Category Archives: Tourette syndrome

CBT can reduce Tics and impact neurophysiology in people with Tourette syndrome

Tourette syndrome is a distressing neurological condition that is characterised by motor and vocal tics. Tics can be described as repetitive and involuntary movements or utterances which can range from facial grimacing, excessive eye blinking, jerky movements of the head, legs, shoulders, or any other part of the body, to constant throat clearing, sniffing, snorting or grunting or making other vocal noises.

No one knows what causes Tourette’s but many professionals believe that Tourette’s could be a result of a disturbance in cell to cell communication in the brain. The Tics tend to be most severe in childhood, perhaps because as children grow into adults they learn to live with the condition, if the Tics are severe enough to interfere with day to day functioning, then drugs such as Neuroleptics are often prescribed to help suppress the Tics.

Now a new study published in the International Journal of Cognitive Therapy has found that Cognitive Behaviour Therapy for treating Tics can be as effective, if not even more effective than medication.

The researchers from Fernand-Seguin Research Centre of the Louis-H Lafontaine Hospital, which is affiliated with Montreal University, noted that the therapy not only had an effect on tics, but also on brain activity.

“This discovery could have major repercussions on the treatment of this illness. In some cases, the physiological measures could allow for the improvement of the therapy in order to tailor it to a specific type of patient” stated Dr. Marc Lavoie, a researcher at Fernand-Seguin Research Centre of the Louis-H Lafontaine Hospital and with the Psychiatry Department of Université de Montréal.

The research involved asking one group of 10 adults with Tourette syndrome and 14 adults with no neurological impairment to carry out a series of tasks which would stimulate certain areas of the brain. In order to assess brain activity, an electroencephalogram was used.

Six months later they were all asked to carry out the same tasks again after having received cognitive behaviour therapy or CBT as it is often called. Dr Lavoie and his team found that after CBT there was a quantifiable “normalisation” of brain activity along with an improvement in the symptoms of Tourette’s.

“On the one hand, therapy leads to cognitive restructuring, and on the other, to behavioural and physiological modifications” said Dr Lavoie. He also pointed out that this is the first study to demonstrate the physiological effects of CBT for patients with Tourette’s, however; other larger studies will be needed to confirm these results.

anxiety – panic the most disabling psychiatric conditions associated with Tourette syndrome

Researchers from the University at Buffalo’s School of Medicine and Biomedical Sciences assessed patients with Tourette syndrome to see if they could identify factors that would contribute to psychosocial and occupational disabilities as a result of vocal tics, a common characteristic of Tourette syndrome.

The results of the study, based on the Global Assessment of Functioning (GAF) scale, will be used to identify patients who are more likely to have or develop significant disabilities related either to the severity of their tics, or to the psychiatric disorders associated with Tourette syndrome such as obsessive-compulsive disorder, mood disorders and drug or alcohol abuse.

“Our study identified the most significant predictors of disability” said Dr. David G. Lichter, first author of the study.

The study involved 45 adult male and 21 adult female patients suffering from Tourette syndrome.

The results revealed that 32 percent had been diagnosed with obsessive compulsive disorder but 62 percent showed obsessive compulsive disorder behaviour.

Almost 29 percent had an anxiety or panic disorder and another 21 percent had symptoms of anxiety.

According to Dr Lichter, it was unexpected to find anxiety and panic as the most disabling psychiatric condition associated with Tourette syndrome and not something like depression.

“The main surprise was that depression was not a major predictor of psychosocial or occupational disability in these patients. Depression has been identified as an important predictor of quality of life in TS,” said Lichter.

Tourette syndrome is a neuropsychiatric disorder that begins in childhood and which is characterised by motor tics like muscle spasms, eye blinking, head jerking, leg kicking and facial twitches, and vocal tics like throat clearing, humming, whistling, and sometimes involuntary swearing.

In most Tourette sufferers, the tics decrease after adolescence, however, as Dr Lichter notes, the results of this study suggests that in those whose tics persist beyond adolescence, it is the severity of the tics that remains the primary factor contributing to global psychosocial and occupational disability.

“In many TS adults, motor tics remain more enduring and prominent than vocal tics and, in our study, motor tics were more severe overall than vocal tics and were more closely correlated with GAF scale score” said Dr Lichter.

The results of the study were presented at the 14th International Congress on Parkinson’s Disease and Movement Disorders, in Buenos Aires, Argentina.