A Comprehensive Neuroanatomical, Clinical, Psychoeducational and Neuropsychological Evaluation of Girls with Tourette Syndrome

Grant Type
Clinical
Grant Year
1994
Institution Location
MD
Institution Organization Name
Johns Hopkins University
Investigators Name
Singer, Harvey, MD

Tourette Syndrome (TS) as defined by the presence of tics is more common in males than in females. Hence, most research to date has focused on males, and information on the syndrome in girls and understanding of the similarities as well as differences conveyed by gender are limited. Nevertheless, in TS there is suggestive evidence that there are differences between males and females in clinical improvement, presence of co-morbid problems, and the size of brain regions. The goal of this study is to investigate neuroanatomical, psychosocial, psychoeducational and neurophysiological correlates in girls with TS. Girls are the selected target of this study because they have been greatly underrepresented in all previous investigations. Girls with TS, ages 7 to 16 years, and a control population of same-community peers are being recruited for this research project. In a prior study performed primarily in boys, we have shown that some TS patients had a reversal of asymmetry in two brain regions, putamen and lenticular nuclei, as compared with controls (Singer et al. 1993). Confirmation of this finding in girls will lend further support to suggestions that the basal ganglia are involved in the pathogenesis of TS. MRI volumetric measurements will be obtained on basal ganglia structures, frontal lobe, corpus callosum and ventricles. Our neuropsychological and psychoeducational studies, performed in a male-dominant TS population, have identified a variety of difficulties including discrepancy-based learning disabilities, executive dysfunction, and inefficient production of output on timed tasks (Harris et al., in press; Singer et al., in press; Scheurholz et al., submitted). We predict that, as a group, girls with TS will manifest significantly more neuropsychological and academic problems than does a control group of non-TS girls of similar age. We also plan to examine whether attention-deficit hyperactivity disorder and obsessive compulsive disorder alter the status of executive function and learning disabilities. Understanding the differences between males and females with TS and the effects of co-morbid problems can provide insight into underlying mechanisms and possible treatment modalities for this disorder. Harvey S. Singer, M.D. The Johns Hopkins University, Baltimore, MD Award $25,000 Tourette Association of America Inc. – Research Grant Award 1994