Evaluation of Prenatal and Perinatal Risk Factors for Tourette Syndrome and Chronic Tic Disorders in a Large, Prospective, Population-based Cohort

Grant Type
Grant Year
Institution Location
Institution Organization Name
Massachusetts General Hospital
Investigators Name
Scharf, Jeremiah, MD, PhD

Although Tourette Syndrome (TS) and chronic tic (CT) disorders are highly heritable, non-genetic factors are also thought to play a role in their development. Previous studies have reported a number of candidate “environmental” TS/CT risk factors, particularly events or exposures arising in the prenatal or perinatal period (during pregnancy and delivery). Unfortunately, these studies have produced conflicting results, possibly because of hidden biases related to their retrospective designs, the limited availability of well-documented environmental exposures or the lack of a comparable unaffected control group. Thus, there is a great need to examine these potential risk factors in individuals where detailed information is identified prior to the onset of any tic symptoms. In this project, we are evaluating the previously reported candidate prenatal and perinatal TS/CT risk factors in a large, prospective British pre-birth cohort, the Avon Longitudinal Study of Parents and Children (ALSPAC). This unique sample contains data collected from all children born to mothers in a specific geographical area between 1991-1992, and includes questionnaires completed during pregnancy, birth records and serial questionnaires about child development, environmental exposures and health outcomes every 6-12 months to the present day. In Year 1 of this award, we determined the prevalence of TS/CT in ALSPAC children and have promising preliminary data regarding prenatal and perinatal risk factors. For Year 2, we will explore these data further with more sophisticated analytic methods. In addition, we will examine how TS/CT cognitive profiles are modified by common co-morbidities and whether these profiles share common non-genetic risk factors with TS/CT. We anticipate that this research will contribute toward improved understanding of the underlying causes of TS and CT and will lay the foundation for future gene-by-environment interaction studies that could identify the specific mechanisms through which these non-genetic factors contribute to the development of these conditions. Jeremiah M. Scharf, M.D., Ph.D.. Massachusetts General Hospital, Boston, MA Yoav Ben-Shlomo, M.D., University of Bristol, Bristol, UK Carol Mathews, M.D. , University of California, San Francisco, CA Award: $39,683(2nd Year) Commentary: Although TS is an inherited condition scientists believe that other non-hereditary factors might influence the development of the disorder. In this study, we will obtain a large database from the United Kingdom (UK) that contains information on the lifestyle, environment and health of parents and their children. This study could lead to the identification of environmental factors that are involved in the development of TS and chronic tics. Tourette Association of America Inc. – Research Grant Award 2010-2011