Tourette Syndrome

Tourette syndrome (TS) is an inherited, neuropsychiatric disorder with onset in childhood, characterized by multiple physical (motor) tics and at least one vocal (phonic) tic. The early symptoms of TS are typically noticed first in childhood, with the average onset between the ages of 3 and 9 years. Approximately 10-15 percent of those affected have a progressive or disabling course that lasts into adulthood. The exact cause of Tourette's is unknown. Genetic studies suggest that some forms of ADHD (Attention Deficit Hyperactivity Disorder) and OCD (Obsessive Compulsive Disorder) are genetically related to TS. TS is seen in people from all ethnic groups and men are affected about three to four times more often than women. It is estimated that 200,000 Americans have the most severe form of TS and one person in every 100 exhibit milder and less complex symptoms such as chronic motor or vocal tics. 

The treatment of TS focuses on identifying and helping the individual manage the symptoms. Most cases of TS are mild, and do not require pharmacological treatment. Psychobehavioral therapy, patient education may be sufficient. Severe tics can be treated with drugs like neuroleptics (risperidone, ziprasidone, haloperidol etc) and antihypertensives (clonidine, guanfacine etc). Cognitive behavioral therapy and Relaxation techniques may be helpful in some patients. NIH-funded investigators are conducting a variety of large-scale genetic studies and finding a gene or genes for TS would be a major step toward understanding genetic risk factors. A number of clinical trials in TS including studies of stimulant treatment of ADHD in TS and behavioral treatments for reducing tic severity in children and adults are being done across the world. Smaller trials of novel approaches to treatment such as dopamine agonists and glutamatergic medications also show promise.