Tourette syndrome and obsessive-compulsive disorder: A comprehensive review of structural alterations and neurological mechanisms

Shitova, Anna D.; Zharikova, Tatyana S.; Kovaleva, Olga N.; Luchina, Anastasia M.; Aktemirov, Arthur S.; Olsufieva, Anna V.; Sinelnikov, Mikhail Y.; Pontes-Silva, André; Zharikov, Yury O.

doi:10.1016/j.bbr.2023.114606

Cited by 6 publications

(5 citation statements)

References 155 publications

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“…Besides, although less obvious in this condition, the strengthening of LICI in the two last sessions also suggests that it was slightly deficient at Session 1. Overall, this lack of intracortical inhibition is in line with the alteration of GABAergic systems previously identified in OCD and GTS ( 17 , 18 , 24 ), as well as with TMS data demonstrating deficient SICI at rest, again both in OCD and GTS ( 20–23 , 25–27 , 82 ), although findings have not been consistent in all studies ( 28 , 29 ). Finally, results were less clear regarding the ICF condition; here, we observed a lack of changes in conditioned MEPs in Session 1 followed by a visible facilitation during Session 2.…”

Section: Discussionsupporting

confidence: 75%

“…Furthermore, several paired-pulse transcranial magnetic stimulation (TMS) studies have shown that short-interval intracortical inhibition (SICI), a phenomenon depending on GABA-A receptors activity ( 19 ), is significantly reduced within M1 in GTS patients ( 20 , 21 ), with the strength of the defect being related to tic severity ( 22 , 23 ). Importantly, similar observations have been made in relation to OCD ( 24 ), with many TMS studies clearly showing alterations of motor inhibition circuits, including SICI ( 25–27 ), although findings have not always been consistent ( 28 , 29 ).…”

Section: Introductionsupporting

confidence: 69%

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Relationship between transcranial magnetic stimulation markers of motor control and clinical recovery in obsessive compulsive disorder/Gilles de la Tourette syndrome: a proof of concept case study

Quoilin,

Chaise,

Duque

et al. 2024

Front. Psychiatry

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BackgroundObsessive compulsive disorder (OCD) and Gilles de la Tourette syndrome (GTS) are neurodevelopmental disorders characterized by difficulties in controlling intrusive thoughts (obsessions) and undesired actions (tics), respectively. Both conditions have been associated with abnormal inhibition but a tangible deficit of inhibitory control abilities is controversial in GTS.MethodsHere, we examined a 25 years-old male patient with severe OCD symptoms and a mild form of GTS, where impairments in motor control were central. Transcranial magnetic stimulation (TMS) was applied over the primary motor cortex (M1) to elicit motor-evoked potentials (MEPs) during four experimental sessions, allowing us to assess the excitability of motor intracortical circuitry at rest as well as the degree of MEP suppression during action preparation, a phenomenon thought to regulate movement initiation.ResultsWhen tested for the first time, the patient presented a decent level of MEP suppression during action preparation, but he exhibited a lack of intracortical inhibition at rest, as evidenced by reduced short-interval intracortical inhibition (SICI) and long-interval intracortical inhibition (LICI). Interestingly, the patient’s symptomatology drastically improved over the course of the sessions (reduced obsessions and tics), coinciding with feedback given on his good motor control abilities. These changes were reflected in the TMS measurements, with a significant strengthening of intracortical inhibition (SICI and LICI more pronounced than previously) and a more selective tuning of MEPs during action preparation; MEPs became even more suppressed, or selectively facilitated depending on the behavioral condition in which they we probed.ConclusionThis study highlights the importance of better understanding motor inhibitory mechanisms in neurodevelopmental disorders and suggests a biofeedback approach as a potential novel treatment.

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Section: Discussionsupporting

confidence: 75%

Section: Introductionsupporting

confidence: 69%

Relationship between transcranial magnetic stimulation markers of motor control and clinical recovery in obsessive compulsive disorder/Gilles de la Tourette syndrome: a proof of concept case study

Quoilin,

Chaise,

Duque

et al. 2024

Front. Psychiatry

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“…Excessive dopamine in the striatum is believed to stimulate thalamocortical circuits [33]. The finding of high platelet counts in ADHD and OCD, both of which share similar neurobiological pathways with TD, supports this assumption [15,17,34]. Investigating the elevated platelet count in TD in future studies may serve as a guiding factor in shedding light on the underlying mechanisms of TD.…”

Section: Discussionmentioning

confidence: 90%

Can Red Blood Cell and Platelet Parameters Be Associated With Inflammation in Children With Tic Disorder?

Kara,

Kul

2023

Cureus

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Objective: Tic disorder (TD) is one of the neurodevelopmental disorders and its etiology has not been fully elucidated. Complete blood count (CBC) values have been used as indicators of a systemic inflammatory response. In our study, we aimed to assess hemogram parameters in drug-naive, comorbidity-free children with TD compared with controls. Methods: This retrospective study included 62 drug-naive children with TD who had undergone CBC within one month prior to the study. A control group of 48 healthy children, matched for age and gender, without any organic or psychiatric disorders, was included. Statistical analysis was performed by using IBM SPSS Statistics for Windows, Version 22.0 (Released 2013; IBM Corp., Armonk, New York, United States). Results: Hematocrit (p = 0.044), mean corpuscular volume (p = 0.002), platelet count (p = 0.011), and plateletcrit (p = 0.031) values were significantly higher in the TD group, whereas mean corpuscular hemoglobin concentration (p = 0.00) was significantly lower in the TD group. Additionally, a significant negative correlation was observed between the duration of illness and platelet (p = 0.05, r=-0.282), plateletcrit (p = 0.038, r = -0.295), and neutrophil count (p = 0.006, r = -0.391), while a positive correlation was found between the duration of illness and eosinophil count (p = 0.018, r = 0.336). Conclusion: The results revealed several significant differences in hemogram parameters between TD patients and the control group. These may suggest the role of inflammation and/or other underlying mechanisms in TD and may inspire new studies. Future studies with larger and more homogeneous samples, including comprehensive inflammatory markers, may contribute to a deeper understanding of the relationship between inflammation and TD.

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“…Improved regulation of these neural pathways can lead to reduced tic severity and can decrease anxiety by enhancing the overall neurological function and emotional regulation[ 32 , 33 ]. In addition, stress is known to exacerbate tics and anxiety[ 34 ]. CBT and HRT can effectively reduce stress levels, potentially through the downregulation of the hypothalamic-pituitary-adrenal axis and the modulation of neurotransmitter systems involved in stress and anxiety, such as serotonin and dopamine[ 34 ].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, stress is known to exacerbate tics and anxiety[ 34 ]. CBT and HRT can effectively reduce stress levels, potentially through the downregulation of the hypothalamic-pituitary-adrenal axis and the modulation of neurotransmitter systems involved in stress and anxiety, such as serotonin and dopamine[ 34 ]. By reducing stress, these therapies indirectly contribute to a decrease in tic severity and anxiety symptoms.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of cognitive-behavioral therapy combined with habit reversal training on anxiety disorders in children with Tourette’s syndrome

Wang,

Zhang,

Han

2024

World J Psychiatry

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BACKGROUND Cognitive-behavioral therapy (CBT) and habit reversal training (HRT) have shown application potential in addressing tic symptoms and comorbid psychiatric conditions. Despite their theoretical potential, empirical evidence on their combined efficacy remains limited. AIM To evaluate the efficacy of CBT combined with HRT on anxiety disorders in children with Tourette’s syndrome (TS). METHODS Clinical data of children with TS admitted to our hospital from January 2022 to June 2023 were collected, and the patients were grouped into the conventional therapy (control) group and the CBT combined with HRT group. Baseline characteristics, anxiety scores, tic severity scores, treatment adherence, and parental satisfaction were assessed. Statistical analysis was performed using t-tests, chi-square tests, and correlation analysis. RESULTS A total of 136 patients, including 65 patients in the control group and 71 patients in the CBT combined with HRT group, were included. The CBT combined with HRT group showed remarkable improvements compared with the control group. Post-intervention assessment revealed a decrease in anxiety scores from 63.52 ± 1.81 to 40.53 ± 1.64 (t = 2.022, P = 0.045), and the Yale Global Tic Severity Scale total score decreased from 22.14 ± 5.67 to 16.28 ± 4.91 (t = 2.288, P = 0.024). Treatment adherence was significantly higher in the CBT combined with HRT group (85.47 ± 7.62%) compared with the control group (82.32 ± 6.54%; t = 2.596, P = 0.010). Parental satisfaction scores were also higher in the CBT combined with HRT group (8.69 ± 1.77) compared with the control group (7.87 ± 1.92; t = 2.592, P = 0.011). CONCLUSION This study demonstrates that CBT combined with HRT significantly reduces anxiety symptoms and tic severity in children with TS, with higher treatment adherence and parental satisfaction. These findings support the potential application of this comprehensive therapeutic approach for TS treatment.

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Tourette syndrome and obsessive-compulsive disorder: A comprehensive review of structural alterations and neurological mechanisms

Cited by 6 publications

References 155 publications

Relationship between transcranial magnetic stimulation markers of motor control and clinical recovery in obsessive compulsive disorder/Gilles de la Tourette syndrome: a proof of concept case study

Relationship between transcranial magnetic stimulation markers of motor control and clinical recovery in obsessive compulsive disorder/Gilles de la Tourette syndrome: a proof of concept case study

Can Red Blood Cell and Platelet Parameters Be Associated With Inflammation in Children With Tic Disorder?

Efficacy of cognitive-behavioral therapy combined with habit reversal training on anxiety disorders in children with Tourette’s syndrome

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