Abstract Details

Title Biofeedback-based Video Game Device to Treat Rage Attacks in Youth with Tourette Syndrome

Topic Child Neurology and Developmental Neurology

Presentation(s) P5 - Poster Session 5 (11:45 AM-12:45 PM)

Poster/Presentation
Number 4-008

Objective To evaluate the feasibility and acceptability of Mightier as a therapeutic intervention for rage attacks in youth with TS.

Background Approximately 20-40% of individuals with Tourette Syndrome (TS) have rage attacks, which are recurrent, explosive behavioral outbursts that can cause significant functional impairment. Despite the impact of rage attacks in TS, there has been limited research on treatment, and most studies have focused on pharmacologic interventions. Non-pharmacologic interventions have the potential to improve symptoms with fewer side effects. Mightier, a biofeedback-based video game device, may help teach emotional regulation through heart rate control and has the potential to improve rage attacks in youth with TS.

Design/Methods Feasibility was assessed by recruitment number and retention rate. Subjects aged 6-12 years old with a diagnosis of TS and rage attacks were enrolled between October 2021 and May 2022 into a 20-week, single-arm trial. We also evaluated efficacy by assessing rage severity (Clinical Global Impressions of Rage (CGI-Rage), Rage Outbursts and Anger Rating Scale (ROARS)) and overall aggression severity (Modified Overt Aggression Scale) pre- and post-intervention. CGI-Improvement was completed post-intervention.

Results

Recruitment rate was 1.1 subjects per month. Of the 8 enrolled subjects, 4 have completed the study and 1 has withdrawn due to medication changes during the study period. Retention rate was 87.5% (n=7). No screening failures occurred. Post-intervention, rage attack severity on CGI-Rage and ROARS improved in 75% (n=3) of subjects and did not change in 1 subject. Aggression did not significantly change (improved by a mean 0.5 points). CGI-I was rated as much improved or very much improved across all subjects.

Conclusions Based on our recruitment rate and retention, Mightier may be feasible for use in youth with rage attacks and TS. Preliminary efficacy outcomes are promising.

Authors/Disclosures
Matthew Tae PRESENTER	Mr. Tae has nothing to disclose.
Samantha P. Myers, MD	Ms. Myers has nothing to disclose.
	No disclosure on file
Nicole Walsh, NP (University of Rochester Medical Center)	Mrs. Walsh has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Jonathan W. Mink, MD, PhD, FAAN	The institution of Dr. Mink has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amicus. The institution of Dr. Mink has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurogene. Dr. Mink has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TEVA. Dr. Mink has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for PTC Therapeutics. Dr. Mink has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Applied Therapeutics. Dr. Mink has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for AAN. The institution of Dr. Mink has received research support from Neurogene. The institution of Dr. Mink has received research support from NIH. Dr. Mink has received publishing royalties from a publication relating to health care. Dr. Mink has received personal compensation in the range of $500-$4,999 for serving as a Member, Study Section with NINDS.
Jennifer A. Vermilion, MD (University of Rochester)	The institution of Dr. Vermilion has received research support from Centers for Disease Control. The institution of Dr. Vermilion has received research support from Emalex Biosciences. The institution of Dr. Vermilion has received research support from Biomarin. The institution of Dr. Vermilion has received research support from Neurogene, Inc. Dr. Vermilion has received personal compensation in the range of $500-$4,999 for serving as a Invited Speaker with Tourette Association of America. Dr. Vermilion has received personal compensation in the range of $500-$4,999 for serving as a Invited Speaker with Centers for Disease Control and Prevention and American Academy of Pediatrics.

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