Neural Correlates of Sensory Phenomena in Tourette Syndrome

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Brief Title

Neural Correlates of Sensory Phenomena in Tourette Syndrome

Official Title

Neural Correlates of Sensory Phenomena in Tourette Syndrome

Brief Summary

      The primary aim of this study is to identify neural correlates of sensory phenomena in adults
      with Tourette syndrome (TS). Adult patients with TS will be recruited 1) to complete a
      standardized clinical symptom assessment battery and 2) to undergo monitoring with
      video-electroencephalogram (EEG) during tactile and auditory tasks, as well as in a resting
      state.
    

Detailed Description

      Tourette syndrome (TS) is a neurodevelopmental disorder affecting 1% of school-aged children;
      one-third of patients suffer persistent tics into adulthood. Diagnostic criteria rely solely
      on motor symptoms, but sensory phenomena are a nearly universal feature, manifesting as 1)
      premonitory urges (PUs) and 2) sensory hypersensitivity. 1) Ninety percent of patients
      perceive unpleasant premonitory bodily urges preceding tic expression, and 60% find these
      more distressing than tics themselves. As PUs and tics are clinically paired, one would
      expect tight symptom severity correlation; however, published results are conflicting.
      Imaging studies reveal the likely role of a widespread sensory processing network in PU
      formation, but much ambiguity surrounds the precise neural substrates of PUs. 2) In addition
      to PUs, 80% of TS patients report heightened awareness of internal and external stimuli.
      Scant research has been devoted to this aspect of TS, but one small series found this sensory
      hypersensitivity to be independent of both PU and tic severity, delineating it as a distinct
      facet of the syndrome. Despite their ubiquity and detrimental impact on quality of life,
      sensory phenomena in TS remain poorly understood: the clinical relationship with tics is
      unclear, the pathophysiologic mechanisms are imprecisely characterized, and the treatment is
      non-existent. Network oscillations, captured in real-time with EEG, are a promising means of
      addressing this crucial knowledge gap.

      Part 1. Clinical Variables and Scales - Adult TS patients will be recruited to complete a
      battery of validated clinical scales, providing a comprehensive phenotype. The scales include
      the following: Yale Global Tic Severity Scale (YGTSS); Dimensional Obsessive-Compulsive Scale
      (DOCS); Adult ADHD Self-Report Screening Scale for DSM-V; Generalized Anxiety Disorder 7
      (GAD-7); Patient Health Questionnaire 9 (PHQ-9); Premonitory Urge to Tic Scale (PUTS);
      Sensory Gating Inventory (SGI); Sensory Perception Quotient (SPQ); and GTS-Quality of Life
      (GTS-QOL) Rating Scale. Patients with previously diagnosed autism spectrum disorder,
      developmental delay, cerebral palsy, other significant neurologic disease, schizophrenia, or
      psychotic disorders will be excluded, in order to lessen potentially confounding factors.
      Patients with obsessive-compulsive disorder (OCD), attention deficit hyperactivity disorder
      (ADHD), anxiety, and/or depression will be permitted, given that these diagnoses are widely
      prevalent in the adult TS population. Age-matched, healthy-controls (HCs) will be recruited
      to complete the mood and sensory instruments. All study procedures will be completed during a
      single testing session. Medical and neurologic history, family history, substance use
      history, developmental history, and current and past psychotropic pharmacotherapies, will be
      reviewed.

      Part 2. EEG Testing - Each participant will undergo a single-session EEG paradigm consisting
      of somatosensory and auditory event-related potentials (ERP), as well as a resting state
      condition. The somatosensory stimulus consists of a non-painful stimulus to the arm, and the
      auditory stimulus consists of a non-painful sound delivered through headphones. The entire
      recording session will take approximately 1-1.5 hours. Participants will be video-recorded,
      to allow for subsequent identification of tics.
    


Study Type

Observational


Primary Outcome

Network Oscillations in the Gamma (>30 Hz) Frequency Range

Secondary Outcome

 Premonitory Urge to Tic Scale (PUTS)

Condition

Tourette Syndrome

Intervention

Electroencephalogram (EEG) testing procedure

Study Arms / Comparison Groups

 Tourette Syndrome
Description:  Adults (>18 years of age) with diagnosis of Tourette 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


Recruitment Status

Diagnostic Test

Estimated Enrollment

50

Start Date

August 20, 2019

Completion Date

December 2022

Primary Completion Date

April 2022

Eligibility Criteria

        Inclusion Criteria:

          -  Diagnosis of Tourette syndrome

          -  Age greater than or equal to 18 years

        Exclusion Criteria:

          -  Prior diagnosis of autism spectrum disorder, developmental delay, cerebral palsy,
             other significant neurologic disease, schizophrenia, or psychotic disorders

          -  Previously diagnosed hearing or tactile impairment

          -  Current use of benzodiazepines (e.g. Clonazepam, Diazepam, Alprazolam) or anti-seizure
             medications (e.g. Topiramate, Lamotrigine)
      

Gender

All

Ages

18 Years - N/A

Accepts Healthy Volunteers

Accepts Healthy Volunteers

Contacts

, 6159362025, [email protected]

Location Countries

United States

Location Countries

United States

Administrative Informations


NCT ID

NCT03914664

Organization ID

NCoSPTS


Responsible Party

Principal Investigator

Study Sponsor

Vanderbilt University Medical Center


Study Sponsor

, , 


Verification Date

September 2021