A Clinical Study of Rage Attacks and Episodic Dyscontrol in Children and Adolescents with Tourette Syndrome

Grant Type
Grant Year
Institution Location
Institution Organization Name
Cornell University
Investigators Name
Budman, Cathy, MD

Our Movement Disorder Center consists of an interdisciplinary team of consultants from the departments of psychiatry, neurology and neuropsychology.* Our teamwork enables us to better evaluate, understand and treat Tourette Syndrome (TS) from multiple, integrated perspectives. We have found that a significant number of children and adolescents with TS who come for treatment exhibit rage attacks. According to recent scientific studies, about one third of all TS patients have episodes of sudden and explosive anger of varying degrees. These outbursts are very different from the person’s usual personality and are out of proportion to any obvious precipitant or stressor. Such symptoms seem to be more common and cause more problems in children with TS under age 18. Rage attacks can be the worst symptom for the patient with TS and his/her family. At this time, there is no specific treatment for patients with TS who have this problem. There are a number of other neurobehavioral conditions that are also associated with rage attacks such as brain injuries, Huntington’s Disease, obsessive compulsive disorder (OCD), attention deficit hyperactive disorder (ADHD), and major depression (MD), to name a few. Because other conditions such as OCD and ADHD often co-exist with TS, we wondered whether the presence or absence of rage attacks might be related to the presence or absence of additional disorders such as ADHD or OCD. In a small pilot study we actually found that in all cases, persons with TS with rage attacks also had both OCD and ADHD symptoms. This funding will allow us to further investigate how these children and adolescents differ from their TS counterparts without rage attacks. We will be screening TS subjects between ages 6-17 years with standardized clinical rating scales to assess the presence or absence of OCD, ADHD, MD, conduct disorder, oppositional disorder, and note their tic severity. We will then determine whether rage attacks correlate with any of these possible co-morbid conditions. This study will improve our understanding of the neurobiological factors contributing to rage symptoms in patients with TS. Hopefully, our results will also enable us to devise more effective medications and other treatments that will help control, and perhaps prevent in some measure these distressing symptoms. Cathy L. Budman, M.D. Cornell University Medical College North Shore University Hospital, Manhasset, NY Award $6,575 Tourette Association of America Inc. – Research Grant Award 1995