OBJECTIVE:To compare the difference in the clinical efficacy on infantile Tourette syndrome between the integrated therapy of acupuncture and pingganjianpi decoction and haloperidol tablets.

METHODS:Forty-seven children were randomized into an observation group (25 cases) and a control group (22 cases). In the observation group, acupuncture was applied to Taichong (LR 3), Baihui (GV 20), Zhongwan (CV 12), Zusanli (ST 36), etc. The needles were retained for 30 min. Acupuncture was given once a day and there were 5 days at intervals after 10 times of acupuncture. Additionally, pinggan jianpi decoction was prescribed. In the control group, haloperidol tablets were prescribed, starting from the small dose, 0. 05 mg/kg per day, twice a day. The treatment of 30 days made one session and 3 sessions were required. Yale global tic severity scale (YGTSS) was adopted to observe tic time, tic frequency and tic severity score before treatment and in 30 days, 60 days and 90 days after treatment in the two groups. The efficacy and adverse reactions were compared between the two groups.

RESULTS:The total effective rates were 40. 0% (10/25), 64.0% (16/25) and 76.0% (19/25) in the observation group and were 59.1% (13/22), 68.2% (15/22) and 77.3% (17/22) in the control group in 30 days, 60 days and 90 days after treatment respectively. The effect in 30 days after treatment in the control group was better than that in the observation group (P<0. 05). The differences at the other time points were not significant between the two groups (all P>0. 05). The tic time, tic frequency and tic severity score at the each time point after treatment were reduced obviously as compared with those before treatment (all P<0. 05). Each item score in the control group was reduced obviously as compared with that in the observation group in 30 days after treatment (all P<0. 05). The differences at the other time points were not significant between the two groups (all P>0.05). The probability of adverse reaction in the observation group was less than that in the control group.

CONCLUSION:The integrated therapy of acupuncture and medicine achieves the similar effect on infantile Tourette syndrome to haloperidol tablets and the side effects of it are less.

OBJECTIVE:To compare the difference in the clinical efficacy on infantile Tourette syndrome between the integrated therapy of acupuncture and pingganjianpi decoction and haloperidol tablets.

METHODS:Forty-seven children were randomized into an observation group (25 cases) and a control group (22 cases). In the observation group, acupuncture was applied to Taichong (LR 3), Baihui (GV 20), Zhongwan (CV 12), Zusanli (ST 36), etc. The needles were retained for 30 min. Acupuncture was given once a day and there were 5 days at intervals after 10 times of acupuncture. Additionally, pinggan jianpi decoction was prescribed. In the control group, haloperidol tablets were prescribed, starting from the small dose, 0. 05 mg/kg per day, twice a day. The treatment of 30 days made one session and 3 sessions were required. Yale global tic severity scale (YGTSS) was adopted to observe tic time, tic frequency and tic severity score before treatment and in 30 days, 60 days and 90 days after treatment in the two groups. The efficacy and adverse reactions were compared between the two groups.

RESULTS:The total effective rates were 40. 0% (10/25), 64.0% (16/25) and 76.0% (19/25) in the observation group and were 59.1% (13/22), 68.2% (15/22) and 77.3% (17/22) in the control group in 30 days, 60 days and 90 days after treatment respectively. The effect in 30 days after treatment in the control group was better than that in the observation group (P<0. 05). The differences at the other time points were not significant between the two groups (all P>0. 05). The tic time, tic frequency and tic severity score at the each time point after treatment were reduced obviously as compared with those before treatment (all P<0. 05). Each item score in the control group was reduced obviously as compared with that in the observation group in 30 days after treatment (all P<0. 05). The differences at the other time points were not significant between the two groups (all P>0.05). The probability of adverse reaction in the observation group was less than that in the control group.

CONCLUSION:The integrated therapy of acupuncture and medicine achieves the similar effect on infantile Tourette syndrome to haloperidol tablets and the side effects of it are less.

OBJECTIVE:To explore an ideal program for acupuncture treatment of Tourette's syndrome (TS).

METHODS:One hundred and two cases of TS were randomly divided into a treatment group of 68 cases and a control group of 34 cases. The treatment group were treated with acupuncture at Taichong (LR 3) and Hegu (LI 4) as main, and the control group with oral administration of heloperidol. Their therapeutic effects were compared, and changes of somatosensory evoked potentials (SEP) before and after treatment were investigated in the treatment group.

RESULTS:After treatment for 3 courses, 56 cases were cured, 10 improved and 2 ineffective with an effective rate of 97.1% in the treatment group; and 15 cases were cured, 11 improved and 8 ineffective with an effective rate of 76.5% in the control group, with a very significant difference in the effective rate between the two groups (P<0.001); after treatment, the abnormal rate of SEP decreased by 41.1% in the treatment group (P<0.001).

CONCLUSION:Acupuncture is a very effective therapy for TS and has a certain restoring action on mild abnormal change of SEP.

OBJECTIVE:To explore an ideal program for acupuncture treatment of Tourette's syndrome (TS).

METHODS:One hundred and two cases of TS were randomly divided into a treatment group of 68 cases and a control group of 34 cases. The treatment group were treated with acupuncture at Taichong (LR 3) and Hegu (LI 4) as main, and the control group with oral administration of heloperidol. Their therapeutic effects were compared, and changes of somatosensory evoked potentials (SEP) before and after treatment were investigated in the treatment group.

RESULTS:After treatment for 3 courses, 56 cases were cured, 10 improved and 2 ineffective with an effective rate of 97.1% in the treatment group; and 15 cases were cured, 11 improved and 8 ineffective with an effective rate of 76.5% in the control group, with a very significant difference in the effective rate between the two groups (P<0.001); after treatment, the abnormal rate of SEP decreased by 41.1% in the treatment group (P<0.001).

CONCLUSION:Acupuncture is a very effective therapy for TS and has a certain restoring action on mild abnormal change of SEP.

OBJECTIVE:To explore the clinical efficacy of integrative Chinese and Western medicine in treating Tourette syndrome (TS).

METHODS:Ninety children with TS were randomized into two groups by randomizing: digital table method: the 60 patients in the treated group were treated by Ningdong Granule (NDG) plus haloperidol, and the 30 in the control group treated by haloperidol alone. The course for both groups was 6 months. Conditions of the patients were estimated before and after treatment with Yale Global Tic Severity Scale (YGTSS), the short-term efficacy, adverse reaction of treatment were assessed at the end of treatment, and the long-term efficacy as well as the recurrent rate were evaluated half a year after the treatment was ended.

RESULTS:Of the 60 patients in the treated group, the treatment on 36 was evaluated as remarkably effective, 21 as effective, and 3 as ineffective, the total effective rate being 95.0% (57/60), while of the 30 patients in the control group, the corresponding data were 9, 13, 8 and 73.3% (22/30), respectively, differences between groups in markedly effective rate and total effective rate were statistically significant (chi(2)=7.20, and chi(2)=6.85, P<0.01). The improvement on the condition of illness, motor tic and vocal tic, as well as the long-term efficacy of treatment were all better in the treated group than in the control group (P<0.05 or P<0.01). The incidence of adverse reaction and the recurrent rate in the treated group were 13.3% (8/60) and 8.3% (5/60) respectively, all were lower than those in the control group, 36.7% (11/30) and 43.3 (13/30), showing statistical significances (P<0.05 and P<0.01).

CONCLUSION:Integrative medical treatment on TS was markedly effective in clinical practice with less adverse reaction and lower recurrent rate.

OBJECTIVE:To observe therapeutic effects of different needle-retained durations at scalp acupoints on Tourette syndrome (TS).

METHODS:Sixty-two cases of TS were randomly divided into an observation group and a control group, 31 cases in each group. In the observation group, the needles were retained for 2 h and in the control group, they were retained for 30 min. The middle line of forehead, middle line of vertex and lateral line 1 of vertex were selected as main acupoints, and anterior oblique line of vertex-temporal and posterior temporal line were selected as adjuvant acupoints. They were treated for 2 months, once other day. Yale Global Tic Severity Scale (YGTSS) and Tourette Syndrome Global Scale (TSGS) were used for assessment of therapeutic effects and their therapeutic effects were compared.

RESULTS:After treatment, YGTSS and TSGS scores had very significant changes in the two groups as compared with those before treatment (both P<0.01), indicating an obvious improvement in kinetic Tic and vocalizing Tic. The total effective rate was 61.3% in the observation group and 67.7% in the control group with no significant difference between the two groups (P>0.05).

CONCLUSION:Scalp acupuncture therapy of both 2 h and 0.5 h retaining needle can significantly improve symptoms of TS patients, with a similar therapeutic effect.

OBJECTIVE:To observe therapeutic effects of different needle-retained durations at scalp acupoints on Tourette syndrome (TS).

METHODS:Sixty-two cases of TS were randomly divided into an observation group and a control group, 31 cases in each group. In the observation group, the needles were retained for 2 h and in the control group, they were retained for 30 min. The middle line of forehead, middle line of vertex and lateral line 1 of vertex were selected as main acupoints, and anterior oblique line of vertex-temporal and posterior temporal line were selected as adjuvant acupoints. They were treated for 2 months, once other day. Yale Global Tic Severity Scale (YGTSS) and Tourette Syndrome Global Scale (TSGS) were used for assessment of therapeutic effects and their therapeutic effects were compared.

RESULTS:After treatment, YGTSS and TSGS scores had very significant changes in the two groups as compared with those before treatment (both P<0.01), indicating an obvious improvement in kinetic Tic and vocalizing Tic. The total effective rate was 61.3% in the observation group and 67.7% in the control group with no significant difference between the two groups (P>0.05).

CONCLUSION:Scalp acupuncture therapy of both 2 h and 0.5 h retaining needle can significantly improve symptoms of TS patients, with a similar therapeutic effect.

Tourette syndrome (TS), a developmental neurobehavioral disorder, is characterized by involuntary behavioral stereotypies. Clinical studies have confirmed the positive effect of acupuncture on treating TS, but the underlying mechanisms are not fully understood. In the present study, we used behavioral tests, Western blotting, double-immunofluorescence labeling, and fluorescence spectrophotometry to investigate whether acupuncture performed at acupoints"Baihui"(GV20) and"Yintang"(GV29) affected behavioral stereotypies and regulated the dopamine (DA) system in three different brain regions in Balb/c mice injected with 3,3'-iminodipropionitrile (IDPN) as a model for TS. We found that acupuncture alleviated behavioral stereotypies, down-regulated the expression of D1R and D2R in the striatum (STR) and substantia nigra pars compacta (SNpc), and decreased the concentration of DA in the STR, SNpc, and prefrontal cortex (PFC) as well. Moreover, acupuncture reduced the expression of tyrosine hydroxylase (TH) in the SNpc. Conclusively, acupuncture ameliorated behavioral stereotypies by regulating the DA system in the STR, SNpc, and PFC. Our findings provide novel evidence for the therapeutic effect of acupuncture on TS.

Rats receiving fluoride during the whole pregnancy up to the 9th day of lactation showed, when isolated at 10th day of life, a reduced rate of ultrasonic vocalizations (UV) in male pups (NaF 5.0 mg) and, in 90th days male rats, an increase of the Pre-Pulse Inhibition (PPI) with a reduction of the Peak response to the Startle stimulus given alone. Newborn rat reactivity could represent a useful and validated model in anxiety studies which could be moored with the Acoustic Startle Reflex (ASR) and PPI, appropriate models to study, in adulthood, particular neurological and psychiatric disorders showing deficits in attention and sensory-motor gating (Tourettes' syndrome, obsessive compulsive disorders, Huntington's disease and schizophrenia).

OBJECTIVES:The pharmacological treatment of Tourette syndrome (TS) has improved due to the application of new medications and combinations of medications, coupled to greater phenomenological and neurobiological understanding of the condition. Nevertheless, for many individuals with TS, potentially troublesome tics persist despite optimized drug treatment. Anecdotally, a relationship is frequently described between tic frequency and states of bodily arousal and/or focused attention. The galvanic skin response (GSR) is an accessible and sensitive index of sympathetic nervous activity, reflecting centrally induced changes in peripheral autonomic arousal. Sympathetic nervous arousal, measured using GSR, has been shown to have an inverse relationship with an electroencephalographic index of cortical excitability (slow cortical potential), and GSR arousal biofeedback shows promise as an adjunctive therapy in management of treatment-resistant epilepsy.

METHOD:We examined how changes in sympathetic arousal, induced using GSR biofeedback, impact on tic frequency in individuals with TS. Two different physiological states (sympathetic arousal and relaxation) were induced using GSR biofeedback in 15 individuals with a diagnosis of TS. During both biofeedback sessions, participants were videotaped to monitor the occurrence of tics.

RESULTS:We observed significantly lower tics during relaxation biofeedback compared to arousal biofeedback, with tic frequency positively correlating with sympathetic arousal during the arousal session.

CONCLUSION:These findings indicate that the conjunction of focused attention to task and reduced peripheral sympathetic tone inhibits tic expression and suggests a potential therapeutic role of biofeedback relaxation training for tic management in patients with TS.

OBJECTIVE:This case series examines the practicality of using a standardized method of training children in self-hypnosis (SH) methods to explore its efficiency and short-term efficacy in treating tics in patients with Tourette syndrome.

METHODS:The files of 37 children and adolescents with Tourette syndrome referred for SH training were reviewed, yielding 33 patients for analysis. As part of a protocol for SH training, all viewed a videotape series of a boy undergoing SH training for tic control. Improvement in tic control was abstracted from subjective patient report.

RESULTS:Seventy-nine percent of the patients trained in this technique experienced short-term clinical response, defined as control over the average 6-week follow-up period. Of the responders, 46% achieved tic control with SH after only 2 sessions and 96% after 3 visits. One patient required 4 visits.

CONCLUSIONS:Instruction in SH, aided by the use of videotape training, augments a protocol and probably shortens the time of training in this technique. If SH is made more accessible in this way, it will be a valuable addition to multi-disciplinary management of tic disorders in Tourette syndrome.

The purpose of this study was to examine associations between physical activity, sleep and symptom severity in children with tic disorders. Children with tic disorders wore the GeneActiv device, a wrist-worn accelerometer that measures physical activity intensity and sleep/wake parameters continuously for seven days, and completed questionnaires on sleep quality, exercise and severity of tics, ADHD, obsessive-compulsive behaviours, anxiety and depression. 110 children participated in the study. Children with more severe tics had significantly more frequent comorbid diagnoses, greater impairment in subjective sleep measures, greater sedentary activity time and less light, moderate and vigorous activity time (all p < 0.05). There was a significant negative correlation between light, moderate and vigorous physical activity and the severity of tics (- 0.22, p = 0.04), obsessive compulsive behaviours (- 0.22, p = 0.03), anxiety (- 0.35, p = 0.0005) and depression (- 0.23, p = 0.03). Therewas no correlation between objective sleep time, sleep efficiency and symptom severity. Subjective sleep quality was positively correlated with all symptom severity measures, with the strongest correlation with ADHD severity (0.42, p < 0.00001). The results of this observational study indicate a small, but significant relationship between activity and sleep measures and the severity of the main symptom domains present in tic disorders.