RESEARCH - Tourette's Syndrome and Tic Disorders

Comprehensive Behavioral Intervention for Tics

Principal Investigator: John T. Walkup, M.D.

This multi-site research study is sponsored by the NIMH and conducted by members of the Tourette Syndrome Association Behavioral Sciences Consortium. The purpose is to evaluate the relative efficacy of two different behavioral therapies for reducing tics in children and adolescents with chronic tic disorder or Tourette’s Syndrome. The two (eight-session) treatments are a comprehensive behavioral intervention for tics (CBIT) based on habit reversal training to reduce tic severity, and psychoeducation/supportive therapy designed to emulate current community practice to help with other difficulties such as behavior problems and stress. Approximately 160 children and adolescents, ages 9-17 years, will be enrolled in the study across three sites over a four-year period - 53 of these will be at Johns Hopkins. Tic severity, distress, and impairment will be assessed at the end of treatment and at 3 months and 6 months following treatment. If CBIT is successful in reducing tic severity, this will provide an additional treatment option for those who cannot tolerate or do not benefit from traditional tic-suppressing neuroleptic medications.

Publications:

Himle, M. B., Woods, D. W., Piacentini, J. C., & Walkup, J. W. (2006). Brief review of habit reversal training for Tourette syndrome. Journal of Child Neurology, 21(8), 719-725.

Walkup, J.T., Mink, J.W., & Hollenbeck, P.J. (Eds.). (2006). Advances in neurology, volume 99: Tourette Syndrome. Philadelphia: Lippencott Williams & Wilkins.

A Genetic Linkage Study of Tourette's Syndrome

Principal Investigator: Marco Grados, M.D., M.P.H.

This international multisite study is sponsored by the Tourette Syndrome Association (TSA) and funded by the NIH in order to examine the genetic basis of Tourette's Sydrome (TS). In a prior phase of this research, the TSA International Genetics Consortium completed two linkage studies which point to a region in the genome that might contain a susceptibility gene for GTS (2p). In the current phase additional fine-mapping strategies are planned to further pinpoint the localization of this gene and a new sample of informative families is being collected in order to replicate the prior finding. In addition, the research emphasizes the phenotypic analysis of the related disorders obsessive-compulsive disorder (OCD) and attention-deficit hyperactivity disorder (ADHD) in relation to TS. In conjunction with this grant, Dr. Grados, the Hopkins site Principal Investigator, has received research funding support from TSA to explore the relationship between TS, OCD and ADHD and their genetic determinants. For example, it is plausible that while TS and OCD can occur independent of each other, the occurrence together of TS and OCD, and of TS and OCD and ADHD, indictes a different or greater genetic loading that needs to be specifically examined. This research projects thus aims to understand the genetics basis of TS, as well as the etiological relationship of TS to OCD and ADHD.  

Publications:

Tourette Syndrome Association International Consortium for Genetics. Genome scan for Tourette disorder in affected-sibling-pair and multigenerational families. Am J Hum Genet. 2007 Feb;80(2):265-72.

Grados MA, Walkup JT.A new gene for Tourette's syndrome: a window into causal mechanisms? Trends Genet. 2006 Jun;22(6):291-3.