Emerging Treatment Strategies in Tourette Syndrome

Termine, Cristiano; Selvini, Claudia; Rossi, Giorgio; Balottin, Umberto

doi:10.1016/b978-0-12-411546-0.00015-9

Cited by 35 publications

(16 citation statements)

References 104 publications

(102 reference statements)

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“…[3, 31, 32] The first consideration of course is whether to treat or not. Treatment is only symptomatic and some patients have only mild tics; hence, treatment might be worse than the disease.…”

Section: Treatmentmentioning

confidence: 99%

Tourette Syndrome: Update

Hallett

2015

Brain and Development

111

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Tourette Syndrome is a disorder characterized by tics. It typically begins in childhood and often improves in adult life. Tics are best described as voluntary movements made automatically so that volition is not ordinarily appreciated. There is frequently an urge, sometimes in the form of a specific sensory feeling (sensory tic), that precedes the tic. Patients say that they make the tic in order to reduce the urge, although shortly after the tic, the urge recurs. The sensory feeling may arise due to defective sensory habituation. Since tics relieve the urge, this can be considered rewarding, and repetition of this behavior may perpetuate the tic as a habit. Tourette Syndrome affects boys more than girls and is associated with attention deficit hyperactivity disorder and obsessive compulsive disorder. Although Tourette Syndrome often appears to be autosomal recessive in inheritance, it has been difficult to find any abnormal genes. There is a loss of inhibition in these patients and recent studies show abnormalities in brain GABA. Certainly there is also an abnormality in dopamine function and dopamine blocking agents are effective therapy. In severe drug-refractory patients, deep brain stimulation can be effective.

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Section: Treatmentmentioning

confidence: 99%

Tourette Syndrome: Update

Hallett

2015

Brain and Development

111

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“…Although pilot clinical studies in narcolepsy, schizophrenia and attention deficit disorder have yielded mixed results (with more favorable outcomes in conditions characterized by hypersomnia), preclinical evidence strongly suggests that H3 antagonism could open novel therapeutic avenues in TS and other neuropsychiatric disorders [99]. Specifically, the use of H3 antagonists could be assessed either as a monotherapy or in combination therapy for patients already taking medication, with the goal of expanding the relatively narrow range of safe and effective pharmacological options currently available to clinicians treating patients with TS [39,40,100]. Further implications of additional research into this field may include identification of families at risk of TS.…”

Section: Promising Avenues For Researchmentioning

confidence: 99%

Histaminergic modulation in Tourette syndrome

Cox

Seri

Cavanna

2016

Expert Opinion on Orphan Drugs

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“…Tourette’s syndrome is a neurodevelopmental disorder characterized by sudden, rapid and brief motor and vocal tics, as well as a wide spectrum of other behavioral problems including obsessions, compulsions, impulsivity, distractibility, and hyperactivity (Roessner, et al, 2013; Termine, Selvini, Rossi, & Balottin, 2013; Thomas & Cavanna, 2013). Although the etiology of Tourette’s is currently unclear, hyperactivity of the brain dopaminergic system appears to be involved as dopamine blockers symptomatically improve the motor and vocal tics (Roessner, et al, 2013; Termine, et al, 2013; Thomas & Cavanna, 2013). However, currently available drugs are only partially effective and associated with side effects and thus new therapies are constantly being sought.…”

Section: Nicotine Administration Improves Motor Symptoms Associatementioning

confidence: 99%

Role for the nicotinic cholinergic system in movement disorders; therapeutic implications

Quik¹,

Zhang²,

Perez³

et al. 2014

Pharmacology & Therapeutics

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A large body of evidence using experimental animal models shows that the nicotinic cholinergic system is involved in the control of movement under physiological conditions. This work raised the question whether dysregulation of this system may contribute to motor dysfunction and whether drugs targeting nicotinic acetylcholine receptors (nAChRs) may be of therapeutic benefit in movement disorders. Accumulating preclinical studies now show that drugs acting at nAChRs improve drug-induced dyskinesias. The general nAChR agonist nicotine, as well as several nAChR agonists (varenicline, ABT-089 and ABT-894) reduce L-dopa-induced abnormal involuntary movements or dyskinesias up to 60% in parkinsonian nonhuman primates and rodents. These dyskinesias are potentially debilitating abnormal involuntary movements that arise as a complication of L-dopa therapy for Parkinson’s disease. In addition, nicotine and varenicline decrease antipsychotic-induced abnormal involuntary movements in rodent models of tardive dyskinesia. Antipsychotic-induced dyskinesias frequently arise as a side effect of chronic drug treatment for schizophrenia, psychosis and other psychiatric disorders. Preclinical and clinical studies also show that the nAChR agonist varenicline improves balance and coordination in various ataxias. Lastly, nicotine has been reported to attenuate the dyskinetic symptoms of Tourette’s disorder. Several nAChR subtypes appear to be involved in these beneficial effects of nicotine and nAChR drugs including α4β2*, α6β2* and α7 nAChRs (the asterisk indicates the possible presence of other subunits in the receptor). Overall, the above findings, coupled with nicotine’s neuroprotective effects, suggest that nAChR drugs have potential for future drug development for movement disorders.

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Emerging Treatment Strategies in Tourette Syndrome

Cited by 35 publications

References 104 publications

Tourette Syndrome: Update

Tourette Syndrome: Update

Histaminergic modulation in Tourette syndrome

Role for the nicotinic cholinergic system in movement disorders; therapeutic implications

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