Health Report - Tourette Syndrome Tic Study

Tourette Syndrome
Tourette Syndrome is a neurological disorder characterized by involuntary rapid motor/vocal expressions, known as tics. It is named for the French physician, Georges Gilles de la TOURETTE who identified the condition as a type of movement disorder.

The tics associated with TOURETTE Syndrome can be classified as simple or complex. Simple tics involve brief, isolated actions or sounds. Examples of simple motor tics include: eye blinking, head jerking, facial grimacing and shoulder shrugging. Some simple vocal tics are throat clearing, grunting, sighing and barking. Complex tics involve more coordinated muscle movements or vocal phrasing. Some examples of complex motor tics are jumping, spinning around, repetitive touching and hand gesturing. Complex vocal tics may include repetition of phrases out of context and echoing statements by oneself or others. Expressions of obscene language and cursing (called coprolalia) are also a type of complex vocal tic. However, these symptoms occur in fewer than 15 percent of patients.

The TOURETTE Syndrome Association estimates about 200,000 people in the U.S. have the disorder. The condition typically appears between 2 and 15. Signs develop by seven in about half of all patients. Boys are affected about three to four times more often than girls.

The exact cause of TOURETTE isn’t known. Heredity appears to play some role in risk. People with TOURETTE may also have other associated conditions, like attention deficit/hyperactivity disorder, obsessive compulsive disorder, learning disabilities, behavioral problems, anxiety, depression and sleep problems.

Living with TOURETTE Syndrome
The course for TOURETTE Syndrome is slightly unpredictable. The frequency and severity of tics varies from person to person. Most patients have mild symptoms. However, factors like stress, anxiety, fatigue or infection, may exacerbate symptoms.

Although TOURETTE is generally considered to be a lifelong disorder, research suggests many patients experience a decrease in the frequency and duration of symptoms by their late teens. Sometimes weeks or years may go by with few or no symptoms. The organization, WE MOVE™ reports some patients experience complete resolution of symptoms by early adulthood.

Treating TOURETTE Syndrome
Patients with very mild cases of TOURETTE may only need reassurance and education about their symptoms. However, children and parents may need extra support and counseling to deal with possible ridicule or rejection by peers or adults.

Patients with frequent or severe symptoms may benefit from medications. Low doses of neuroleptic drugs (like Haldol® or Risperdal®) may help to reduce the frequency and intensity of tics. The medications must be used with caution because they may cause side effects, such as drooling, slowness of movement, restlessness or contraction of the facial and neck muscles. A serious side effect associated with neuroleptic medications is the development of tardive dyskinesia, a condition characterized by persistent, repetitive involuntary movements.

Cognitive Behavior Therapy for Tics
Researchers are now looking at a way to help patients safely deal with tics without medication, using a comprehensive program of cognitive behavioral therapy (CBT). CBT is commonly used for patients with mental health disorders. Therapists teach patients about the nature of their problem (for TOURETTE patients, tics) and develop ways to help them cope with the symptoms that bring on the tic response.

Alan Peterson, Ph.D., a Psychiatry Professor/Researcher at UT Health Science Center, San Antonio, is testing CBT for tics. The goal is to teach specific strategies or techniques to reduce, or in some cases, eliminate, tics.

People with TOURETTE usually experience sensory phenomenon or feelings of tension before the onset of a tic. Patients may learn to recognize the signs and hold back on expression of the tic, through methods like distraction or muscle contraction. Peterson uses a very comprehensive program that involves about 8 sessions lasting 60 to 90 minutes each. He cautions the treatment is not a cure, but may significantly reduce the frequency and intensity of tics.

The San Antonio researchers are still looking for adult participants. The study is also taking place at Yale University and Harvard University. Investigators want to learn how well the treatment works and how long the effects last.

For general information on TOURETTE Syndrome:
National Institute of Neurological Disorders and Stroke, http://www.ninds.nih.gov
Tourette Syndrome Association, http://tsa-usa.org
WE MOVE™” Worldwide Education and Awareness for Movement Disorders, http://www.wemove.org