Tourette Syndrome (cont.)
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What research is being done for Tourette syndrome?
Within the Federal government, the leading supporter of research on Tourette syndrome and other neurological disorders is the National Institute of Neurological Disorders and Stroke (NINDS). The NINDS, a part of the National Institutes of Health (NIH), is responsible for supporting and conducting research on the brain and central nervous system.
NINDS sponsors research on Tourette syndrome both in its laboratories at the NIH and through grants to major medical institutions across the country. The National Institute of Mental Health, the National Center for Research Resources, the National Institute of Child Health and Human Development, the National Institute on Drug Abuse, and the National Institute on Deafness and Other Communication Disorders also support research of relevance to Tourette syndrome. And another component of the Department of Health and Human Services, the Centers for Disease Control and Prevention, funds professional education programs as well as Tourette syndrome research.
Knowledge about Tourette syndrome comes from studies across a number of medical and scientific disciplines, including genetics, neuroimaging, neuropathology, clinical trials (medication and non-medication), epidemiology, neurophysiology, neuroimmunology, and descriptive/diagnostic clinical science.
Genetic studies. Currently, NIH-funded investigators are conducting a variety of large-scale genetic studies. Rapid advances in the technology of gene finding will allow for genome-wide screening approaches in Tourette syndrome, and finding a gene or genes for Tourette syndrome would be a major step toward understanding genetic risk factors. In addition, understanding the genetics of Tourette syndrome genes will strengthen clinical diagnosis, improve genetic counseling, lead to the clarification of pathophysiology, and provide clues for more effective therapies.
Neuroimaging studies. Within the past 5 years, advances in imaging technology and an increase in trained investigators have led to an increasing use of novel and powerful techniques to identify brain regions, circuitry, and neurochemical factors important in Tourette syndrome and related conditions.
Neuropathology. Within the past 5 years, there has been an increase in the number and quality of donated postmortem brains from Tourette syndrome patients available for research purposes. This increase, coupled with advances in neuropathological techniques, has led to initial findings with implications for neuroimaging studies and animal models of Tourette syndrome.
Clinical trials. A number of clinical trials in Tourette syndrome have recently been completed or are currently underway. These include studies of stimulant treatment of ADHD in Tourette syndrome and behavioral treatments for reducing tic severity in children and adults. Smaller trials of novel approaches to treatment such as dopamine agonist and GABAergic medications also show promise.
Epidemiology and clinical science. Careful epidemiological studies now estimate the prevalence of Tourette syndrome to be substantially higher than previously thought with a wider range of clinical severity. Furthermore, clinical studies are providing new findings regarding Tourette syndrome and co-existing conditions. These include subtyping studies of Tourette syndrome and OCD, an examination of the link between ADHD and learning problems in children with Tourette syndrome, a new appreciation of sensory tics, and the role of co-existing disorders in rage attacks. One of the most important and controversial areas of Tourette syndrome science involves the relationship between Tourette syndrome and autoimmune brain injury associated with group A beta-hemolytic streptococcal infections or other infectious processes. There are a number of epidemiological and clinical investigations currently underway in this intriguing area.
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