Pathophysiological Markers in the ‘Pre-Tourette’ Population

Grant Type
Clinical
Grant Year
2010-2011
Institution Location
MO
Institution Organization Name
Washington University
Investigators Name
Greene, Deanna Jacquelyn, PhD

As many as 20-30% of all children manifest motor and/or vocal tics at some time in their life. Typically, these new-onset tics disappear within a few months. However, for about 1% of children these tics represent the beginning of a prolonged and often serious disorder: Tourette syndrome (TS) or Chronic Tic Disorder (CTD). Given these epidemiological data, development of TS/CTD could be conceived as a two-step process: first tics appear, then they fail to remit. We propose that this step can be observed prospectively, thereby minimizing the biases inherent in retrospective study designs. Equally important is that studies of tic persistence may identify entirely different causative factors than studies of established TS/CTD, where onset and persistence are confounded. This earliest phase of tic disorders may hold the key to discovering etiology, prevention or treatment. Our project is the first-ever pathophysiological study of the “pre-Tourette” population (i.e., children with new-onset tics that will either persist or remit with time). With Drs. Kevin Black and Bradley Schlaggar, I will use carefully selected neuroimaging (functional connectivity MRI, task-based fMRI, volumetric structural MRI), neuropsychological, and clinical methods to examine children with recent-onset tics and follow them clinically through the one-year anniversary of tic onset. Those whose tics persist will be compared with those whose tics remit. Thus, we will be able to examine whether putative biomarkers of TS/CTD can be used to predict prognosis of recent-onset tics. Further, this project is meant to demonstrate feasibility of this prospective approach. Deanna Jacquelyn Greene, Ph.D., Kevin Black, M.D., Bradley Schlaggar, M.D., Ph.D. Washington University School of Medicine, St. Louis, MO Award: $40,000 (Fellowship) Commentary: In this study we will use advanced brain imaging methods to examine the brains of children who have not yet been diagnosed as having TS. We will do brain scans in a group of children whose tics began within the past few months, and will monitor these children clinically for one year after their first tic. After the year period, many of these children will no longer have tics, but those who do will be diagnosed as having either Tourette syndrome or Chronic Tic Disorder (TS/CTD). Brain scans from these children will be compared with each other. From this work we hope to identify new avenues of research on what causes tics and how to prevent early tics from developing into TS. Tourette Association of America Inc. – Research Grant Award 2010-2011