{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T18:33:31Z","timestamp":1791484411945,"version":"4.3.4"},"reference-count":44,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,5,3]],"date-time":"2023-05-03T00:00:00Z","timestamp":1683072000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["T032588"],"award-info":[{"award-number":["T032588"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020624","name":"NIHR Nottingham Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100020624","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011695","name":"Tourettes Action","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011695","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bpspsychub.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neuropsychology"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Tourette syndrome (TS) and chronic tic disorder (CTD) are neurological disorders of childhood onset characterized by the occurrence of tics; repetitive, purposeless, movements or vocalizations of short duration which can occur many times throughout a day. Currently, effective treatment for tic disorders is an area of considerable unmet clinical need. We aimed to evaluate the efficacy of a home\u2010administered neuromodulation treatment for tics involving the delivery of rhythmic pulse trains of median nerve stimulation (MNS) delivered via a wearable \u2018watch\u2010like\u2019 device worn at the wrist. We conducted a UK\u2010wide parallel double\u2010blind sham\u2010controlled trial for the reduction of tics in individuals with tic disorder. The device was programmed to deliver rhythmic (10\u2009Hz) trains of low\u2010intensity (1\u201319\u2009mA) electrical stimulation to the median nerve for a pre\u2010determined duration each day, and was intended to be used by each participant in their home once each day, 5\u2009days each week, for a period of 4\u2009weeks. Between 18th March 2022 and 26th September 2022, 135 participants (45 per group) were initially allocated, using stratified randomization, to one of the following groups; active stimulation; sham stimulation or to a waitlist (i.e. treatment as usual) control group. Recruited participants were individuals with confirmed or suspected TS\/CTD aged 12\u2009years of age or upward with moderate to severe tics. Researchers involved in the collection or processing of measurement outcomes and assessing the outcomes, as well as participants in the active and sham groups and their legal guardians were all blind to the group allocation. The primary outcome measure used to assess the \u2018offline\u2019 or treatment effect of stimulation was the Yale Global Tic Severity Scale\u2013Total Tic Severity Score (YGTSS\u2013TTSS) assessed at the conclusion of 4\u2009weeks of stimulation. The primary outcome measure used to assess the \u2018online\u2019 effects of stimulation was tic frequency, measured as the number of tics per minute (TPM) observed, based upon blind analysis of daily video recordings obtained while stimulation was delivered. The results demonstrated that after 4\u2010week stimulation, tic severity (YGTSS\u2010TTSS) had reduced by 7.1 points (35 percentile reduction) for the active stimulation group compared to 2.13\/2.11 points for the sham stimulation and waitlist control groups. The reduction in YGTSS\u2013TTSS for the active stimulation group was substantially larger, clinically meaningful (effect size\u2009=\u2009.5) and statistically significant (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u2009.02) compared to both the sham stimulation and waitlist control groups, which did not differ from one another (effect size\u2009=\u2009\u2212.03). Furthermore, blind analyses of video recordings demonstrated that tic frequency (tics per minute) reduced substantially (\u221215.6 TPM) during active stimulation compared to sham stimulation (\u22127.7 TPM). This difference represents a statistically significant (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u2009.03) and clinically meaningful reduction in tic frequency (&gt;25 percentile reduction: effect size\u2009=\u2009.3). These findings indicate that home\u2010administered rhythmic MNS delivered through a wearable wrist\u2010worn device has the potential to be an effective community\u2010based treatment for tic disorders.\n                  <\/jats:p>","DOI":"10.1111\/jnp.12313","type":"journal-article","created":{"date-parts":[[2023,5,3]],"date-time":"2023-05-03T11:59:17Z","timestamp":1683115157000},"page":"540-563","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["A double\u2010blind, sham\u2010controlled, trial of home\u2010administered rhythmic 10\u2010Hz median nerve stimulation for the reduction of tics, and suppression of the urge\u2010to\u2010tic, in individuals with Tourette syndrome and chronic tic disorder"],"prefix":"10.1111","volume":"17","author":[{"given":"Barbara Morera","family":"Maiquez","sequence":"first","affiliation":[{"name":"School of Psychology University of Nottingham Nottingham 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