Tourette Syndrome (TS) is characterized by the failure to inhibit premonitory urges and subsequent tics. From phenomenological and neuropsychological standpoints, tic symptoms appear to reflect deficient inhibitory mechanisms that involve dysfunctional frontostriatal pathways. Existing data has shown response inhibition (RI) deficits among individuals with TS. Two recent randomized controlled trial studies showed that impaired RI negatively predicted treatment response to behavior therapy based on habit reversal training (HRT) for the co-morbid condition, ADHD. Thus, it is crucial to determine whether behavioral interventions for TS can be improved by enhancing RI capabilities among young children with TS. The current research seeks to examine the feasibility of using a computer-based RI training program as an adjunctive intervention for the Comprehensive Behavioral Intervention for Tics (CBIT). Our central hypothesis is that cognitive training designed to enhance RI will potentiate treatment outcomes of CBIT. To this end, we will conduct a two-arm placebo-controlled double-blind trial, in which 20 children with TS will be randomly assigned to CBIT with computerized RI training (CBIT+RIT; n=10) or CBIT with placebo computer training (CBIT +PLT; n=10). CBIT consists of eight weekly sessions that present awareness training, competing response training, relaxation training and functional contingency management in a manualized format. The adjunctive computer training (RIT or PLT) will be delivered during the first 4 weeks of CBIT (i.e. 8 twice-weekly 40-min sessions). Tic symptoms and RI capabilities will be assessed at baseline, mid-treatment, post-treatment, and 1 month follow-up. This project is expected to increase our understanding about the nature of response inhibition deficits in TS and generate knowledge that will guide the development of effective cognitive interventions for TS. Han Joo Lee, Ph.D., Douglas W. Woods, Ph.D. University of Wisconsin- Milwaukee, Milwaukee, WI Award: $74,916 Commentary: Many researchers suspect that individuals with TS may have poor response inhibition (RI) which is essential to inhibit inappropriate responses, resulting in vocal or motor tics. These investigators will test whether a well-established behavior therapy for TS (CBIT) can be improved by increasing the individual’s RI capabilities. To this end, 20 children will be randomly assigned to CBIT with computer-based RI training or CBIT with placebo computer-based cognitive training. They propose that the computer-based RI training will enhance the therapeutic effect of the well-established behavioral therapy, CBIT. Tourette Association of America Inc. – Research Grant Award 2011-2012