Brain Activation in Vocal and Motor Tics

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Brief Title

Brain Activation in Vocal and Motor Tics

Official 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

Brief 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.
    

Detailed Description

      The purpose of this study is to determine the areas of the brain responsible for motor tics
      in patients with tic disorders including Tourette's Syndrome and Chronic Motor or Vocal Tic
      Disorder. Previous studies have been done looking at brain activity during tics using
      electroencephalography (EEG) and positron emission tomography (PET). 16 adult patients with
      DSM-IV-TR (American Psychiatric Association 2000) diagnosis of a tic disorder and frequent
      tics will be studied. We will utilize blood oxygenation level dependent functional magnetic
      resonance imaging (BOLD fMRI) on patients with tics while they are experiencing spontaneous
      tics and while they are voluntarily imitating those tics. The differential activation between
      the tics and the voluntary movements may shed light on the regions of the brain responsible
      for generation of tics.
    


Study Type

Observational




Condition

Tourette's Syndrome



Publications

* Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.

Recruitment Information



Estimated Enrollment

30

Start Date

November 2001

Completion Date

January 2005


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.
      

Gender

All

Ages

N/A - N/A

Accepts Healthy Volunteers

Accepts Healthy Volunteers

Contacts

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Location Countries

United States

Location Countries

United States

Administrative Informations


NCT ID

NCT00026000

Organization ID

020027

Secondary IDs

02-N-0027


Study Sponsor

National Institute of Neurological Disorders and Stroke (NINDS)


Study Sponsor

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Verification Date

January 2005