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Cheryl Richards edited Treatment.md
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An open label trial of psychotherapy using a cognitive psychophysiological model of tic behavior was conducted with 102 adults with 49 TS sbujects and 36 subjects with chronic tic disorder completing treatment. The treatment consisted of 10 weeks of individual psychotherapy involved a variety of tasks including increasing awareness of tics, muscle discrimination, decreasing muscle tension and an overactivte style of action, identifying low and high risk activities in terms of tic probability, highlighting the differences in behaviors, thoughts and feelings; decreasing perfectionistic beliefs linked to tension and relapse prevention. These psychotherapy tasks were chosen because of research suggesting that some TS subjects have perfectionist beliefs when they plan actions and this leads to an impulsive overactive style resulting in frustration, tension and tics. Large effect sizes were sen for both control groups compared to the waiting list control. 65% of the chronic tic disorder group and 74% of the TS group had reductions of more than 35% on the Tourette Syndrome Global Scale. At the end of treatment 78 of 85 completers were rated as mild or below regardless of the starting severity and the other 7 were considered to have moderate symptoms. Large effect sizes were seen whether they were imple or complex and similar results were seen for tic locations (i.e., eyes, face, head, neck and shoulder, trunk and abdomen, phonic).
This group (Morand-Beaulieu et al., "Cognitive-behavioral therapy induces sensorimotor and specific electocortical changes") examined the effects of this psychotherapy approach on event-related potentials and lateralized readiness potentials (LRPs). 20 EEGS were recorded for TS subjects and 20 control subjects matched for age, sex and Raven Progressive Matrices score, while performing a stimulus-response compatibility inhibition task. During the NoGo condition, the TS group exhibited a delayed and overactivated frontal late positive component. The authors interpreted this result as evidence that this
frontal activation may be an adaptive mechanism that allows patients to perform behaviorally similarly to the control subjects. TS subjects exhibited
larger amplitudes of the delayed stimulus-locked lateralized readiness potential
that occurs when two incompatible responses are automatically triggered and the inappropriate response needs to be aborted. The onset latency. TS subjects also
produced a displayed larger
response-locked LRP peak
amplitudes which
is are associated with the
retrieval execution of the motor program for the correct
response is retrieved and then executed. response. The authors suggest that
these the larger amplitudes may reflect overactivation of the pre-motor and motor cortex in TS patients. The larger sLRP amplitude was not normalized after psychotherapy. In contrast the sLRP onset and the
rSLP rLRP peak were normalized after psychotherapy.
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