Attentional and inhibitory mechanisms in Tourette's syndrome

  • Research type

    Research Study

  • Full title

    Tourette's syndrome: The role of attention and inhibitory mechanisms in the generation and management of tics

  • IRAS ID

    200509

  • Contact name

    Eileen Joyce

  • Contact email

    e.joyce@ucl.ac.uk

  • Sponsor organisation

    University College London, Tabitha Kavoi, Senior Portfolio Coordinator

  • Clinicaltrials.gov Identifier

    Z6364106/2016/05/34 clinical research, UCL Data Protection Registration Number

  • Duration of Study in the UK

    2 years, 1 months, 1 days

  • Research summary

    Tourette’s syndrome (TS) is characterised by involuntary movements and vocalisations known as tics. Symptoms of obsessive compulsive disorder or attention deficit hyperactivity disorder often coexist. Tics arise in childhood and, over time, severity often decreases. However, in a significant proportion tics persist into adulthood and are socially disabling.
    Tics are thought to arise from a neurophysiological imbalance in the sensorimotor system. They are preceded by an ‘urge’ to tic and at this stage some people can actively suppress the tic from developing. Current psychological therapy uses this phenomenon to help people control their tics based on the hypothesis there is a problem with motor inhibition. However this is often not successful in adults.
    Tics often automatically reduce when distracted or concentrating on something. This suggests that there may also be an additional problem with attention. Rather than focusing on urges to help prevent tics, learning distraction techniques may be a promising alternative therapy.
    We propose to investigate the extent to which adult TS is associated with problems in attention and inhibition. To do this we will: a) assess the contribution of attention and inhibition and the impact of voluntary suppression on the performance of response conflict flanker and continuous performance tasks; this will tell us how these mechanisms are affected in TS and the role they play in tic generation and management; b) compare performance on a range of attentional and inhibitory function tasks using the computerised CANTAB battery; this will tell us the relative importance of these processes on tasks relevant to everyday life; c) assess the characteristics of neurophysiological imbalance using transcranial magnetic stimulation; d) examine whether pharmacological treatment regulates neurophysiological imbalance; and e) assess the relevance of comorbid symptoms to cognitive and neurophysiological indices of impairment. Results may provide the basis for the development of a new therapy.

  • REC name

    London - Queen Square Research Ethics Committee

  • REC reference

    16/LO/1417

  • Date of REC Opinion

    9 Sep 2016

  • REC opinion

    Further Information Favourable Opinion