Protocol Number: 02-N-0027

Title:

Brain Activation in Motor and Vocal Tics in Patients with Tourette's Syndrome or Chronic Motor or Vocal Tic Disorder Using Blood Oxygenation Level Dependent Functional MRI

Number:

02-N-0027

Summary:

This study will investigate the brain areas that are activated by vocal and motor tics in patients with Tourette's syndrome and other tic disorders. Tics are involuntary repetitive movements similar to voluntary movements. They may be simple, involving only a few muscles or simple sounds, or complex, involving several groups of muscles in orchestrated bouts. This study will involve only simple motor tics, such as eye blinking, nose wrinkling, facial grimacing and abdominal tensing, and simple vocal tics, such as throat clearing, sniffing and snorting.

Healthy normal volunteers and patients between 14 and 65 years of age with simple motor or vocal tics may be eligible for this study.

Participants will have a brief medical history and physical examination and magnetic resonance imaging (MRI) of the brain. MRI uses a magnetic field and radio waves to produce images. For the procedure, the subject lies on a table that is moved into a cylindrical chamber containing a strong magnet. Earplugs are worn to muffle the loud thumping sounds made by electrical switching of the radio frequency circuits and protect against temporary hearing impairment.

During the scan, normal volunteers will be asked to make simple movements or sounds designed to imitate tics, such as raising eyebrows, blinking or coughing. Patients with tic disorders will have two parts to the scanning session. First they will relax and allow tics to occur spontaneously, then they will be asked to imitate a specific tic when there is no urge to tic.

Patients and healthy subjects will have electromyography (EMG) to record the timing of the voluntary movements and tics. For this procedure, several pairs of small, saucer-like electrodes are attached to the skin with a gel or paste. Electric signals from the electrodes are amplified and recorded on a computer. A microphone may be placed near patients to record any vocal tics. A video camera may also be used to record the tics.

Sponsoring Institute:

National Institute of Neurological Disorders and Stroke (NINDS)

Recruitment Detail

Type: Active Accrual Of New Subjects

Gender: Male & Female

Referral Letter Required: No

Population Exclusion(s): Children

Eligibility Criteria:

INCLUSION CRITERIA

Patients will have a clinically documented tic disorder as defined by DSM-IV-TR and evaluation of tics severity using Yale Tic Sale. This criterion will be established by the preliminary screening in the NINDS Movement Disorders Outpatient Clinic.

Patients will be in age range 14 to 65.

Patients may be male or female.

Patients will be asked to stop any medications that can influence central nervous system for at least 24 hours prior to exam also they will be asked to abstain from alcohol for 24 hours before the study.

10 normal controls will be included; controls will be screened in the NINDS Movement Disorders Outpatient Clinic, and will have neurological and physical examination.

Controls with chronic illnesses, taking any medication that affects the CNS will be excluded.

Controls will be asked to abstain from alcohol for 24 hours before the study.

All subjects participating in MR studies should have a valid Clinical Center Medical Record Number.

EXCLUSION CRITERIA

Patients younger than 14 years old will be excluded from the study.

Patients with MRI findings consistent with brain tumors, strokes, trauma or AVMs will be excluded.

Patients with progressive neurological disorders other than a tic disorder will be excluded.

Patients with a history of significant medical disorders, or requiring chronic treatment with other drugs, which cannot be stopped, will be excluded.

Patients with cancer will be excluded.

Pregnant women will be excluded.

Patients not capable of giving informed consent will be excluded.

Special Instructions: Currently Not Provided

Keywords:

Voluntary Movement

Basal Ganglia

Frontal Lobe

Motor Cortex

Recruitment Keywords:

Motor Tic Disorder

Tourette's Syndrome

Vocal Tic Disorder

Tic

Healthy Volunteer

HV

Normal Control

Conditions:

Tourette's Syndrome

Chronic Motor Tic Disorder

Chronic Motor Vocal Disorder

Investigational Drug(s):

None

Investigational Device(s):

None

Contacts:

Patient Recruitment and Public Liaison Office
Building 61
10 Cloister Court
Bethesda, Maryland 20892-4754
Toll Free: 1-800-411-1222
TTY: 301-594-9774 (local),1-866-411-1010 (toll free)
Fax: 301-480-9793

Electronic Mail:prpl@mail.cc.nih.gov

Citations:

Simple motor tics may be preceded by a premotor potential

Blind separation of auditory event-related brain responses into independent components

Simple tics in Gilles de la Tourette's syndrome are not prefaced by a normal premovement EEG potential

• Questions about participating in a study, please contact the Patient Recruitment and Public Liaison Office, CC.
• Technical questions regarding the Clinical Center web site, please contact the Department of Networks and Applications, CC.

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Bethesda, Maryland 20892. Last update: 10/20/2004