Evidence Hub

Complementary and Integrative Medicine for the Treatment of Tourette's Syndrome

Pringsheim T, Deans C, Anis S, Bhatia P, Black K, Degirmenci Y, Gilbert D, Hartmann A et al.

Movement disorders clinical practice, 2026

Abstract

Background: There is widespread interest in complementary and integrative medicine (CIM) among people with Tourette's syndrome (TS).

Objective: To perform a systematic review of evidence on the use of CIM to reduce tics and improve tic-related quality of life.

Methods: We included clinical studies of CIM in children, adolescents and adults with TS and chronic tic disorders, and assessed the change in tic severity and/or tic-related quality of life using validated scales. Risk of bias of randomized controlled trials was assessed using the risk of bias tool of the American Academy of Neurology, which classifies studies into Class I, II, III or IV based on quality criteria.

Results: 49 clinical studies and three systematic reviews were included. Most studies were rated Class IV and therefore at high risk of bias. Class I studies demonstrated efficacy of functional MRI neurofeedback, 5-Ling granule, Jingxin Zhidong formula, and Ningdong granule in reducing tic severity. Class II studies suggest efficacy of mindfulness-based intervention for tics, acupuncture combined with atlantoaxial joint bone setting therapy, and art therapy. Systematic reviews summarizing the Chinese literature on acupuncture, acupuncture with herbal medicine and massage therapy suggest greater reduction in tics compared to conventional treatments but there is low confidence in the evidence due to poor methodological quality of included studies.

Conclusions: Evidence to support the use of complementary and…

How strong is the evidence?

Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

Read the paper

Related studies

Go deeper in Evidence Hub

Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.

Open this study Sign up free