Hypersensitivity in Tourette Syndrome

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Brief Title

Hypersensitivity in Tourette Syndrome

Official Title

Hypersensitivity in Tourette Syndrome: An Evaluation of Perceived Intensity Versus Threshold

Brief Summary

      This study will investigate how the sensitivity to touch and smell in patients with Tourette
      syndrome (TS) may differ from that of people without TS. TS is a neurological disorder that
      causes people to have uncontrolled movements called "tics." A tic can also be vocal, like a
      cough or bark or string of bad words. The tic is preceded by a "premonitory urge" that may
      feel like an itch or pressure that builds until the tic occurs. To some patients, the tic
      feels like a response to an involuntary sensation. In patients with TS, sensory information
      may be processed differently than it is in people without TS. This study will compare how
      strong a sensation feels in TS patients and healthy volunteers. It will also look for muscle
      activity that may be responsible for the feelings in the area of the tic.

      Healthy normal volunteers and people with Tourette syndrome, 18 to 65 years of age, may be
      eligible for this study. Candidates are screened with a medical history and brief physical
      and neurological examinations. TS patients complete a questionnaire about their tics and are
      interviewed by a psychiatrist. Women who can become pregnant will have a urine pregnancy test
      prior to any other procedures. Pregnant women cannot participate.

      All participants undergo sensory testing for touch and smell. They are asked to distinguish
      between a scented and scentless object and rate how strongly they feel the scent. Later, with
      their eyes closed, they are asked to tell whether or not they are being touched, and to rate
      how intensely they felt the touch.

      In addition to the sensory testing, TS patients, but not normal volunteers, undergo
      electromyography (EMG), a test that measures the electrical activity of muscles. For surface
      EMG, small metal disks called electrodes are filled with a conductive gel and taped to the
      skin. Wire EMG involves inserting a wire into a muscle using a needle. All patients have
      surface EMG and those who consent to it will also have wire EMG.
    

Detailed Description

      OBJECTIVE:

      This study will explore sensory phenomena associated with Tourette syndrome (TS). The first
      part will evaluate threshold levels versus perceived intensity of tactile and olfactory
      stimuli in areas reported to be hypersensitive in TS patients. The second part will use
      electromyography (EMG) to seek correlation between muscle activity and the perceived
      intensity of "urge" in focal areas of premonitory sensations.

      STUDY POPULATION:

      Twenty-six patients and 22 control subjects will be studied. Subjects can be of any race,
      gender, handedness, or age from 18 to 65 years.

      DESIGN:

      To determine olfactory and tactile threshold, n-butanol and Von Frey hairs will be presented
      in forced-choice modified method of limits paradigms. Perceived intensity will be examined
      using a generalized labeled magnitude scale (gLMS), whose word values are placed on a ruler
      for numerical reporting. Randomly arranged series of 7 stimuli for olfaction and touch will
      be presented in 4 sets, and subjects will report a number on the gLMS that corresponds to the
      intensity of each sensation. Both threshold and intensity will be measured in the peroneal
      nerve territory in all subjects, and at one other variable place, which will be matched 1:1
      between patients and controls. The variable spot will consist of a patient's sensory tic
      site. Next, EMG activity will be measured from up to 8 muscles in the area of a sensory tic.
      Patients will report when a sensory tic is occurring, and will be asked to resist the motor
      tic for at least 12 seconds from that point. Total EMG activity will be measured in muscles
      surrounding the sensation at 1, 4, and 7 seconds before and after the tic.

      OUTCOME MEASURES:

      Outcome measures include the sensory threshold values for olfaction and touch and the
      reported intensity values. The outcome measures of the EMG study include the power of total
      EMG activity at time points before and after a tic.
    


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

46

Start Date

August 21, 2006

Completion Date

May 24, 2011


Eligibility Criteria

        -  INCLUSION CRITERIA:

        Healthy Volunteers ages 18 to 65 who have who have given their consent.

        Patients will be ages 18 to 65 and have clinically documented Tourette's syndrome or
        chronic motor tic disorder as defined by DSM-IV-TR (American Psychiatric Association, 2000)
        and evaluation of tic severity using the Yale Tic Scale (YGTS). This criterion will be
        established by preliminary screening in the NINDS Movement Disorders Outpatient Clinic.
        Structure Clinical Interview for (DSMIV SCID) will be administered to all patients to
        ensure that strict DSM-IV criteria for Tourette Syndrome have been met and to assess for
        possible comorbid psychiatric disorders.

        Patients with at least moderate premonitory urge, as evaluated with the PUTS.

        EXCLUSION CRITERIA:

        Subjects younger than 18 or older than 65 years.

        Subjects with 1) major depression, 2) bipolar disorder, or 3) psychotic disorder.

        Subjects who are unable to abstain from alcohol or any psychiatric medications 24 hours
        prior to the study.

        Subjects with acute or chronic upper respiratory illness, nasal allergies, or subjects
        using medications to treat these conditions, including antihistamines, nasal topical
        steroids, vasoconstrictor nasal sprays, or normal saline sprays.

        Women who are pregnant.

        Individuals with Restless Legs syndrome.

        Individuals with a diagnosis of peripheral neuropathy.
      

Gender

All

Ages

18 Years - 65 Years

Accepts Healthy Volunteers

No

Contacts

, , 

Location Countries

United States

Location Countries

United States

Administrative Informations


NCT ID

NCT00368433

Organization ID

060232

Secondary IDs

06-N-0232


Study Sponsor

National Institute of Neurological Disorders and Stroke (NINDS)


Study Sponsor

, , 


Verification Date

May 24, 2011