Evidence map›Paper›PMID 31668476›Full record

Trial reportBiological psychiatry2020

Randomized, Sham-Controlled Trial of Real-Time Functional Magnetic Resonance Imaging Neurofeedback for Tics in Adolescents With Tourette Syndrome.

Denis G Sukhodolsky, Christopher Walsh, William N Koller, Jeffrey Eilbott, Mariela Rance, Robert K Fulbright, Zhiying Zhao, Michael H Bloch, Robert King, James F Leckman and 3 more

Open access · greenAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Biological psychiatry, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 4 pooled it
7.3field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 4 syntheses or guidelines pooled it, 51 citations in OpenAlex.

  1. Pooled it
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  12. A protocol formedRxiv : the preprint server for health sciences · 2025
    Article
  13. Functional Neuroanatomy of Tics: A Brain Network Perspective.The Psychiatric clinics of North America · 2025
    Review
  14. Article
  15. From lab to life: challenges and perspectives of fNIRS for haemodynamic-based neurofeedback in real-world environments.Philosophical transactions of the Royal Society of London. Series B, Biological sciences · 2024
    Review
  16. Article
  17. Article
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  19. Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 1 institution in 1 country.

Denis G SukhodolskyChild Study Center, Yale School of Medicine, New Haven, Connecticut.
Christopher WalshDepartment of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut.
William N KollerDepartment of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut.
Jeffrey EilbottSurveyBott LLC, Brooklyn, New York.
Mariela RanceDepartment of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut.
Robert K FulbrightDepartment of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut.
Zhiying ZhaoDepartment of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut.
Michael H BlochChild Study Center, Yale School of Medicine, New Haven, Connecticut.
Robert KingChild Study Center, Yale School of Medicine, New Haven, Connecticut.
James F LeckmanChild Study Center, Yale School of Medicine, New Haven, Connecticut.
Dustin ScheinostChild Study Center, Yale School of Medicine, New Haven, Connecticut; Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut; Department of Statistics and Data Science, Yale University, New Haven, Connecticut.
Brian PittmanDepartment of Psychiatry, Yale School of Medicine, New Haven, Connecticut.
Michelle HampsonChild Study Center, Yale School of Medicine, New Haven, Connecticut; Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut; Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut. Electronic address: michelle.hampson@yale.edu.
Yale University · US

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Research Training for Medical Students & Physician-Scientists in Child PsychiatryR25MH077823 · NIMH · YALE UNIVERSITY · PI ANDRES S MARTIN · 2006 to 2026
$4.0M
Biofeedback of activity in the orbitofrontal cortex for OCDR01MH100068 · NIMH · YALE UNIVERSITY · PI HAMPSON, MICHELLE · 2014 to 2018
$2.5M
Biofeedback of activity in the supplementary motor area for Tourette SyndromeR01MH095789 · NIMH · YALE UNIVERSITY · PI HAMPSON, MICHELLE · 2012 to 2016
$2.1M
Neurofeedback of amygdala activity for PTSDR61MH115110 · NIMH · YALE UNIVERSITY · PI HAMPSON, MICHELLE, HARPAZ-ROTEM, ILAN · 2018 to 2021
$1.2M
Neurobiology of Behavior Therapy for Children with Tourette SyndromeK01MH079130 · NIMH · YALE UNIVERSITY · PI SUKHODOLSKY, DENIS G · 2008 to 2012
$833k
NCATS NIH HHS UL1 TR001863NIMH NIH HHS K01 MH079130NIMH NIH HHS R01 MH095789NIMH NIH HHS R01 MH100068NIMH NIH HHS R25 MH077823NIMH NIH HHS R61 MH115110
6 · The paper itself

Abstract

backgroundActivity in the supplementary motor area (SMA) has been associated with tics in Tourette syndrome (TS). The aim of this study was to test a novel intervention-real-time functional magnetic resonance imaging neurofeedback from the SMA-for reduction of tics in adolescents with TS.

methodsTwenty-one adolescents with TS were enrolled in a double-blind, randomized, sham-controlled, crossover study involving two sessions of neurofeedback from their SMA. The primary outcome measure of tic severity was the Yale Global Tic Severity Scale administered by an independent evaluator before and after each arm. The secondary outcome was control over the SMA assessed in neuroimaging scans, in which subjects were cued to increase/decrease activity in SMA without receiving feedback.

resultsAll 21 subjects completed both arms of the study and all assessments. Participants had significantly greater reduction of tics on the Yale Global Tic Severity Scale after real neurofeedback as compared with the sham control (p < .05). Mean Yale Global Tic Severity Scale Total Tic score decreased from 25.2 ± 4.6 at baseline to 19.9 ± 5.7 at end point in the neurofeedback condition and from 24.8 ± 8.1 to 23.3 ± 8.5 in the sham control condition. The 3.8-point difference is clinically meaningful and corresponds to an effect size of 0.59. However, there were no differences in changes on the secondary measure of control over the SMA.

conclusionsThis first randomized controlled trial of real-time functional magnetic resonance imaging neurofeedback in adolescents with TS suggests that this neurofeedback intervention may be helpful for improving tic symptoms. However, no effects were found in terms of change in control over the SMA, the hypothesized mechanism of action.

Indexed as

NeurofeedbackTicsTourette SyndromeAdolescentCross-Over StudiesHumansMagnetic Resonance ImagingSeverity of Illness IndexBiofeedbackNeurofeedbackrt-fMRISupplementary motor areaTicsTourette syndrome

Identifiers

PMID31668476
PMCPMC7015800
OpenAlexW2967945776

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.