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Tourette Syndrome and CBT

A recent study published in the International Journal of Cognitive Therapy found that cognitive behavior therapy (CBT) may significantly improve motor functions and brain activity in individuals with Gilles de la Tourette syndrome (GTS).  GTS is a neuropsychiatric disorder characterized by simple or complex multiple motor tics and one or more vocal tics. GTS can hinder daily living, especially in adults and contributes to cognitive impairment (e.g., deficits in learning and fine motor coordination). The current study investigated the relationships between symptom expression, complex motor processing, and brain activity in GTS before and after a CBT intervention program. The researchers aimed to determine the impact of CBT on these parameters (symptom expression, complex motor processing, and brain activity) and how changes in brain processes relates to  corresponding changes in GTS symptoms.

Participants in the current study included 10 previously diagnosed GTS patients and 14 individuals without neurological or psychiatric problems. A CBT management program was implemented with participants.  Before and following the CBT program, participants were given the traffic light paradigm, a task which measures reaction time, to compare cortical events during automatic processing versus controlled processing. An electroencephalogram (EEG) recorded the electrophysiological signals emitted during the traffic light paradigm and symptom severity was assessed using the Tourette Syndrome Global Scale (TSGS) and the Yale Global Tourette Syndrome Scale (YGTSS).  These scales were administered during structured interviews conducted by a clinician.

GTS participants showed significant reductions in tic frequency as measured by the TSGS and YGTSS post-CBT intervention.  Fine motor dexterity improved and there were significant changes in electrophysiological measures. Participants also showed reduced cerebral activation post-CBT in central regions of the brain when inhibiting automatic motor responses during the traffic light paradigm. These findings suggest a new and exciting way to bridge neuroscience and cognitive behavior therapy.

Imbriglio, T.V.,  Lavoie, M. E., O’Connor, K. P., Stip, E. (2011). Neurocognitive Changes Following Cognitive-Behavior Treatment in Tourette Syndrome and Chronic Tic Disorder. International Journal of Cognitive Therapy, 4(1), 34-50.