Biofeedback treatment for Tourette syndrome: a preliminary randomized controlled trial

Yoko Nagai, Andrea E Cavanna, Hugo D Critchley, Jeremy J Stern, Mary M Robertson, Eileen M Joyce

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)


OBJECTIVE: To study the clinical effectiveness of biofeedback treatment in reducing tics in patients with Tourette syndrome.

BACKGROUND: Despite advances in the pharmacologic treatment of patients with Tourette syndrome, many remain troubled by their tics, which may be resistant to multiple medications at tolerable doses. Electrodermal biofeedback is a noninvasive biobehavioral intervention that can be useful in managing neuropsychiatric and neurologic conditions.

METHODS: We conducted a randomized controlled trial of electrodermal biofeedback training in 21 patients with Tourette syndrome.

RESULTS: After training the patients for 3 sessions a week over 4 weeks, we observed a significant reduction in tic frequency and improved indices of subjective well-being in both the active-biofeedback and sham-feedback (control) groups, but there was no difference between the groups in these measurements. Furthermore, the active-treatment group did not demonstrably learn to reduce their sympathetic electrodermal tone using biofeedback.

CONCLUSIONS: Our findings indicate that this form of biofeedback training was unable to produce a clinical effect greater than placebo. The main confounding factor appeared to be the 30-minute duration of the training sessions, which made it difficult for patients to sustain a reduction in sympathetic tone when their tics themselves were generating competing phasic electrodermal arousal responses. Despite a negative finding in this study, electrodermal biofeedback training may have a role in managing tics if optimal training schedules can be identified.

Original languageEnglish
Pages (from-to)17-24
Number of pages8
JournalCognitive and Behavioral Neurology
Issue number1
Publication statusPublished - Mar 2014


  • Adolescent
  • Adult
  • Biofeedback, Psychology
  • Female
  • Galvanic Skin Response
  • Humans
  • Male
  • Surveys and Questionnaires
  • Tics/etiology
  • Tourette Syndrome/psychology
  • Treatment Outcome
  • electrodermal activity
  • sympathetic autonomic arousal


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