Electrophysiological studies were discussed as a possible therapeutic modality for tic disorders. Transcranial magnetic stimulation (TMS) for tics has been discussed in several reviews. Repetitive TMS has shown to improve tic symptoms and tic comorbidities, and its safety has been confirmed \cite{Bejenaru2022,Yu2022}. Other review articles have discussed not only on TMS but also on other electrophysiological modalities such as transcranial direct current stimulation (tDCS), peripheral nerve stimulation, and cranial electrotherapeutic stimulation (CES) \cite{Frey2022}. In contrast to repetitive TMS, tDCS, which stimulates by applying a constant low current to electrodes attached directly to the scalp, is inexpensive, portable, and easy to implement. To date, results have been mixed and inconclusive as many studies have been open-label designs. Vagus nerve stimulation (VNS) treatment has also been reported to improve tic symptoms, but it is still unknown how VNS affects tic symptoms. Stimulation of peripheral nerves (i.e., median nerve) with 12 Hz rhythmic pulses synchronized with mu-band oscillations in the brain has been reported to significantly reduce the frequency and severity of tics. CES is a small, portable device that stimulates the brain with a weak electric current and is being studied for its effectiveness in treating tic disorders.
Neuroimaging studies
Pharmacological studies
Other
Treatment
Psychological interventions
A RCT in 40 children age 9-16 found video HRT or ERP equally effective as face-to-face therapy \citep{35686189}.
In 116 patients treated with ERP, those who completed the treatment (or quit early due to improvement) retained significantly better outcome when followed up 1 year after the end of therapy \citep{36473491}.
Comorbid ADHD or OCD improve with internet-delivered CBIT for tics \citep{35011787}.
Medication
Results were presented from a phase 2b parallel group RCT of the dopamine D1 antagonist ecopipam in 153 children and adolescents with TS \citep{wanaski2022,36628546}. YGTSS total tic scores and clinician severity ratings both declined significantly more in the active treatment group, without adverse metabolic or motor effects (such as akathisia or rigidity-bradykinesia).