Neurobehavioral aspects, pathophysiology, and management of Tourette syndrome

David R. Shprecher, Lauren Schrock, Michael Himle

Research output: Contribution to journalReview articlepeer-review

13 Scopus citations

Abstract

PURPOSE OF REVIEW: This update summarizes progress in understanding Tourette syndrome clinical characteristics, etiology, and treatment over the past year. RECENT FINDINGS: Premonitory sensory phenomena were found to have important impacts on Tourette syndrome quality of life. A rare genetic form of Tourette syndrome due to L-histidine-decarboxylase mutation, with similar features in human and rodent, has inspired new research on functional anatomy of Tourette syndrome. In response to new data, treatment guidelines have been revised to include behavioral therapy as first-line treatment. Novel dopamine receptor antagonists aripiprazole and ecopipam have shown potential efficacy - as well as tolerability concerns. Recent work has suggested efficacy and tolerability of topiramate and fluphenazine, but more rigorous studies are needed to further understand their role in Tourette syndrome management. Recent consensus guidelines explain when deep brain stimulation can be considered for severe refractory cases under a multidisciplinary team. SUMMARY: More research is needed to identify better tolerated treatments for, to understand pathophysiology or functional anatomy of, and to predict or influence longitudinal outcome of Tourette syndrome.

Original languageEnglish (US)
Pages (from-to)484-492
Number of pages9
JournalCurrent Opinion in Neurology
Volume27
Issue number4
DOIs
StatePublished - Aug 2014

Keywords

  • MRI
  • Tourette syndrome
  • attention deficit hyperactivity disorder
  • comprehensive behavioral intervention for tics
  • deep brain stimulation
  • obsessive compulsive disorder
  • tic

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