Association of cortical disinhibition with tic, ADHD, and OCD severity in Tourette syndrome

Donald L. Gilbert · Alok S Bansal · Gopalan Sethuraman · Floyd R. Sallee · Jie Zhang · Tara D. Lipps +1 more

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Obsessive-Compulsive Spectrum Disorders Neurological disorders and treatments Transcranial Magnetic Stimulation Studies

Abstract

Hyperkinetic disorders may involve excess excitatory output from thalamus to cerebral cortex. Case-control, neurophysiological studies in persons with Tourette Syndrome (TS), Attention Deficit Hyperactivity Disorder (ADHD), and Obsessive-Compulsive Disorder (OCD) support this model. To compare the strength of association between motor cortex inhibition and tic, ADHD, and OCD severity in TS, we used transcranial magnetic stimulation to measure motor cortex inhibition in 36 children and adults with TS. Current symptom severity was assessed with standard clinical rating scales and compared with neurophysiological measures using correlational and multivariate regression analyses. Severity of ADHD symptoms and motor tics were associated significantly and independently with short interval intracortical inhibition (SICI) (r(2) = 0.50; F[2,27] = 13.7; P < 0.001), particularly in subjects not taking neuroleptics (r(2) = 0.68; F[2,17] = 17.8; P < 0.0001). The correlation of cortical disinhibition was greater with ADHD symptoms severity (r = 0.53; P = 0.003) than with tic severity (r = 0.42; P = 0.02), suggesting that in TS, the association between SICI and ADHD symptoms may be more consistent or direct than the association between SICI and tics.

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References

1989The Yale Global Tic Severity Scale: Initial Testing of a Clinician-Rated Scale of Tic Severity 1997Children's Yale-Brown Obsessive Compulsive Scale: Reliability and Validity 2000Tourette syndrome, associated conditions and the complexities of treatment 1998A Functional Magnetic Resonance Imaging Study of Tic Suppression in Tourette Syndrome 1996Sensorimotor gating in boys with Tourette's syndrome and ADHD: Preliminary results 1997Decreased motor inhibition in Tourette's disorder: evidence from transcranial magnetic stimulation 2001Basal ganglia dysfunction in Tourette’s syndrome: a new hypothesis 2000A Functional Neuroanatomy of Tics in Tourette Syndrome

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