Enhanced stress responsivity of tourette syndrome patients undergoing lumbar puncture

Chappell, Philip; Riddle, Mark A.; Anderson, George M.; Scahill, Lawrence; Hardin, Maureen T.; Walker, David E.; Cohen, Donald J.; Leckman, James F.

doi:10.1016/0006-3223(94)90060-4

Cited by 96 publications

(57 citation statements)

References 30 publications

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“…These findings seem to reflect heightened responsivity of the HPA axis in response to stress in the TS group a finding consistent with previous research and clinical observation. For example, in response to lumbar puncture, adult patients with TS showed elevated ACTH compared to control subjects (Chappell et al, 1994) and higher levels of CRF than individuals with OCD and control participants (Chappell et al, 1996). The enhanced cortisol level in children with TS was observed especially in response to the stressor, but also in anticipation of the MRI environment.…”

Section: Discussionmentioning

confidence: 95%

“…Despite the observation that tics associated with Tourettte syndrome may be exacerbated by stress (Lombroso et al, 1991;Peterson, 1996), there has been a dearth of research exploring the HPA axis in TS (Chappell et al, 1994;Sandyk, 1988;Sandyk & Bamford, 1988;Young et al, 1981), and no such work in children, who are typically most strongly affected by TS.…”

Section: Introductionmentioning

confidence: 99%

“…Another study (Chappell et al, 1994) examined the stressful effects of lumbar puncture on plasma ACTH and cortisol, urinary catecholamines, and self-and clinician ratings of anxiety in 13 medication-free TS patients and 10 normal controls, ages 17 to 41 years. The TS patients secreted significantly more ACTH than the control subjects following lumbar puncture, as manifested by greater mean and peak ACTH levels.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Examining cortisol rhythmicity and responsivity to stress in children with Tourette syndrome

Corbett

Mendoza

Baym

et al. 2008

Psychoneuroendocrinology

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Examining cortisol rhythmicity and responsivity to stress in children with Tourette syndrome

Corbett

Mendoza

Baym

et al. 2008

Psychoneuroendocrinology

View full text Add to dashboard Cite

show abstract

“…Potential mechanisms by which these autoantibodies cause clinical manifestations in central nervous system (CNS) diseases include direct stimulation or blockade of receptors in the basal ganglia, or immune complexes promoting inflammation of these brain regions (Giedd et al 1996(Giedd et al , 2000. Antineuronal antibody binding to basal ganglia tissue was found in both patients with PANDAS (Pavone et al 2004) and patients with ADHD (Sanchez-Carpintero et al 2009), whereas in SC patients, increased antineuronal antibody binding to basal ganglia tissue correlates with symptom severity (Church et al 2002;Husby et al 1976;Kotby et al 1998). More recently, monoclonal antibodies to N-acetyl-beta-d-glucosamine, the dominant epitope of GAS carbohydrate, and lysoganglioside GM1, a neuronal cell-surface molecule, have been cloned from children with SC (Kirvan et al 2003(Kirvan et al , 2006.…”

Section: Serologic and Prospective Studiesmentioning

confidence: 99%

“…If true group differences exist, the etiology is still likely to be multifactorial with cumulative and varying contributions from hypothalamicpituitary-adrenal (HPA) axis dysfunction and stress as well as from influences of genetics, nutrition, medication, and illness. Clinical observations as well as studies of TD and early-onset OCD have consistently suggested that these disorders are sensitive to psychosocial stress (Bornstein et al 1990;Chappell et al 1994;Charmandari et al 2003;Hoekstra et al 2004). For example, a number of reports documented an abnormal response to stress in TD patients (Chappell et al 1996;Lin et al 2007;Corbett et al 2008).…”

Section: The Role Of Psychosocial Stressmentioning

confidence: 99%

The Immunobiology of Tourette's Disorder, Pediatric Autoimmune Neuropsychiatric Disorders Associated withStreptococcus, and Related Disorders: A Way Forward

Murphy

Kurlan

Leckman

2010

Journal of Child and Adolescent Psychopharmacology

Self Cite

143

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Obsessive-compulsive disorder (OCD) and related conditions including Tourette's disorder (TD) are chronic, relapsing disorders of unknown etiology associated with marked impairment and disability. Associated immune dysfunction has been reported and debated in the literature since the late 80s. The immunologic culprit receiving the most interest has been Group A Streptococcus (GAS), which began to receive attention as a potential cause of neuropsychiatric symptoms, following the investigation of the symptoms reported in Sydenham's chorea (SC) and rheumatic fever, such as motor tics, vocal tics, and both obsessive-compulsive and attention deficit/hyperactivity symptoms. Young children have been described as having a sudden onset of these neuropsychiatric symptoms temporally associated with GAS, but without supporting evidence of rheumatic fever. This presentation of OCD and tics has been termed pediatric autoimmune neuropsychiatric disorders associated with Streptococcus (PANDAS). Of note, SC, OCD, and TD often begin in early childhood and share common anatomic areas-the basal ganglia of the brain and the related cortical and thalamic sites-adding support to the possibility that these disorders might share a common immunologic and/or genetic vulnerability. Relevant manuscripts were identified through searches of the PsycINFO and MedLine databases using the following keywords: OCD, immune, PANDAS, Sydenham chorea, Tourette's disorder Group A Streptococcus. Articles were also identified through reference lists from research articles and other materials on childhood OCD, PANDAS, and TD between 1966 and December 2010. Considering the overlap of clinical and neuroanatomic findings among these disorders, this review explores evidence regarding the immunobiology as well as the relevant clinical and therapeutic aspects of TD, OCD, and PANDAS.

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Tourette syndrome and the norepinephrine transporter gene: Results of a systematic mutation screening

et al. 1999

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Tourette syndrome (TS) is a complex inherited neuropsychiatric disorder characterized by multiple motor and phonic tics. Involvement of central norepinephrine mechanisms is suggested by central norepinephrinic hyperactivity in patients with TS and by the therapeutic effects of the presynaptic alpha2-adrenergic agonist clonidine. The norepinephrine transporter gene (NET) was systematically screened by single-strand conformation analysis for genetic variants, including the whole coding region and adjacent exon-intron boundaries in 43 patients with TS and 46 healthy controls. We detected 12 DNA sequence variants, among them four missense mutations (Val69Ile, Thr99Ile, Va1245Ile, and Gly478Ser). The observed missense mutations may alter conformational rearrangements during gating of the transporter, assembly of subunits, and norepinephrine-specific uptake affinity. Allele frequency and genotype distribution of the genetic variants showed no differences between TS patients and controls. No mutation of likely functional significance was found that distinguished TS patients from healthy controls, indicating that genetic variants of the NET gene are not causally related to Tourette syndrome.

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Enhanced stress responsivity of tourette syndrome patients undergoing lumbar puncture

Cited by 96 publications

References 30 publications

Examining cortisol rhythmicity and responsivity to stress in children with Tourette syndrome

Examining cortisol rhythmicity and responsivity to stress in children with Tourette syndrome

The Immunobiology of Tourette's Disorder, Pediatric Autoimmune Neuropsychiatric Disorders Associated withStreptococcus, and Related Disorders: A Way Forward

Tourette syndrome and the norepinephrine transporter gene: Results of a systematic mutation screening

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