Traditional Chinese Medicine in the Comprehensive Management of Tourette Syndrome: Insights from Genetics and Pathophysiology: A Review

Tourette syndrome (TS) is a neurodevelopmental disorder characterized by recurrent motor and vocal tics, often accompanied by comorbid psychiatric symptoms. While pharmacological treatments are commonly used, they often provide incomplete symptom relief and may cause adverse effects. Traditional Chinese Medicine (TCM) has been increasingly applied in clinical practice and is considered a valuable complementary approach. This review summarizes current research on TS from the perspectives of genetics, pathophysiology, and TCM, with particular attention to how biological findings inform syndrome differentiation and treatment. Genetic studies have identified polymorphisms such as IL1RN and SLC1A3, which are associated with immune dysfunction and neurotransmitter imbalance, respectively. These findings may correspond to TCM syndromes such as "Liver Wind Stirring Internally", linked to inflammation, and "Liver Yin Deficiency with Yang Hyperactivity", associated with excitatory overactivity. Pathophysiological mechanisms, including cortico-striato-thalamo-cortical (CSTC) circuit abnormalities and dopaminergic dysregulation, have been recognized as core contributors to tic development. TCM interventions appear to target these mechanisms. Tianma Gouteng Decoction has been shown to regulate neurotransmitter function and reduce liver yang hyperactivity, while Ningdong Granule can inhibit neuroinflammatory responses by modulating microglial activity. These effects are consistent with modern findings on the neural and immune changes observed in TS. Moreover, clinical evidence supports that combining TCM with Western pharmacotherapy may improve overall treatment efficacy, reduce side effects, and enhance patient outcomes. By linking genetic and neural mechanisms with traditional syndrome patterns, this review offers a comprehensive framework for understanding and applying TCM in TS treatment. The integration of TCM principles with modern scientific knowledge may support more individualized and biologically informed approaches to care.