This study will use electroencephalography (EEG) and electromyography (EMG) to examine how the brain generates tics and controls voluntary movement in patients with Tourette's syndrome and chronic motor tic disorder. EEG records the electrical activity of the brain. For this test, a cap with built-in electrodes is placed on the subject's head, and the electrodes are connected to a monitor that records the brain activity. EMG records muscle activity using electrodes placed on the skin over muscles on the fingers or above the outer corner of the eyes.

Healthy normal volunteers and patients with Tourette's syndrome and chronic motor tic disorder between 21 and 65 years of age may be eligible for this 2- to 3-hour study. Each candidate will be screened with a medical history, physical and neurological examinations, and a questionnaire that screens for psychiatric disorders.

During EEG and EMG recordings, participants undergo the following tasks while seated comfortably in a sound-shielded room:

Patients

- Finger task: Patients raise their index finger once every 10 seconds for about 25 minutes.

- Tic evaluation and mimicking: Patients allow their tics to occur as they do naturally. After each tic, they report whether the tic was voluntary and whether it was preceded by a sensation of urge. They then mimic tics that they normally have, at a rate of about once every 10 seconds.

- Tic suppression task: Patients suppress tics they normally have for several minutes. They then allow the tics to occur naturally, without attempting to suppress them.

Normal Volunteers

- Finger task: Volunteers raise their index finger once every 10 seconds for about 25 minutes.

- Open eye task: Volunteers keep their eyes open for a minute or so, and then resume blinking as often as feels comfortable. The process is repeated several times.

Condition
Tourette Syndrome Tic Disorders

This study examines the spatiotemporal dynamics of cortical functional interconnectivity involved tics and voluntary movement in patients with Tourette's syndrome or chronic motor tic disorder. By employing a combination of EEG methods that utilize analyses in the domains of both frequency (e.g., event-related desynchronization/synchronization (ERD/ERS), event-related partial coherence, phase coherence) and time (e.g., event-related partial correlation), we intend to determine

1) whether the cortical neurocircuitry involved in the performance of a simple, voluntary motor task differs in patients with tic disorders from that of healthy controls;

2) whether the network involved in the generation of unwanted tics differs from that of normal voluntary movement (i.e., mimicked tics); and

3) what role, if any, premonitory urge and/or tic suppression plays in the modulation of this neurocircuitry.

Genders Eligible for Study:  Both

Accepts Healthy Volunteers

Criteria

INCLUSION CRITERIA:
Twenty seven patients and 27 controls, able and willing to give consent, will be studied.
Subjects of any race, gender, handedness, or age between 21 and 65 will be included.
Patients will have clinically documented Tourette's syndrome or chronic motor tic disorder as defined by DSM-IV-TR and evaluation of tic severity using the Yale Tic Scale.
Regarding co-morbid disorders such as ADHD and OCD, we will accept a mild degree of ADHD and mild to moderate degree of OCD. These disorders will be established by a psychiatrist.
Only those with no more than mild to moderate severity of symptoms of Obsessive Compulsive Disorder (OCD) and Attention Deficit Hyperactivity Disorder (ADHD) in Tourette's syndrome will be accepted into the study.
EXCLUSION CRITERIA:
Subjects younger than 21 or older than 65 years.
Subjects with 1) major depression, 2) bipolar disorder, or 3) psychotic disorder.
Subjects taking benzodiazepines, anti-depressant or neuroleptic medications.
Subjects with major acute or chronic illness.
Pregnant women.

Maryland
      National Institute of Neurological Disorders and Stroke (NINDS), 9000 Rockville Pike,  Bethesda,  Maryland,  20892,  United States; Recruiting

Study ID Numbers:  030126; 03-N-0126
Record last reviewed:  February 4, 2004
Last Updated:  February 4, 2004
Record first received:  March 12, 2003
ClinicalTrials.gov Identifier:  NCT00056420
Health Authority: United States: Federal Government
ClinicalTrials.gov processed this record on 2004-11-08