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Researchers have also studied complementary and alternative (CAM) treatments. An open label trial of cranial electrical stimulation (CES) treatment was provided to 42 children with TS who were less than 12 years old \citep{25546850}. The patients applied electrodes to their earlobes when they went to bed so that they could receive the treatment on a daily basis for 24 weeks. Treatment was provided for 60 minutes and they could go to sleep if they wanted. Only one child dropped out before the completion of the study. The mean YGTSS score significantly decreased from 26.3 when they were initially seen to 11.4 after 24 weeks of treatment. Functional MRI scanning was optional and only 8 subjects completed the scans before and after treatment. Independent component analysis with hierarchical partner matching was used to examine functional connectivity among regions within the cortico-striato-thalamo-cortical circuit followed by Granger causality to examine effective connectivity. After the CES treatment this subsample had stronger functional activity and connectivity in the anterior cingulate cortex, caudate and posterior cingulate cortex and weaker activity in the supplementary motor area. These results must be viewed as preliminary, since an RCT is required to rule out spontaneous improvement.  Another CAM treatment undergoing initial efficacy testing is an oral orthotic device with which some patients have reported success. The rationale and design of the study, and initial safety results, were [reported reported  at the London meeting](http://www.webcitation.org/6hNT4PRxf), meeting \citep{orthotic:London},  and efficacy testing continues (see [the trial summary at ClinicalTrials.gov](https://clinicaltrials.gov/ct2/show/NCT02067819)).