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We tested cortical plasticity by conditioning left primary motor cortex with intermittent or continuous theta\u2010burst stimulation in 2 separate sessions. Test stimulation consisted of 20 motor\u2010evoked potentials recorded from right first interosseous muscle before and after theta\u2010burst stimulation. We also tested brain stem plasticity by conditioning the right supraorbital nerve with facilitatory electric high\u2010frequency stimulation delivered at the same time as the late response of the blink reflex or inhibitory high\u2010frequency stimulation delivered before the late response on 2 separate sessions. Test stimulation consisted of 10 blink reflexes from the right orbicularis oculi muscle before and after high\u2010frequency stimulation. After intermittent theta\u2010burst stimulation, motor\u2010evoked potential amplitudes in healthy subjects increased significantly but remained unchanged in patients. Similarly, after continuous theta\u2010burst stimulation, motor\u2010evoked potential amplitudes decreased significantly in healthy subjects but did not in patients. After facilitatory high\u2010frequency stimulation, the blink reflex late response area in healthy subjects increased, whereas after inhibitory high\u2010frequency stimulation, it decreased. Conversely, in patients, both interventions left the blink reflex late response area unchanged. The lack of the expected inhibitory and facilitatory changes in motor\u2010evoked potential amplitudes and blink reflex late response area suggests that abnormal plasticity in the primary motor cortex and brain stem play a role in the pathophysiology of Gilles de la Tourette syndrome. \u00a9 2011 Movement Disorder Society<\/jats:p>","DOI":"10.1002\/mds.23706","type":"journal-article","created":{"date-parts":[[2011,3,27]],"date-time":"2011-03-27T20:57:41Z","timestamp":1301259461000},"page":"1703-1710","source":"Crossref","is-referenced-by-count":48,"title":["Abnormal cortical and brain stem plasticity in Gilles de la Tourette 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