Tourette’s Disorder

Question 1

Tourette’s disorder

Answer 1

• Disorder of tics
• Typically be­gins early in life, but the symp­toms tend to become more complex and se­vere as the patient grows older.
• Tourette’s disorder develops in 0.3–1 percent of the population
• It is four times more frequent in male children than in female children
• Concordance rates are 50 percent for monozygotic twins and 10 percent for dizygotic twins
• Many medical profes­sionals believe that tic suppression is inevitably followed by a rebound however, this is not the case.

Question 2

Tics

Answer 2

Involuntary, repetitive, stereotyped movements or vocalizations

Question 3

coprolalia –> tourette’s

Answer 3

Uttering obscenities(volslagen vieze uitingen)

Question 4

palilalia –> tourette’s

Answer 4

Repetition of one’s own words

Question 5

Neural bases of Tourette’s disorder

Answer 5

• Research focused on the striatum (caudate plus putamen). Patients with the disorder tend to have smaller striatal volumes, and when they suppress their tics, fMRI activity is re­corded in both the prefrontal cortex and caudate nuclei. Presumably, the decision to suppress the tics comes from the prefrontal cortex, which initiates the suppression by acting on the caudate nuclei.
• Evidence of dysfunctional dopaminer­gic and GABAergic signaling within the cortical­striatal­ thalamic­cortical brain circuits in Tourette’s disorder. Interesting because those brain circuits are implicated in motor learning—including habit formation.
• Most studies of the neural bases of Tourette’s disorder focused on the striatum, but brain differences appear to be more widespread. –> kids: thinning in sensorimotor cortex gray matter –> prominent in the areas that controlled the face, mouth, and larynx (voice box).

Question 6

How is tourette’s disorder treated?

Answer 6

1. Patient, family members, friends, and teachers are educated about the nature of the syndrome
2. Focus on the ancillary(onderliggende) emotional problems (e.g., anxiety and depression)
3. Treating the tics usually with antipsychotics.

Question 7

Antipsychotics in treatment Tourette

Answer 7

• Can reduce tics by about 70 percent
• Adverse side effects (e.g., weight gain, fa­tigue, dry mouth).
• Disorder is related to changes in the cortical­-striatal­-thalamic­-cortical circuit–> relies heavily on dopaminergic signaling, thus success of antipsychotics in block­ing tics.