Transcript Tourette-handout

Symptoms
• Movement Tics
– Involve head, torso, and
upper or lower limb
movements that the
patient is unable to
control
• Verbal Tics
– Coprolalia
• Uttering obscenities
• Occurs in only about
10% of people
– Various words or
sounds including
• Clicks, grunts, yelps,
barks, sniffs, snorts, and
coughs
Neurobiology
Regions of the brain that may be involved in Tourettes:
Basal Ganglia, Striate, Thalamus
 Basal Ganglia
 Is involved with the control of movement
 Has three parts, two of which are thought to be involved with
Tourette
 Caudate and Putamen
 Striate (Primary Visual Cortex)
 Sensitive to orientation and movement
 The ventral Striate is related to habits and patterns of movement
 Thalamus
 Receives sensory information from sensory systems
 Relay sensory information to specific areas in the cerebral cortex
 The ventrolateral nucleus of the Thalamus is thought to be
important in Tourette
 It projects information from the cerebellum to the primary motor cortex
Neurobiology…
Motor Cortex, Broca’s Area
• Motor Cortex
– Made of the Motor Association Cortex and
the Primary Motor Cortex
– Involved in planning and executing movements
(Association Cortex)
– Neurons are connected to various parts of the
body (Motor Cortex)
• Broca’s Area
– Contains motor memories needed to articulate
sound
Dopamine
 Dopamine is a neurotransmitter involved in many activities
including movement
 Some studies suggest there is a higher pre-synaptic dopamine
function in the caudate nucleus, putamen, and frontal cortex
 Other studies suggest there are more Dopamine binding sites in
the caudate nucleus
 Dopamine is synthesized in four pathways
 Nigrostriatal: pathway involved with control of movements and localized in
caudate and putamen
 Mesocortical: innervates regions of frontal cortex (motor cortex and motor
association cortex)
 Mesolimbic: deals with the ventral striatum, olfactory tubercle and parts of
the limbic system
 Tuberinfundibular: involved in parts of the brain that deal with stress
(Collins, J & McCabe, P.)
Implications for School
Psychologists
 Approximately 40% of students with
Tourette also have a learning disability
 Detailed records of behavior is needed to
diagnose Tourette because there is no known
test to determine it
 Stress, excitement and fatigue may make tics worse
 Provide information to parents, teachers and
the child with Tourette
 Provide a support system for children with
Tourette, as they may have significant social
problems
(Collins, J. & McCabe, P.)
Works Cited
Black, Kevein, J., , , . Tourette syndrome and other tic disorders. (2007, March 30).
Retrieved May 19, 2007, from www.emedicine.com/neuro/topic664.htm
Collins, J. &McCabe, P. (2004, Nov.) Neurochemical bases of tourette syndrome and
implications for school psychologists. NASPCommunique. Retrieved May 20, 2007
from www.nasponline.org/publications/cq/mocq333pedsp_tourette.aspx
Retrieved May 2, 2007, from www.faculty.washington.edu
Retrieved May 2, 2007, from www.ninds.nih.gov
Frey, Kirk, A., Albin, Roger, L. (2006). Neuroimaging of tourette syndrome. Journal of
Child Neurology, 21, 672-677.
Gerard, Elizabeth, & Pererson, Bradley, S. (2003). Developmental processes and brain
imaging studies in tourette syndrome. Journal of Psychomatic Research, 55, 13-22.
Harris, Kendra, & Singer, Harvey, S. (2006). Tic disorders: neural circuits, neurochemistry,
and neuroimmunology. Journal of Child Neurology, 21, 678-689.
Marshall, Ed, Paul. Retrieved May 2, 2007, from www.tourettes-disorder.com