Biofeedback-Based Videogame May Improve Rage Attacks in Tourette Syndrome

Area of Science:

• Neurology and Psychiatry
• Behavioral Therapy
• Pediatric Medicine

Background:

• Rage attacks (RA) affect 20%-40% of individuals with Tourette syndrome (TS), causing significant impairment.
• Limited research exists on RA treatments in TS, with a focus on pharmacologic interventions.
• Non-pharmacologic interventions may offer symptom improvement with fewer side effects.

Purpose of the Study:

• To evaluate the feasibility and acceptability of Mightier, a video game-based biofeedback therapy, for treating rage attacks in youth with Tourette syndrome.
• To assess the potential of Mightier in teaching emotional regulation through heart rate control.

Main Methods:

• A 20-week single-arm trial enrolled 11 participants aged 6-12 with TS and RA.
• Feasibility was assessed by enrollment rates, screen failures, retention, and device engagement.
• Efficacy was measured using Clinical Global Impressions of Rage, ROARS, and MOAS pre- and post-intervention.

Main Results:

• The study demonstrated feasibility with a 91% retention rate and consistent device engagement (38 min/week).
• No adverse effects were reported during the intervention.
• Significant improvements were observed in rage severity across all assessment measures, with all participants reporting improvement.

Conclusions:

• Mightier is a feasible and acceptable intervention for children with Tourette syndrome and rage attacks.
• The therapy demonstrated positive outcomes in reducing rage severity and aggression.
• Mightier shows promise as a valuable tool for managing rage attacks in pediatric TS patients.