Journal of Neurology

, Volume 253, Issue 1, pp 1–15 | Cite as

Tic disorders: from pathophysiology to treatment

  • L. Rampello
  • A. Alvano
  • G. Battaglia
  • V. Bruno
  • R. Raffaele
  • F. Nicoletti


Tic disorders are stereotypic behaviours,more frequent than once believed, and therefore likely to be encountered by primary care physicians. Tics usually begin in childhood and are the clinical hallmark of Tourette Syndrome (TS), the most common cause of tics. TS is a relatively common neurobehavioural disorder with a spectrum of manifestations that wax and wane during its natural course. The pathophysiology of tics, at molecular and cellular level, is still unknown,whereas structural and functional neuroimaging studies have shown the involvement of the basal ganglia and related cortico–striato–thalamo–cortical circuits, and the dopaminergic neuronal system. Moreover, TS has a strong genetic background. The management of TS is often complicated by the presence of attention–deficit/hyperactivity disorder, obsessivecompulsive disorder, and other behaviour disorders. The correct diagnosis is a fundamental step for a proper management of these disorders, and a multimodal treatment is usually indicated. This approach includes educational and supportive interventions, as well as pharmacological treatments when tics are at their worst.

Key words

tics Tourette syndrome hyperkinetic movement disorders 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Adams JR, Troiano AR, Calne DB (2004) Functional imaging in Tourette’s syndrome. J Neural Transm 111:1495–1506PubMedCrossRefGoogle Scholar
  2. 2.
    Albin RL, Koeppe RA, Bohnen NI, Nichols TE, Meyer P, Wernette K, Minoshima S, Kilbourn MR, Frey KA (2003) Increased ventral striatal monoaminergic innervation in Tourette syndrome. Neurology 61:310–315PubMedGoogle Scholar
  3. 3.
    Allen AJ (1997) Group streptococcal infections and childhood neuropsychiatric disorder. Curr Opin 267:75Google Scholar
  4. 4.
    Almeras N, Despres JP, Villeneuve J, Demers MF, Roy MA, Cadrin C, Mottard JP, Bouchard RH (2004) Development of an atherogenic metabolic risk factor profile associated with the use of atypical antipsychotics. J Clin Psychiatry 65:557–564PubMedCrossRefGoogle Scholar
  5. 5.
    Alsobrook JP, Pauls DL (1997) The genetics of Tourette syndrome. Neurol Clin 15:381–893PubMedGoogle Scholar
  6. 6.
    Amann BL, Pogarell O, Mergl R, Juckel G, Grunze H, Mulert C, Hegerl U (2003) EEG abnormalities associated with antipsychotics: a comparison of quetiapine, olanzapine, haloperidol and healthy subjects. Hum Psychopharmacol 18:641–646PubMedGoogle Scholar
  7. 7.
    American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: American Psychiatric Assn 103Google Scholar
  8. 8.
    Anca MH, Giladi N, Korczyn AD (2004) Ropinirole in Gilles de la Tourette syndrome. Neurology 62:1626–1627PubMedGoogle Scholar
  9. 9.
    Awaad Y, Michon AM, Minarik S (2005) Use of levetiracetam to treat tics in children and adolescents with Tourette syndrome. Mov Disord 20:714–718PubMedCrossRefGoogle Scholar
  10. 10.
    Bagheri MM, Kerbeshian J, Burd L (1999) Recognition and management of Tourette’s syndrome and tic disorders. Am Fam Physician 59:2263–2272PubMedGoogle Scholar
  11. 11.
    Begum M (2005) Clozapine–induced stuttering, facial tics and myoclonic seizures: a case report. Aust N Z J Psychiatry 39:202PubMedCrossRefGoogle Scholar
  12. 12.
    Black KJ (2002) Tourette Syndrome and Other Tic Disorders Available from: http://www. eMedicine. comGoogle Scholar
  13. 13.
    Black KJ, Mink JW (2000) Response to levodopa challenge in Tourette syndrome. Mov Disord 15:1194–1198PubMedCrossRefGoogle Scholar
  14. 14.
    Bonnier C, Nassogne M, Evrard P (1999) Ketanserin Treatment of Tourette’s Syndrome in Children. Am J Psychiatry 156:1122–1123PubMedGoogle Scholar
  15. 15.
    Bruggeman R, van der Linden C, Buitelaar JK (2001) Risperidone versus pimozide in Tourette’s disorder: a comparative double–blind parallelgroup study. J Clin Psychiatry 62:50–56PubMedCrossRefGoogle Scholar
  16. 16.
    Carr JE, Bailey JS (1996) A brief behavior therapy protocol for Tourette syndrome. J Behav Ther Exp Psychiatry 27:33–40PubMedGoogle Scholar
  17. 17.
    Chang HL, Tu MJ, Wang HS (2004) Tourette’s syndrome: psychopathology in adolescents. Psychiatry Clin Neurosci 58:353–358 PubMedCrossRefGoogle Scholar
  18. 18.
    Chappell PB, Riddle MA, Scahill L, Lynch KA, Schultz R, Arnsten A, Leckman JF, Cohen DJ (1995) Guanfacine treatment of comorbid attentiondeficit hyperactivity disorder and Tourette’s syndrome: preliminary clinical experience. J Am Acad Child Adolesc Psychiatry 34:1140–1146PubMedGoogle Scholar
  19. 19.
    Cohen DJ, Jankovic J, Goetz CG (2001) Tourette syndrome. In: Advances in Neurology. Philadelphia, Pa: Lippincott Williams and WilkinsGoogle Scholar
  20. 20.
    Crawford FC, Ait–Ghezala G, Morris M, Sutcliffe MJ, Hauser RA, Silver AA, Mullan MJ (2003) Translocation breakpoint in two unrelated Tourette syndrome cases, within a region previously linked to the disorder. Hum Genet 113:154–161PubMedGoogle Scholar
  21. 21.
    Cuker A, State MW, King RA, Davis N, Ward DC (2004) Candidate locus for Gilles de la Tourette syndrome/obsessive compulsive disorder/chronic tic disorder at 18q 22.Am J Med Genet 130:37–39Google Scholar
  22. 22.
    Demirkiran M, Jankovic J (1995) Paroxysmal dyskinesias: clinical features and classification. Ann Neurol 38:571–579PubMedCrossRefGoogle Scholar
  23. 23.
    Devor EJ, Magee HJ (1999) Multiple childhood behavioral disorders (Tourette syndrome, multiple tics, ADD, and OCD) presenting in a family with a balanced chromosome translocation (t1; 8)(q21. 1;q22. 1). Psychiatr Genet 9:149–151PubMedGoogle Scholar
  24. 24.
    Dion Y, Annable L, Sandor P, Chouinard G (2002) Risperidone in the treatment of tourette syndrome: a double–blind, placebo–controlled trial. J Clin Psychopharmacol 22:31–39PubMedCrossRefGoogle Scholar
  25. 25.
    Eapen V, Pauls DL, Robertson MM (1993) Evidence for autosomal dominant transmission in Tourette syndrome. Br J Psychiatry 162:593–596PubMedCrossRefGoogle Scholar
  26. 26.
    Eichstedt JA, Arnold SL (2001) Childhood– onset obsessive–compulsive disorder: a tic–related subtype of OCD? Clin Psychol Rev 21:137–157PubMedGoogle Scholar
  27. 27.
    Evidente VG (2000) Is it a tic or Tourette’s? Clues for differentiating simple from more complex tic disorders. Postgraduate Medicine 108:5Google Scholar
  28. 28.
    Fahn S (1988) Blepharospasm: a form of focal dystonia. Adv Neurol 49:125–133PubMedGoogle Scholar
  29. 29.
    Fattapposta F, Restuccia R, Colonnese C, Labruna L, Garreffa G, Bianco F (2005) Gilles de la Tourette syndrome and voluntary movement: a functional MRI study. Psychiatry Res 138:269–272PubMedGoogle Scholar
  30. 30.
    Fountoulakis KN, Iacovides A, St Kaprinis G (2004) Successful treatment of Tourette’s disorder with amisulpride. Ann Pharmacother 38:90Google Scholar
  31. 31.
    Fredericksen KA, Cutting LE, Kates WR, Mostofsky SH, Singer HS, Cooper KL, et al. (2002) Disproportionate increases of white matter in right frontal lobe in Tourette syndrome. Neurology 58:85–89PubMedGoogle Scholar
  32. 32.
    Gaffney Gr, Perry PJ, Lund BC, Bever– Stille KA, Arndt S, Kuperman S (2002) Risperidone versus clonidine in the treatment of children and adolescents with Tourette’s syndrome. J Am Acad Child Adolesc Psychiatry 41:330–336PubMedGoogle Scholar
  33. 33.
    Gaulin BD, Markowitz JS, Caley CF, Nesbitt LA, Dufresne RL (1999) Clozapine– Associated Elevation in Serum Triglycerides. Am J Psychiatry 156:1270–1272PubMedGoogle Scholar
  34. 34.
    Gazdag G, Barna I, Ivanyi Z, Tolna J (2004) The impact of neuroleptic medication on seizure threshold and duration in electroconvulsive therapy. Ideggyogy Sz 57:385–390PubMedGoogle Scholar
  35. 35.
    Gerber PE, Lynd LD (1998) Selective serotonin–reuptake inhibitor–induced movement disorders. Ann Pharmacother 32:692–698PubMedGoogle Scholar
  36. 36.
    Gilbert DL, Batterson JR, Sethuraman G, Sallee FR (2004) Tic reduction with risperidone versus pimozide in a randomized, double–blind, crossover trial. J Am Acad Child Adolesc Psychiatry 43:206–214PubMedGoogle Scholar
  37. 37.
    Gilbert DL, Dure L, Sethuraman G, Raab D, Lane J, Sallee FR (2003) Tic reduction with pergolide in a randomized controlled trial in children. Neurology 60:606–611PubMedGoogle Scholar
  38. 38.
    Gilbert DL, Sallee FR, Zhang J, Lipps TD, Wassermann EM (2005) Transcranial Magnetic Stimulation–Evoked Cortical Inhibition: A Consistent Marker of Attention–Deficit/Hyperactivity Disorder Scores in Tourette Syndrome. Biol Psychiatry 57:1597–1600PubMedCrossRefGoogle Scholar
  39. 39.
    Gilbert DL, Sethuraman G, Sine L, Peters S, Sallee FR (2000) Tourette’s syndrome improvement with pergolide in a randomized, double–blind, crossover trial. Neurology 54:1310–1315PubMedGoogle Scholar
  40. 40.
    Goetz CG, Chmura TA, Lanska DJ (2001) History of tic disorders and Gilles de La Tourette syndrome: Part 5 of the MDS–sponsored history of movement disorders exhibit, Barcelona. Mov Disord 16:346–349PubMedGoogle Scholar
  41. 41.
    Graybiel AM, Rauch SL (2000) Toward a neurobiology of obsessivecompulsive disorder. Neuron 28:343–347PubMedCrossRefGoogle Scholar
  42. 42.
    Hallett JJ, Harling–Berg CJ, Knopf PM, Stopa EG, Kiessling LS (2000) Antistriatal antibodies in Tourette syndrome cause neuronal dysfunction. J Neuroimmunol 111:195–202PubMedCrossRefGoogle Scholar
  43. 43.
    Hallett M (2001) Neurophysiology of tics. Adv Neurol 85:237–244PubMedGoogle Scholar
  44. 44.
    Hamilton CS, Garvey MA, Swedo SE (2001) Therapeutic implications of immunology for tics and obsessivecompulsive disorder. Adv Neurol 85:311–318PubMedGoogle Scholar
  45. 45.
    Hanna PA, Janjua FN, Contant CF (1999) Bilineal transmission in Tourette syndrome. Neurology 53:813–818PubMedGoogle Scholar
  46. 46.
    Hanna PA, Jankovic J (2002) Sleep and tic disorders. In: Chokroverty S, Hening Walters A (eds) Sleep and movement disorders. Woburn, Mass Butterworth–Heinemann, pp 181–189Google Scholar
  47. 47.
    Hoekstra PJ, Anderson GM, Limburgc PC, Korfd J, Kallenbergc CGM, Minderaa RB (2004) Neurobiology and neuroimmunology of Tourette’s syndrome: an updateGoogle Scholar
  48. 48.
    Hornsey H, Banerjee S, Zeitlin H, Robertson M (2001) The prevalence of Tourette syndrome in 13–14–year–olds in mainstream schools. J Child Psycol Psychiatry 42:1035–1039Google Scholar
  49. 49.
    Horrigan JP, Barnhill LJ (1995) Guanfacine for treatment of attentiondeficit hyperactivity disorder in boys. J Child Adolesc Psychopharmacol 5:215–223CrossRefGoogle Scholar
  50. 50.
    Hunt RD, Arnsten AFT, Asbell MD (1995) An open trial of guanfacine in the treatment of attention deficit hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 34:50–54PubMedGoogle Scholar
  51. 51.
    Hyde TM, Aaronson BA, Randolph C, Rickler KC, Weinberger DR (1992) Relationship of birth weight to the phenotypic expression of Gilles de la Tourette’s syndrome in monozygotic twins. Neurology 42:652–658PubMedGoogle Scholar
  52. 52.
    Jankovic J (1997) Tourette syndrome: phenomenology and classification of tics. Neurol Clin 15:267–275PubMedGoogle Scholar
  53. 53.
    Jankovic J (2001) Tourette’s syndrome. N Engl J Med 345:1184–1192PubMedCrossRefGoogle Scholar
  54. 54.
    Jankovic J (2001) Differential diagnosis and etiology of tics. Adv Neurol 85:15–29PubMedGoogle Scholar
  55. 55.
    Jimenez–Jimenez FJ, Garcia–Ruiz PJ (2001) Pharmacological options for treatment of Tourette’s disorder. Drugs 61:2207–2220 PubMedGoogle Scholar
  56. 56.
    Kates WR, Frederikse M, Mostofsky SH, Folley BS, Cooper K, Mazur–Hopkins P, Kofman O, Singer HS, Denckla MB, Pearlson GD, Kaufmann WE (2002) MRI parcellation of the frontal lobe in boys with attention deficit hyperactivity disorder or Tourette syndrome. Psychiatry Res 116:63–81PubMedGoogle Scholar
  57. 57.
    Kiessling LS, Marcotte AC, Culpepper L (1993) Antineuronal antibodies in movement disorders. Pediatrics 92:39–43PubMedGoogle Scholar
  58. 58.
    King RA, Scahill L (2001) Emotional and behavioral difficulties associated with Tourette syndrome. Adv Neurol 85:79–88PubMedGoogle Scholar
  59. 59.
    Kofoed L, Tadepalli G, Oesterheld JR, Awadallah S, Shapiro R (1999) Case series: clonidine has no systematic effects on PR or QTc intervals in children. J Am Acad Child Adolesc Psychiatry 38:1193–1196PubMedGoogle Scholar
  60. 60.
    Kossoff EH, Singer HS (2001) Tourette syndrome: clinical characteristics and current management strategies. Paediatr Drugs 3:355–363PubMedGoogle Scholar
  61. 61.
    Kumar R, Lang AE (1997) Tourette syndrome. Secondary tic disorders. Neurol Clin 15:309–331PubMedCrossRefGoogle Scholar
  62. 62.
    Kurlan K, Lichter D, Hewitt D (1989) Sensory tics in Tourette’s Syndrome. Neurology 39:731–734PubMedGoogle Scholar
  63. 63.
    Kurlan R, Como PG, Miller B (2002) The behavioural spectrum of tic disorders: a community–based study. Neurology 59:414–420 PubMedGoogle Scholar
  64. 64.
    Kurlan R (1997) Tourette syndrome. Treatment of tics. Neurol Clin 15:403–409PubMedGoogle Scholar
  65. 65.
    Kurlan R (1998) Tourette’s syndrome and ‘PANDAS’:Will the relation bear out? Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection. Neurology 50:1530–1534PubMedGoogle Scholar
  66. 66.
    Kwak C, Dat VK, Jankovic J (2003) Premonitory sensory phenomenon in Tourette’s syndrome. Mov Disord 18:1530–1533PubMedCrossRefGoogle Scholar
  67. 67.
    Kwak C, Vuong KD, Jankovic J (2003) Migraine headache in patients with Tourette syndrome. Arch Neurol 60:1595–1598PubMedCrossRefGoogle Scholar
  68. 68.
    Kwak CH, Hanna PA, Jankovic J (2000) Botulinum toxin in the treatment of tics. Arch Neurol 57:1190–1193PubMedCrossRefGoogle Scholar
  69. 69.
    Lang AE (1991) Patient perception of tics and other movement disorders. Neurology 41:223–228PubMedGoogle Scholar
  70. 70.
    Lang AE (2001) Update on the treatment of tics. Adv Neurol 85:355–362PubMedGoogle Scholar
  71. 71.
    Lebovitz HE (2003) Metabolic consequences of atypical antipsychotic drugs. Psychiatr Q Fall 74:277–290Google Scholar
  72. 72.
    Leckman JF, Cohen DJ (1988) Descriptive and diagnostic classification of tic disorders. In: Cohen DJ, Bruun RD, Leckman JF (eds) Tourette's Syndrome and Tic Disorders: Clinical Understanding and Treatment. New York, NY: John Wiley and Sons, pp 3–21Google Scholar
  73. 73.
    Leckman JF, Cohen DJ (1999) Tourette’s syndrome–Tics, Obsessions, Compulsions: Developmental Psychopathology and Clinical Care. New York: John Wiley and SonsGoogle Scholar
  74. 74.
    Leckman JF, Dolnansky ES, Hardin MT, Clubb M, Walkup JT, Stevenson J, et al. (1990) Perinatal factors in the expression of Tourette’s syndrome: an exploratory study. J Am Acad Child Adolesc Psychiatry 29:220–226PubMedGoogle Scholar
  75. 75.
    Leckman JF, Hardin MT, Riddle MA, Stevenson J, Ort SI, Cohen DJ (1991) Clonidine treatment of Gilles de la Tourette's syndrome. Arch Gen Psychiatry 48:324–328PubMedGoogle Scholar
  76. 76.
    Leckman JF, Katsovich L, Kawikova I, Lin H, Zhang H, Kronig H, Morshed S, Parveen S, Grantz H, Lombroso PJ, King RA (2005) Increased serum levels of interleukin–12 and tumor necrosis factor–alpha in Tourette’s syndrome. Biol Psychiatry 57:667–673PubMedCrossRefGoogle Scholar
  77. 77.
    Leckman JF, Peterson BDS, Anderson GM, Arnsten ATF, Pauls DL, Cohen DJ (1997) Pathogenesis of Tourette’s syndrome. J Child Psychol Psychiatry 38:119–142PubMedGoogle Scholar
  78. 78.
    Leckman JF, Peterson BS, King RA (2001) Phenomenology of tics and natural history of tic disorders. Adv Neurol 85:1–14PubMedGoogle Scholar
  79. 79.
    Leckman JF, Peterson BS, Pauls DL, Cohen DJ (1997) Tic disorders. Psychiatr Clin North Am 20:839–861PubMedCrossRefGoogle Scholar
  80. 80.
    Leckman JF, Riddle MA (2000) Tourette's syndrome: when habitforming systems form habits of their own? Neuron 28:349–354PubMedCrossRefGoogle Scholar
  81. 81.
    Leckman JF, Walker DE, Cohen DJ (1993) Premonitory urges in Tourette's syndrome. Am J Psychiatry 150:98–102PubMedGoogle Scholar
  82. 82.
    Lesperance P, Djerroud N, Diaz Anzaldua A, Rouleau GA, Chouinard S, Richer F;Montreal Tourette Study Group (2004) Restless legs in Tourette syndrome. Mov Disord 19:1084–1087PubMedGoogle Scholar
  83. 83.
    Marcus D, Kurlan R (2001) Tics and its disorders. Neurol Clin 19:735–758PubMedCrossRefGoogle Scholar
  84. 84.
    Marras C, Andrews D, Sime E, Lang AE (2001) Botulinum toxin for simple motor tics: a randomized, doubleblind, controlled clinical trial. Neurology 56:605–610PubMedGoogle Scholar
  85. 85.
    Merette C, Brassard A, Potvin A, Bouvier H, Rousseau F, Emond C, et al. (2000) Significant linkage for Tourette syndrome in a large French Canadian family. Am J Hum Genet 67:1008–1013PubMedGoogle Scholar
  86. 86.
    Mink JW (2003) The basal ganglia and involuntary movements. Arch Neurol 60:1365–1368PubMedCrossRefGoogle Scholar
  87. 87.
    Mink JW (1996) The basal ganglia: focused selection and inhibition of competing motor programs. Prog Neurobiol 50:381–425PubMedCrossRefGoogle Scholar
  88. 88.
    Mink JW (2001) Neurobiology of basal ganglia circuits in Tourette syndrome: faulty inhibition of unwanted motor patterns? Adv Neurol 85:113–122PubMedGoogle Scholar
  89. 89.
    Morshed SA, Parveen S, Leckman JF (2001) Antibodies against neural, nuclear, cytoskeletal, and streptococcal epitopes in children and adults with Tourette’s syndrome, Sydenham’s chorea, and autoimmune disorders. Biol Psychiatry 50:566–577PubMedCrossRefGoogle Scholar
  90. 90.
    Mukaddes NM, Abali O (2003) Quetiapine treatment of children and adolescents with Tourette’s disorder. J Child Adolesc Psychopharmacol 13:295–299PubMedCrossRefGoogle Scholar
  91. 91.
    Mullen N, Riedel M, Straube A, Gunther W, Wilske B (2000) Increased anti–streptococcal antibodies in patients with Tourette's syndrome. Psychiatry Res 94:43–49Google Scholar
  92. 92.
    Muller N (2004) Anti–inflammatory therapy with a COX–2 inhibitor in Tourette's syndrome. Inflammopharmacology 12:271–275PubMedGoogle Scholar
  93. 93.
    Muller N, Riedel M, Blendinger C, Oberle K, Jacobs E, Abele–Horn M (2004) Mycoplasma pneumoniae infection and Tourette's syndrome. Psychiatry Res 129:119–125PubMedCrossRefGoogle Scholar
  94. 94.
    Muller–Vahl KR (2002) The treatment of Tourette’s syndrome: current opinions. Expert Opin Pharmacother 3:899–914PubMedGoogle Scholar
  95. 95.
    Muller–Vahl KR (2003) Cannabinoids reduce symptoms of Tourette's syndrome. Expert Opin Pharmacother 4:1717–1725 PubMedGoogle Scholar
  96. 96.
    Muller–Vahl KR, Kolbe H, Schneider U (1999) Cannabis in movement disorders. Forsch Komplementarmed 6:23–27PubMedGoogle Scholar
  97. 97.
    Muller–Vahl KR, Meyer GJ, Knapp WH, Emrich HM, Gielow P, Brucke T, Berding G (2005) Serotonin transporter binding in Tourette Syndrome. Neurosci Lett (Epub ahead of print)Google Scholar
  98. 98.
    Muller–Vahl KR, Prevedel H, Theloe K, Kolbe H, Emrich HM, Schneider U (2003) Treatment of Tourette syndrome with delta–9–tetrahydrocannabinol (delta 9–THC): no influence on neuropsychological performance. Neuropsychopharmacology 28:384–388PubMedGoogle Scholar
  99. 99.
    Murphy TK, Bengtson MA, Soto O, Edge PJ, Sajid MW, Shapira N, Yang M (2005) Case series on the use of aripiprazole for Tourette syndrome. Int J Neuropsychopharmacol 28:1–2Google Scholar
  100. 100.
    Murphy TK, Goodman WK, Fudge MW (1997) B lymphocyte antigen D8/17: a peripheral marker for childhood– onset obsessive–compulsive disorder and Tourette's syndrome? Am J Psychiatry 154:402–407PubMedGoogle Scholar
  101. 101.
    Niederhofer H, Staffen W, Mair A (2003) A placebo–controlled study of lofexidine in the treatment of children with tic disorders and attention deficit hyperactivity disorder. J Psychopharmacol 17:113–119PubMedCrossRefGoogle Scholar
  102. 102.
    Nordstrom EJ, Burton FH (2002) A transgenic model of comorbid Tourette's syndrome and obsessivecompulsive disorder circuitry. Mol Psychiatry 7:524Google Scholar
  103. 103.
    Olson S (2004) Neurobiology. Making sense of Tourette's. Science 305:1390–1392PubMedGoogle Scholar
  104. 104.
    Onofrj M, Paci G, D'Andrea M, Toma L (2000) Olanzapine in severe Gilles de la Tourette syndrome: a 52–week double–blind cross–over study vs. low–dose pimozide. J Neurol 247:443–446 PubMedCrossRefGoogle Scholar
  105. 105.
    Orth M, Amann B, Robertson MM, Rothwell JC (2005) Excitability of motor cortex inhibitory circuits in Tourette syndrome before and after single dose nicotine. Brain 128:292–1300CrossRefGoogle Scholar
  106. 106.
    Parraga HC, Parraga MI, Woodward RL, Fenning PA (2003) Quetiapine treatment of children with Tourette's syndrome: report of two cases. J Am Acad Child Adolesc Psychiatry 42:623–624Google Scholar
  107. 107.
    Paschou P, Feng Y, Pakstis AJ, Speed WC, DeMille MM, Kidd JR, Jaghori B, Kurlan R, Pauls DL, Sandor P, Barr CL, Kidd KK (2004) Indications of linkage and association of Gilles de la Tourette syndrome in two independent family samples: 17q25 is a putative susceptibility region. Am J Hum Genet 75:545–560PubMedCrossRefGoogle Scholar
  108. 108.
    Pauls DL (2001) Update on the genetics of Tourette syndrome. Adv Neurol 85:281–293PubMedGoogle Scholar
  109. 109.
    Pauls DL (2003) An update on the genetics of Gilles de la Tourette syndrome. J Psychosom Res 55:7–12 PubMedCrossRefGoogle Scholar
  110. 110.
    Perlmutter SJ, Garvey MA, Castellanos X, Mittleman BB, Giedd J, Rapoport JL, Swedo SE (1998) A case of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections. Am J Psychiatry 155:1592–1598PubMedGoogle Scholar
  111. 111.
    Perry P, Gaffney G Pediatric Psychopharmacology: Tourette's Syndrome. Clinical Psychopharmacology Seminar 1996 Peer Review. Available from: http://www. vh. org/Providers/ Conferences/CPS/42. html 4Google Scholar
  112. 112.
    Peterson AL, Azrin NH (1992) An evaluation of behavioral treatments for Tourette syndrome. Behav Res Ther 30:167–174PubMedGoogle Scholar
  113. 113.
    Peterson BS, Thomas P, Kane MJ, Scahill L, Zhang H, Bronen R, King RA, Leckman JF, Staib L (2003) Basal Ganglia volumes in patients with Gilles de la Tourette syndrome. Arch Gen Psychiatry 60:415–424PubMedGoogle Scholar
  114. 114.
    Plessen KJ, Wentzel–Larsen T, Hugdahl K, Feineigle P, Klein J, Staib LH, Leckman JF, Bansal R, Peterson BS (2004) Altered interhemispheric connectivity in individuals with Tourette's disorder. Am J Psychiatry 161:2028–2037PubMedCrossRefGoogle Scholar
  115. 115.
    Pogarell O, Juckel G, Mulert C, Amann B, Möller HJ, Heger U (2004) EEG Abnormalities Under Treatment with Atypical Antipsychotics: Effects of Olanzapine and Amisulpride as Compared to Haloperidol. Pharmacopsychiatry 37:304–305PubMedCrossRefGoogle Scholar
  116. 116.
    Porta M, Maggioni G, Ottaviani F, Schindler A (2004) Treatment of phonic tics in patients with Tourette's syndrome using botulinum toxin type A Neurol Sci 24:420–423PubMedCrossRefGoogle Scholar
  117. 117.
    Posey DJ, Puntney JI, Sasher TM, Kem DL, McDougle CJ (2004) Guanfacine treatment of hyperactivity and inattention in pervasive developmental disorders: a retrospective analysis of 80 cases. J Child Adolesc Psychopharmacol 14:233–241PubMedCrossRefGoogle Scholar
  118. 118.
    Poyurovsky M, Bergman Y, Shoshani D, Schneidman M, Weizman A (1998) Emergence of obsessive–compulsive symptoms and tics during clozapine withdrawal. Clin Neuropharmacol 21:97–100PubMedGoogle Scholar
  119. 119.
    Raffaele R, Vecchio I, Alvano A, Proto G, Nicoletti G, Rampello L (2004) Blink reflex abnormalities in Tourette sindrome. Clin Neurophysiol 115:320–324PubMedCrossRefGoogle Scholar
  120. 120.
    Rampello L, Nicoletti G, Vecchio I (1995) Clinical and evolutive aspects of Tourette's syndrome. J Neurol 242:88Google Scholar
  121. 121.
    Rampello L, Vecchio I, Furnari P (2000) Tourette's sindrome: phenotipic and aetiopathogenetic spectrum. Mov Disord 15:248Google Scholar
  122. 122.
    Robertson MM (2000) Tourette syndrome, associated conditions and the complexities of treatment. Brain 123:425–462PubMedGoogle Scholar
  123. 123.
    Rothenberger A, Kostanecka T, Kinkelbur J, Cohrs S, Woerner W, Hajak G (2001) Sleep and Tourette syndrome. In: Cohen DJ, Jankovic J, Goetz CG (eds) Tourette syndrome. Vol 85 of Advances in neurology. Philadelphia: Lippincott Williams and Wilkins, pp 245–259Google Scholar
  124. 124.
    Ruth U, Mayer–Rosa J, Schlamp D, Freisleder FJ (2000) Tourette's syndrome and antidepressant therapy: exacerbation of nervous tics with paroxetine. Z Kinder Jugendpsychiatr Psychother 28:105–108PubMedGoogle Scholar
  125. 125.
    Sallee FR, Kurlan R, Goetz CG, Singer H, Scahill L, Law G, Dittman VM, Chappell PB (2000) Ziprasidone treatment of children and adolescents with Tourette's syndrome: a pilot study. J Am Acad Child Adolesc Psychiatry 39:292–299PubMedGoogle Scholar
  126. 126.
    Sallee FR, Nesbitt L, Jackson C, Sine L, Sethuraman G (1997) Relative efficacy of haloperidol and pimozide in children and adolescents with Tourette's disorder. Am J Psychiatry 154:1057–1062PubMedGoogle Scholar
  127. 127.
    Scahill L, Chappell PB, Kim YS, Schultz RT, Katsovich L, Shepherd E, Arnsten AF, Cohen DJ, Leckman JF (2001) A Placebo–Controlled Study of Guanfacine in the Treatment of Children With Tic Disorders and Attention Deficit Hyperactivity Disorder. Am J Psychiatry 158:1067–1074PubMedCrossRefGoogle Scholar
  128. 128.
    Scahill L, Leckman JF, Schultz RT, Katsovich L, Peterson BS (2003) A placebo–controlled trial of risperidone in Tourette syndrome. Neurology 60:1130–1135PubMedGoogle Scholar
  129. 129.
    T L, Tanner C, Dure L (2001) The epidemiology of tics and Tourette syndrome in children and adolescents. Adv Neurol 85:261–271PubMedGoogle Scholar
  130. 130.
    Serrien DJ, Orth M, Evans AH, Lees AJ, Brown P (2005) Motor inhibition in patients with Gilles de la Tourette syndrome: functional activation patterns as revealed by EEG coherence. Brain 128:116–125PubMedGoogle Scholar
  131. 131.
    Shapiro E, Shapiro AK, Fulop G, Hubbard M, Mandeli J, Nordlie J, Phillips RA (1989) Controlled study of haloperidol, pimozide and placebo for the treatment of Gilles de la Tourette's syndrome. Arch Gen Psychiatry 46:722–730PubMedGoogle Scholar
  132. 132.
    Silay YS, Jankovic J (2005) Emerging drugs in Tourette syndrome. Expert Opin Emerg Drugs 10:365–380PubMedCrossRefGoogle Scholar
  133. 133.
    Silver AA, Shytle RD, Philipp MK (2001) Transdermal nicotine and haloperidol in Tourette's disorder: a double–blind placebo–contolled study. J Clin Psychiatry 62:707–714PubMedCrossRefGoogle Scholar
  134. 134.
    Simonic I, Nyholt DR, Gericke, GS, Gordon D, Matsumoto N, Ledbetter DH, Ott J, Weber JL (2001) Further evidence for linkage of Gilles de la Tourette syndrome (GTS) susceptibility loci on chromosomes 2p11, 8q22, and 11q23–24 in South African Afrikaners. Am J Med Genet 105:163–167PubMedCrossRefGoogle Scholar
  135. 135.
    Singer HS (1995) Neurobiology of Tourette syndrome Biol Psychiatry 37:629Google Scholar
  136. 136.
    Singer HS (2000) Current issues in Tourette Syndrome. Mov Disord 15:1051–1063PubMedCrossRefGoogle Scholar
  137. 137.
    Singer HS (2005) Tourette's syndrome: from behaviour to biology. Lancet Neurol 4:149–159PubMedGoogle Scholar
  138. 138.
    Singer HS, Giuliano JD, Hansen BH, Hallett JJ, Laurino JP, Benson M, Kiessling LS (1998) Antibodies against human putamen in children with Tourette syndrome. Neurology 50:1618–1624PubMedGoogle Scholar
  139. 139.
    Singer HS, Giuliano JD, Hansen BH, et al. (1999) Antibodies against a neuron–like (HTB10 neuroblastoma) cell in children with Tourette syndrome. Biol Psychiatry 46:775–780PubMedCrossRefGoogle Scholar
  140. 140.
    Singer HS, Krumholz A, Giuliano J, Kiessling LS (1997) Antiphospholipid antibodies: an epiphenomenon in Tourette syndrome. Mov Disord 12:738–742PubMedGoogle Scholar
  141. 141.
    Smith JL, Johnstone SJ, Barry RJ (2004) Inhibitory processing during the Go/NoGo task: an ERP analysis of children with attention–deficit/hyperactivity disorder. Clin Neurophysiol 115:1320–1331PubMedCrossRefGoogle Scholar
  142. 142.
    Smith SJ, Lees AJ (1989) Abnormalities of the blink reflex in Gilles de la Tourette syndrome. J Neurol Neurosurgery Psychiatry 52:895–898CrossRefGoogle Scholar
  143. 143.
    State MW, Greally JM, Cuker A, Bowers PN, Henegariu O, Morgan TM, et al. (2003) Epigenetic abnormalities associated with a chromosome 18(q21–q22) inversion and a Gilles de la Tourette syndrome phenotype. Proc Natl Acad Sci USA 100:4684–4689PubMedCrossRefGoogle Scholar
  144. 144.
    Stein DJ (2002) Obessive–compulsive disorder. Lancet 360:397–405 PubMedCrossRefGoogle Scholar
  145. 145.
    Stephens RJ, Bassel C, Sandor P (2004) Olanzapine in the treatment of aggression and tics in children with Tourette's syndrome–a pilot study. J Child Adolesc Psychopharmacol 14:255–266PubMedCrossRefGoogle Scholar
  146. 146.
    Stern JS, Burza S, Robertson MM (2005) Gilles de la Tourette's syndrome and its impact in the UK. Postgrad Med J 81:12–19PubMedCrossRefGoogle Scholar
  147. 147.
    Tatlipinar S, Iener EC, Ilhan B (2001) Ophtalmic manifestations of Gilles de la Tourette syndrome. Eur Ophtalmol 11:223–226Google Scholar
  148. 148.
    Temel Y, Visser–Vandewalle V (2004) Surgery in Tourette syndrome. Mov Disord 19:3–14 PubMedCrossRefGoogle Scholar
  149. 149.
    The Tourette Syndrome Association International Consortium for Genetics (1999) A complete genome screen in sib pairs affected by Gilles de la Tourette syndrome. Am J Hum Genet 65:1428–1436Google Scholar
  150. 150.
    The Tourette Syndrome Classification Study Group (1993) Definitions and classification of tic disorders. Arch Neurol 50:1013–1016Google Scholar
  151. 151.
    Tolchard B (1995) Treatment of Gilles de la Tourette syndrome using behavioural psychotherapy: a single case example. J Psychiatr Ment Health Nurs 2:233–236PubMedGoogle Scholar
  152. 152.
    Toren P, Toren A, Weizman A, Mozes T, Eldar S, Magor A, Mandel M, Rechavi G, Many A, Mester R (1994) Tourette's disorder: is there an association with the antiphospholipid syndrome? Biol Psychiatry 35:495–498PubMedGoogle Scholar
  153. 153.
    Toren P, Weizman A, Ratner S, Cohen D, Laor N (2005) Ondansetron treatment in Tourette's disorder: a 3–week, randomized, double–blind, placebocontrolled study. J Clin Psychiatry 66:499–503PubMedCrossRefGoogle Scholar
  154. 154.
    Tourette's Syndrome Study Group (2002) Treatment of ADHD in children with tics: a randomized controlled trial. Neurology 58:527–536Google Scholar
  155. 155.
    Vandewalle V, van der Linden C, Groenewegen HJ (1999) Stereotactic treatment of Gilles de la Tourette syndrome by high frequency stimulation of thalamus. Lancet 353:724PubMedCrossRefGoogle Scholar
  156. 156.
    Verdellen CW, Keijsers GP, Cath DC, Hoogduin CA (2004) Exposure with response prevention versus habit reversal in Tourettes's syndrome: a controlled study. Behav Res Ther 42:501–511PubMedGoogle Scholar
  157. 157.
    Verkerk AJ, Mathews CA, Joosse M, Eussen BH, Heutink P, Oostra BA, and the Tourette Syndrome Association International Consortium for Genetics (2003) CNTNAP2 is disrupted in a family with Gilles de la Tourette syndrome and obsessive compulsive disorder. Genomics 82:1–9PubMedCrossRefGoogle Scholar
  158. 158.
    Voelker R (2004) Scientists use neuroimaging, genetic studies to probe biology of tourette syndrome. JAMA 292:909–911PubMedGoogle Scholar
  159. 159.
    Walkup JT, LaBuda MC, Singer HS, Brown J, Riddle MA, Hurko O (1996) Family study and segregation analysis of Tourette syndrome: evidence for a mixed model of inheritance. Am J Hum Genet 59:684–693PubMedGoogle Scholar
  160. 160.
    Wilhelm S, Deckersbach T, Coffey BJ, Bohne A, Peterson AL, Baer L (2003) Habit Reversal Versus Supportive Psychotherapy for Tourette's Disorder: A Randomized Controlled Trial. Am J Psychiatry 160:1175–1177PubMedCrossRefGoogle Scholar
  161. 161.
    Wolf SS, Jones DW, Knable MB, Gorey JG, Lee KS, Hyde TM, et al. (1996) Tourette syndrome: prediction of phenotypic variation in monozygotic twins by caudate nucleus D2 receptor binding. Science 273:1225–1227PubMedGoogle Scholar
  162. 162.
    Woods DW, Twohig MP, Flessner CA, Roloff TJ (2003) Treatment of vocal tics in children with Tourette syndrome: investigating the efficacy of habit reversal. J Appl Behav Anal 36:109–112PubMedGoogle Scholar
  163. 163.
    Zhang H, Leckman JF, Pauls DL, Tsai CP, Kidd KK, Campos MR (2002) Genome wide scan of hoarding in sib pairs in which both sibs have Gilles de la Tourette syndrome. Am J Hum Genet 70:896–904PubMedCrossRefGoogle Scholar

Copyright information

© Steinkopff-Verlag 2005

Authors and Affiliations

  • L. Rampello
    • 3
  • A. Alvano
    • 3
  • G. Battaglia
    • 1
  • V. Bruno
    • 1
    • 2
  • R. Raffaele
    • 3
  • F. Nicoletti
    • 3
  1. 1.Department of NeuroscienceI. R. C. C. S. I. N. M. NeuromedPozzilliItaly
  2. 2.Department of Human Physiology and PharmacologyUniversity "La Sapienza"RomaItaly
  3. 3.Department of NeurosciencesUniversity of Catania, Neurology, Azienda PoliclinicoCataniaItaly

Personalised recommendations