Multiple Tics Research Articles

舌こう傷を伴ったトゥレット障害の１例

We describe a case of Tourette's disorder in a 7-year-old boy. Symptoms of Tourette's disorder include tic disorders, multiple tics, and voice tics; these sympotoms persist for more than 1 year. Tic disorders are attributed to psychological stress in the household environment.Generally, tics appear in childhood and induce self mutilation. Our patient had severe bite wounds in the tongue caused by self mutilation. These symptoms were suggested to be caused by a poor relation with his mother. We were nearly satisfied with the outcome of our symptomatic treatment. However, continuous treatment by a psychiatrist or other specialist is considered necessary.

Multiple childhood behavioral disorders (Tourette syndrome, multiple tics, ADD and OCD) presenting in a family with a balanced chromosome translocation (t1;8)(q21.1;q22.1).

Multiple childhood behavioral disorders (Tourette syndrome, multiple tics, ADD and OCD) presenting in a family with a balanced chromosome translocation (t1;8)(q21.1;q22.1).

Neuropsychiatric disorders of childhood: Tourette's syndrome as a model.

Neuropsychiatric disorders of childhood include conditions such as autism, pervasive developmental disorder and attention deficit hyperactivity disorder. Tourette's syndrome (TS) of chronic, multiple, motor and vocal tics is a model neuropsychiatric disorder with a childhood onset and long-term, and sometimes life-long, course. Symptoms and signs change during the course of maturation, and include obsessions, compulsions, attentional difficulties and psychological responses to the disability. These clinical features reflect the interaction between genetic and environmental factors. The localization and cloning of the genetic substrate will allow for detailed study of the pathways from molecular vulnerability to clinical syndrome.

Gilles de la Tourette's Syndrome in Childhood: A Guide for School Professionals

Gilles de la Tourette's syndrome (GTS) is considered a neuropsychiatrie condition that is characterized by multiple motor and vocal tics that fluctuate in expression and severity with the passage of time. A variety of neurocognitive, social and emotional difficulties are present in some cases. GTS and associated symptoms can interfere with school functioning, both academically and socially. The syndrome also can place children at risk for the development of secondary psychological difficulties such as depression. This article describes the core features of GTS and highlights how symptoms of GTS and their commonly associated features may interfere with school functioning. Recommendations for assessment and intervention in school settings are offered. The school psychologist can play a critical role in the academic, social, and overall adaptive functioning of a student affected with GTS.

Linkage study of the dopamine D5 receptor gene and Gilles de la Tourette syndrome

A defect in the dopamine system has been hypothesized as the etiological defect in Gilles de la Tourette syndrome (TS). In this report, we test the hypothesis that the dopamine D5 receptor locus (DRD5) is linked to the genetic susceptibility to TS in five families studied in Canada. We tested for linkage to the dopamine D5 receptor gene using a microsatellite polymorphism located in the same cosmid clone. Using an autosomal dominant model with reduced penetrance, we were able to exclude linkage in four of the five families for the TS and chronic multiple tics (CMT) phenotype. Also, no evidence for linkage was found using nonparametric methods in all five families.

Linkage analysis and exclusion of regions of chromosomes 3 and 8 in Gilles de la Tourette syndrome following the identification of a balanced reciprocal translocation 46 XY, t(3:8)(p21.3 q24.1) in a case of Tourette syndrome.

Gilles de la Tourette syndrome (GTS) and related disorders such as chronic multiple tics and obsessive compulsive behaviour are likely to be genetically transmitted with a Mendelian autosomal dominant mode of transmission. Following our discovery of a patient with GTS who also carried a balanced translocation 46 XY, t(3:8) (p21.3 q24.1), a linkage study of several families was performed covering the areas on chromosomes 3 and 8 implicated by the cytogenetic abnormality in this unique GTS patient. A positive multipoint lod score of 2.9 was obtained on chromosome 3 with markers at the loci RAF1, THRB and D3S11. Subsequently, the genetic map of this region was improved and new polymorphic markers close to our original three markers were identified. With the new map the maximum two-point lod with any marker was reduced to 1.77 at RAF1, and the FASTMAP approximate multipoint lod excluded the likely region of the breakpoint. After constructing a somatic cell hybrid, the original three markers were mapped relative to the break point of the translocation and to other new markers. It was confirmed that the original markers were at least 20 cM away from the position of the break point. In addition, we traced further family members of our translocation GTS proband, and identified affected individuals who did not possess the translocation. We concluded that the translocation was not responsible for the GTS symptoms in our affected proband.

Exclusion of the 5-HT1A serotonin neuroreceptor and tryptophan oxygenase genes in a large British kindred multiply affected with Tourette's syndrome, chronic motor tics, and obsessive-compulsive behavior

Previous studies have demonstrated a relationship between obsessive-compulsive disorder or behavior and Gilles de la Tourette syndrome. It has been hypothesized that the serotonergic system is implicated in the etiology of obsessive-compulsive disorder. Therefore, the authors investigated whether genetic variation in a serotonergic receptor and a modifying enzyme were associated with Tourette's syndrome. A linkage analysis using DNA and blood group markers was carried out in a large British kindred multiply affected with Tourette's syndrome, chronic motor tics, and obsessive-compulsive behavior. There was no evidence to support the hypothesis that genetic variation in the serotonin 5-HT1A receptor and tryptophan oxygenase genes causes susceptibility to Tourette's syndrome and chronic multiple tics. The results eliminate two possible candidate genes from having a role in the pathophysiology of Tourette's syndrome.

D2 dopamine receptor alleles do not influence severity of Tourette's syndrome. Results from four large kindreds.

We investigated the recently proposed hypothesis that the A1 allele of the Taq I polymorphic system at the D2 dopamine receptor gene (DRD2) influences the severity of Tourette's syndrome (TS). We have previously demonstrated that DRD2 is not linked to TS, establishing that it cannot be the major locus determining the susceptibility to develop TS. We studied alleles at the DRD2 A system in patients with TS or chronic multiple tics in four extended kindreds segregating TS. If this allelic system at DRD2 is associated with severity of TS, then among affected family members, those with the A1 allele should have more severe disease than those without it. Severity of disease was compared in affected members of the kindreds with A1 alleles and in those without A1 alleles. We evaluated disease severity in two ways. First, we evaluated 17 individuals from two families using a derivative of the Yale Global Tic Severity Scale composed of subscales concerning number, frequency, and severity of motor and phonic tics, rated separately. We divided this sample (n = 17, nine with TS and eight with chronic multiple tics) by genotype at the A1/A2 system. The heterozygotes (n = 7) had an average severity score of 11.3; the A2 homozygotes had an average severity score of 14.2. (There were no A1 homozygotes.) Second, we evaluated 47 individuals from two different families (all with TS) using the TS symptomatology evaluation. We compared severity scores for these individuals by genotype at the A1/A2 system. The heterozygotes (n = 24) had a mean severity score of 3.0, and the A2 homozygotes (N = 21) had a mean severity score of 3.7. Our data do not support alleles at the A system of DRD2 as a factor associated with severity of TS.

Multiple tics following cerebral malaria

Medical Journal of AustraliaVolume 160, Issue 5 p. 307-308 Letter to the Editor Multiple tics following cerebral malaria T M E Davis BMedSc(Hons), MB BS, DPhil, MRCP, FRACP, T M E Davis BMedSc(Hons), MB BS, DPhil, MRCP, FRACP Professor of Medicine Department of Medicine, Fremantle Hospital, PO Box 480, Fremantle, WA, 6160Search for more papers by this authorW Knezevic MB BS, FRACP, W Knezevic MB BS, FRACP Consultant Neurologist and Clinical Senior Lecturer Department of Medicine, Fremantle Hospital, PO Box 480, Fremantle, WA, 6160Search for more papers by this author T M E Davis BMedSc(Hons), MB BS, DPhil, MRCP, FRACP, T M E Davis BMedSc(Hons), MB BS, DPhil, MRCP, FRACP Professor of Medicine Department of Medicine, Fremantle Hospital, PO Box 480, Fremantle, WA, 6160Search for more papers by this authorW Knezevic MB BS, FRACP, W Knezevic MB BS, FRACP Consultant Neurologist and Clinical Senior Lecturer Department of Medicine, Fremantle Hospital, PO Box 480, Fremantle, WA, 6160Search for more papers by this author First published: 01 March 1994 https://doi.org/10.5694/j.1326-5377.1994.tb125847.xCitations: 3AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume160, Issue5March 1994Pages 307-308 RelatedInformation

Exclusion of close linkage of Tourette's syndrome to D1 dopamine receptor.

The authors' goal was to establish if a mutation in D1 dopamine receptor locus (DRD1), or one genetically close to it, could cause Gilles de la Tourette's syndrome. DRD1 and linked markers (D5S36, D5S61, and D5S62) were studied in a large Mennonite Tourette's syndrome kindred. Only individuals with the full Tourette's syndrome were considered to be affected in one series of analyses; in another series the diagnostic spectrum was broadened to include chronic multiple tics. Liability classes were defined to take into account age at onset and sex differences; dominant inheritance was assumed. The authors' version of the LINKMAP program of the LINKAGE package modified to run under distributed parallel processing (Linda LINKMAP) was used for the multipoint linkage analysis. Complete (theta = 0.0) linkage of Tourette's syndrome with DRD1 was ruled out (lod score of -10.1) when the disease was defined narrowly. The area of exclusion of linkage (lod score between -2 and -10.5) extended from map position -0.10 to map position 0.50. The authors conducted an additional (centromeric) multipoint analysis with D5S36 as well as glucocorticoid receptor (GRL) and D5S22, resulting in an overlapping area of exclusion to map position -0.30 when the disease was defined narrowly. This result provides strong evidence against linkage of the DRD1 D1 dopamine receptor locus with Tourette's syndrome. This exclusion extends the authors' earlier work with the dopamine system in Tourette's syndrome to exclude the two best characterized dopamine receptors from linkage with Tourette's syndrome.

An epidemiological study of obsessive-compulsive disorder and related disorders in Israeli adolescents.

Five hundred and sixty-two, 16- to 17-year-old consecutive inductees into the Israeli Army, constituting a random sample of their cohort, were screened for obsessive-compulsive disorder (OCD), Tourette's syndrome, transient tics (TT), chronic multiple tics (CMT), and attention-deficit hyperactive disorder (ADHD). Two child psychiatrists interviewed the subjects, using screening items from structured interviews that implement DSM-III-R diagnostic criteria. For OCD, a point prevalence of 3.6% was found, 3.9% for ADHD, 1.8% for CMT, and 1.6% for TT. For ADHD, TT, and CMT, but not for OCD, there was a significantly higher prevalence for males than for females. Among the OCD individuals, there was an elevation of TT, CMT, and Tourette's syndrome relative to the population rates.

The Role of the Amygdaloid Complex in Gilles de la Tourette's Syndrome

Gilles de la Tourette's syndrome (GTS) is a relatively rare neuropsychiatric disorder characterised by multiple motor tics accompanied by vocalisations. It usually starts in early childhood and is more common in males than females. Obsessional compulsive disorder (OCD) is an integral part of GTS (Robertson, 1989). GTS is also associated with coprolalia, copropraxia, and other echophenomena, as well as attention-deficit disorder, self-injury, and other behaviour problems (Robertson et al, 1988; Robertson, 1989). Family pedigree studies have demonstrated that most GTS cases in the community are mild and do not receive medical attention (Kurlan et al, 1987; Robertson & Gourdie, 1990).

Convulsive tic disorder georges gilles de la tourette, guinon and grasset on the phenomenology and psychopathology of gilles de la tourette syndrome.

Gilles de la Tourette gained eponymous fame when he described nine cases of multiple tics, coprolalia and echolalia, and later he, Guinon and Grasset were the first to document the psychopathology of the Gilles de la Tourette syndrome. In particular, they noted the association between obsessional thoughts and behaviours and the tic disorder. In this paper we present the first English translations of their works referring to the psychopathology, comparing and contrasting their ideas to current concepts.

Convulsive Tic Disorder Georges Gilles de la Tourette, Guinon and Grasset on the Phenomenology and Psychopathology of Gilles de la Tourette Syndrome

Gilles de la Tourette gained eponymous fame when he described nine cases of multiple tics, coprolalia and echolalia, and later he, Guinon and Grasset were the first to document the psychopathology of the Gilles de la Tourette syndrome. In particular, they noted the association between obsessional thoughts and behaviours and the tic disorder. In this paper we present the first English translations of their works referring to the psychopathology, comparing and contrasting their ideas to current concepts.

The Ticcing Link

In 1902, a Frenchman identified only as O. bared his soul in print under the title Les Confessions d'un Ticquer. As a boy, 0. wrote, he had felt the urge to imitate any curious gesture, facial expression, phrase or pronunciation he observed in others. In private, he practiced each imitation over and over; in public, the well-rehearsed would involuntarily reappear for months thereafter. 0. soon developed numerous other vocal and body tics, often driven by irrational, irresistible thoughts. For example, as soon as he placed his pince-nez on his nose, he felt compelled to continually readjust its position, occasionally jerking back his head for a better focus. His gaze wandered back and forth, from the rim of the pince-nez to whatever he was looking at, and he felt uncomfortable when either was not in his line of sight. My tics upset my pince-nez, and I have to invent another tic to get it back into place, 0. lamented. The absurdity of this vicious circle does not escape my observation, and I know I am its author, yet that cannot prevent my becoming its victim. O.'s confession also included the comments of his two physicians. They noted that he consciously suppressed his many tics for an hour or two in the company of others. When the pressure to tic became too great, 0. would retreat to an empty room, they wrote, abandoning himself in his moment of solitude to a veritable debauch of absurd gesticulations, a wild muscular carnival, from which he returns comforted, to resume sedately the thread of the interrupted dialogue. O.'s strange condition is known as Tourette's syndrome (TS), and it is hardly a turn-of-the-century relic. Although modern clinical descriptions of TS are rarely as penetrating as O.'s confessions, TS today affects a surprisingly large number of people perhaps 100,000 to 330,000 in the United StAtes alone and currently receives the close attention of several research teams. Some of those scientists, at last May's meeting of the American Psychiatric Association in New York City, described their efforts to uncover the genetic foundation of TS and decipher the connection of multiple tics to a number of psychiatric disorders and behavior problems. One research team even proposes that TS is linked to one or a few genes responsible for many impulsive, compulsive, learning and mood disorders. Others contend that the close study of TS will nudge neurologists and psychiatrists toward a much-needed reconsideration of how brain, mind and body interact.

Familial Tourette's Syndrome in a Large British Pedigree

A British pedigree multiply affected by the Gilles de la Tourette syndrome and spanning six generations is described. Of 122 members identified, 85 were individually interviewed, and 50 were diagnosed as 'cases'. 'Cases' consisted of 29 with definite or probable Gilles de la Tourette syndrome, 17 with definite or probable chronic multiple tics, and four with definite or probable obsessive-compulsive behaviour. Only eight of the 50 'cases' had consulted a doctor for their symptoms. 'Cases' and 'non-cases' could be distinguished on the basis of echo-phenomena, obsessive-compulsive features, self-injurious behaviour, and the trait score of the Leyton Obsessional Inventory, but did not differ significantly on any other psychopathological variables. The pattern of inheritance of the Gilles de la Tourette syndrome in this pedigree is consistent with autosomal dominant transmission.

Tic disorders in childhood (and beyond).

Tic disorders are classified into three main categories: transient (duration more than 1 month but less than 1 year), chronic (duration more than 1 year), and Tourette's syndrome (multiple motor and vocal tics lasting more than 1 year to life). Typically, symptoms increase with emotional stress, diminish with distraction or concentration, and disappear during sleep. Because of the risks involved and the lack of any truly curative value, drug therapy should be used only when tics are seriously disabling. Haloperidol (Haldol), the most widely prescribed medication, is efficacious in about 80% of patients with Tourette's syndrome. Psychotherapy is not effective as a primary therapeutic strategy; it may, however, be indicated in selected cases to relieve the grief and frustration of parents and to help affected children deal with the disorder.

Transient Tics and Tourette's Syndrome

The relation of transient tic disorder (TTD - motor or vocal tics lasting less than 1 year) to Tourette's syndrome (TS multiple motor and vocal tics lasting longer than 1 year) has been evaluated in two Canadian Mennonite families at the Dept of Neurology, Univ of Rochester Sch of Med, NY.

Habit reversal for the treatment of Tourette syndrome

Habit reversal has been found effective for the treatment of individual tics. The present study used habit reversal to treat three subjects with the multiple tics of Tourette Syndrome. Tic frequency was reduced over a 6–8-month period by 93–95% in the clinic setting and by 64–99% in the home setting with a concurrent decrease in severity. The procedure holds promise as a treatment for Tourette Syndrome.

Awareness training in the treatment of head and facial tics

The effectiveness of awareness training alone in treating multiple tics in a young adult was assessed using a multiple baseline across behaviors design. The results showed that the awareness training was very effective in suppressing both head and facial tics and that the treatment effects generalized to a nonclinic situation. Follow-up data showed that both tics were still at low levels one, two, four and eight months after treatment. Treatment satisfaction ratings by the subject and social validation ratings by independent observers are also reported.