Tourette Syndrome TS TS is a neurodevelopmental

Tourette Syndrome (TS) • TS is a neurodevelopmental disorder that is characterized by involuntary motor movements and vocalizations called Tics 1 • Tics are rapid, repetitive, and stereotyped movements or vocalizations – The quantity and complexity of the tics fluctuate over time • TS is a chronic condition that is frequently associated with difficulties in self-esteem, school performance, social acceptance, and family life. • TS is chronic and usually emerges between ages 2 to 15 (~50% affected by age 7) 1 -2 • TS is more common in males than females by a ratio of about 5 to 1. 1 -2 • TS is not a rare disorder, with the number of children affected estimated to be 7 in 1000. 1 -2

Other Characteristics of TS • Other symptoms associated with TS: 3 -4 – speech and conduct problems – mood instability, anxiety, obsessive-compulsive symptoms – impulsivity, distractibility, motor hyperactivity, – learning problems • Common Co-morbidities: – ADHD (55%)5 – Obsessive-Compulsive Disorder (OCD) (20 -60%)6 -8 – Referred to as ‘TS-plus’ – More severe tics, higher the psychiatric co-morbidity • Neuropsychological deficits 9

Causes of TS • Serotonogic & dopaminergic neurotransmitter systems 1 – Tics and comorbidities improve with use of SSRIs and dopamine-receptor blockers • TS has been linked to disruption of brain areas: 1, 10, 11 – Frontal areas – basal ganglia – Caudate • Genetics plays a role 1 – Relatives have higher rates of Tics, OCD, and ADHD – High concordance rate in monozygotic twins

Prognosis • Tics peak between 8 and 12 years 12 • Most Tics are gone by adulthood (only 20% still have significant Tics in adulthood)12 • Treatment: 1 – – – – Medications Behavior Therapy Counseling Cognitive therapy Relaxation theory Awareness and assertiveness training Habit reversal training

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