique comes from case studies. However, although current research samples are small, results are encouraging. In one study, SMR training and Theta downtraining (neurofeedback that targets elevated Theta activation in the frontal regions, and strengthening SMR or Sensory Motor Rhythm in the right central region) were administered twice per week for 22 sessions and significant clinical improvements were seen post-treatment (2). Another case study combining neurofeedback and motor imaging (imagery?) training administered over 80 sessions found significant improvements in two individuals with TS (3). These improvements were also found to be long-lasting, and were present at a one year follow-up assessment (3). Evidence also suggests that neurofeedback may be especially effective for the treatment of TS that is comorbid with attention deficit disorder (4). While one RCT did not find a significant effect of neurofeedback on symptom improvement in TS, authors acknowledged that optimal treatment has not yet been identified which may impact study results (5). Further high-quality research is needed in order to confirm the compelling preliminary evidence that neurofeedback training is effective for treatment of TS.
— S Jacobs & J Thomas
References
- Farkas, A, Bluschke, A, Roessner, V, & Beste, C (2015). Neurofeedback and its possible relevance for the treatment of Tourette syndrome. Neuroscience & Biobehavioral Reviews, 51, 87-99. https://www.ncbi.nlm.nih.gov/pubmed/25616186
- Benvenuti, S, Buodo, G, Leone, V, & Palomba, D (2011). Neurofeedback training for Tourette syndrome: an uncontrolled single case study. Applied psychophysiology and biofeedback, 36(4), 281-288.
- Zhou, C, & Li, L (2014). The application and efficacy of combined neurofeedback therapy and imagery training in adolescents with Tourette syndrome. Journal of child neurology, 29(7), 965-968.
- Kumar, A, Duda, L, Mainali, G, Asghar, S, & Byler, D (2018). A Comprehensive Review of Tourette Syndrome and Complementary Alternative Medicine. Current developmental disorders reports, 1-6.
- Nagai, Y, Cavanna, A, Critchley, H, Stern, J, Robertson, M, & Joyce, E (2014). Biofeedback treatment for Tourette syndrome: a preliminary randomized controlled trial. Cognitive and Behavioral Neurology, 27(1), 17-24.
Neurofeedback for Tourette Syndrome