New Research Program for Children and Adolescents with Tourette’s Disorder
Tourette’s Syndrome is a neurological disorder involving motor tics (eye-blinking, mouth movements, head jerks, shoulder shrugs and arm/leg jerks) and/or vocal tics (fast meaningless sounds or noises, grunting, barks, shouting out single words or sentences, or repeating words) that start in childhood and persist over time.
Patients with mild symptoms of Tourette’s Syndrome are treated with behavioral techniques, but more troublesome cases require the use of drugs. Also, the diagnosis and treatment of Tourette’s Syndrome is complicated due to additional conditions including attention deficit/hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), anxiety, and depression. These problems often require patients with Tourette’s to receive other medicines as well.
While the exact cause of Tourette’s Syndrome is unknown, disturbances in the chemicals controlling the nerves in the brain (neurotransmitters) are thought to play a major role. . Your child is invited to take part in a new clinical research program sponsored by Psyadon Pharmaceuticals which is using PSYRX101, a synthetic drug, where the active ingredient is Ecopipam, that acts as to stop the actions of one of these neurotransmitters and to help relieve the symptoms of Tourette’s.
Dr. Cathy Budman’s practice, in collaboration with the Feinstein Institute for Medical Research, is seeking those with a diagnosis of Tourette’s Syndrome and are willing to participate in this novel approach at treating tics in children and adolescents.
You CAN participate if you:
- Have Tourette’s Syndrome
- Exhibit both motor and vocal tics
- Are male or female, ages 7 through 17
- Weigh over 20kg (45lbs)
You CANNOT participate if you:
- Have a history of schizophrenia, bipolar disorder, or other psychotic disorders
- Have a history of attempted suicide
- Have had a major depressive episode in the past 2 years
- Have a history of seizures
- Have had a myocardial infarction within the past 6 months
- Is a Female who is pregnant or lactating
If your child is currently taking some medicines for their Tourette’s, they may need to stop taking them before they can take part since these other drugs may complicate the test. Please speak with Dr. Budman about what this will mean for your child. If you or someone you know would be interested in participating in this clinical trial, please call: Bibu Jacob, research coordinator, at 516-562-1012 or e-mail at bjacob3@NSHS.edu.
The First Annual Childhood Mental Health Symposium will take place at Rutgers University on November 20, 2014. This inaugural event is presented by NJ Center for Tourette Syndrome & Associated Disorders in collaboration with the Academy of Pediatrics NJ Chapter, NJ Psychiatric Association, NJ Council of Child & Adolescent Psychiatry and Rutgers University. This year’s topic is Neuropsychiatric Disorders: Tics, OCD and Trichotillomania.
The symposium is aimed at medical and mental health professionals.
Professionals please register through the link provided in the flyer below.
If you are a parent, feel free to pass this information along to your child’s treating professionals.
Should you have questions, please contact Leanne Loewenthal at NJCTS at 908-575-7350.
Guided Lecture of RUCDR Infinite Biologics®- The world’s largest university-based biorepository specializing in custom genomic solutions and home to The National Institute of Mental Health (NIMH) Center for Collaborative Studies of Mental Disorders, including samples from families with schizophrenia, bipolar disorder, Alzheimer’s disease, autism, obsessive-compulsive disorder, depression, and ADHD.
Patient and Family Perspective - A panel discussion offering insight into the personal challenges of managing mental health disorders and the best practice approach to achieving optimal wellness. Parents and children will participate in this presentation on social, educational, sibling and parenting issues.
Robert A. King, MD, Medical Director, Tourette/OCD Clinic at Yale Child Study Center - Dr. King leads a team committed to treating and preventing childhood mental illness through the integration of research, clinical practice, and professional training.
Lori Rockmore, Psy.D, former Director of the Tourette Syndrome Program, Graduate School of Applied and Professional Psychology at Rutgers University - Dr. Rockmore is a clinical psychologist with expertise in child development, impulse control disorders, and social and emotional learning.
Michael Bloch, MD, Assistant Director, Yale OCD Research Clinic & Assistant Unit Chief, Clinical Neuroscience Research Unit (CNRU) - Dr. Bloch focuses on developing better treatments for children and adults with mental disorders by examining predictors of long-term outcome with an emphasis on neuroimaging. Dr. Bloch is also an expert in psychopharmacology.
Jay A. Tischfield, PhD, FFACMG, Duncan and Nancy MacMillan Distinguished Professor of Genetics, Pediatrics and Psychiatry, Scientific Director & CEO, RUCDR Infinite Biologics®, Executive Director, Human Genetics Institute of New Jersey- Dr. Tischfield studies the genetic causes of common, complex diseases. His experience in organizing, leading and executing large scale projects involving hundreds of thousands of human subjects provides the background expertise for RUCDR Infinite Biologics.
Registration Fee is $50.00 (includes educational symposium & lunch)
“This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of the American Psychiatric Association (APA) and New Jersey Psychiatric Association. The APA is accredited by the ACCME to provide continuing medical education for physicians.”
The APA designates this live activity for a maximum of 4.25 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Image Credit: Wikipedia, used under CC license.
Lynne Lamberg explains that puberty is associated with delays in nocturnal melatonin secretion, resulting in teens staying up approximately two hours later than pre-pubertal children. But since teens still need as much sleep as prepubertal children, they suffer a sleep deficit if school starts early.
We’ve known this for decades, but even now, most school districts continue to start (too) early. Think of how you function if you do not get enough sleep. Is it any surprise that teens who are sleep-deprived will be more likely to have behavioral and emotional problems or have more difficulty focusing, learning, and producing? Why, oh why, don’t schools just start later?
Lamberg recaps some of the available research in her article on Psychiatric Times:
When school starts later, academic performance and other health indicators improve, said Kyla Wahlstrom, Ph.D., director of the University of Minnesota’s Center for Applied Research and Educational Improvement (CAREI).
Wahlstrom led CAREI’s three-year study of about 9,500 students in grades 6 to 12 in eight public schools in Wyoming, Minnesota, and Colorado following start-time delays. In schools that started at 8:35 a.m., her group found, about 60 percent of students slept eight hours or longer on school nights. In schools that began at 7:30 a.m., only 34 percent of students got that much sleep.
Grades rose in first-period classes in the core subjects of English, math, science, and social studies. State and national standardized achievement test scores also rose, the CAREI team reported earlier this year. “We found a proportional benefit for a proportional delay in start time,” Wahlstrom said. The research was funded by the Centers for Disease Control and Prevention (CDC).
Worries that students will stay up later when schools delay start times are unfounded, Wahlstrom said. Students maintain their previous bedtimes and get more sleep.
An earlier CDC study, using data from the 2007 Youth Risk Behavior Survey, found students who slept less than eight hours a night on average were more likely than those who slept longer to report that they drink, smoke cigarettes, use marijuana, are sexually active, and had at least one physical fight in the preceding year.
Yet after all the research and all the decades, most schools continue to start school too early.
This past year, I’ve seen parents become more active advocates for their children’s privacy and data security. Those are serious issues, but most parents still are not actively involved in advocating for later school start for teens. If we really want to improve educational outcomes and decrease behavioral and emotional problems – in school and out of it – we need to stop starting school for the convenience of the districts and working parents, and start school at an hour that works for the students.
Inattention, hyperactivity, and impulsive behavior in children with ADHD can result in social problems and they tend to be excluded from peer activities. They have been found to have impaired recognition of emotional expression from other faces. The research group of Professor Ryusuke Kakigi of the National Institute for Physiological Sciences, National Institutes of Natural Sciences, in collaboration with Professor Masami K. Yamaguchi and Assistant Professor Hiroko Ichikawa of Chuo University first identified the characteristics of facial expression recognition of children with ADHD by measuring hemodynamic response in the brain and showed the possibility that the neural basis for the recognition of facial expression is different from that of typically developing children. The findings are discussed in Neuropsychologia (available online on Aug. 23, 2014).
The research group showed images of a happy expression or an angry expression to 13 children with ADHD and 13 typically developing children and identified the location of the brain activated at that time. They used non-invasive near-infrared spectroscopy to measure brain activity. Near-infrared light, which is likely to go through the body, was projected through the skull and the absorbed or scattered light was measured. The strength of the light depends on the concentration in “oxyhemoglobin” which gives the oxygen to the nerve cells working actively. The result was that typically developing children showed significant hemodynamic response to both the happy expression and angry expression in the right hemisphere of the brain. On the other hand, children with ADHD showed significant hemodynamic response only to the happy expression but brain activity specific for the angry expression was not observed. This difference in the neural basis for the recognition of facial expression might be responsible for impairment in social recognition and the establishment of peer-relationships.
SOURCE: National Institutes of Natural Sciences.
Carousel image © National Institutes of Natural Sciences
A new study published in August in Dev Cogn Neurosci suggests that there may be some value in trying to reward children for suppressing tics in the early stages of tic emergence. The authors of the study are Greene, Koller, Robichaux-Viehoever, Bihun, Schlaggar, and Black.
Here’s the Abstract:
Tic disorders are childhood onset neuropsychiatric disorders characterized by motor and/or vocal tics. Research has demonstrated that children with chronic tics (including Tourette syndrome and Chronic Tic Disorder: TS/CTD) can suppress tics, particularly when an immediate, contingent reward is given for successful tic suppression. As a diagnosis of TS/CTD requires tics to be present for at least one year, children in these tic suppression studies had been living with tics for quite some time. Thus, it is unclear whether the ability to inhibit tics is learned over time or present at tic onset. Resolving that issue would inform theories of how tics develop and how behavior therapy for tics works. We investigated tic suppression in school-age children as close to the time of tic onset as possible, and no later than six months after onset. Children were asked to suppress their tics both in the presence and absence of a contingent reward. Results demonstrated that these children, like children with TS/CTD, have some capacity to suppress tics, and that immediate reward enhances that capacity. These findings demonstrate that the modulating effect of reward on inhibitory control of tics is present within months of tic onset, before tics have become chronic.
Greene DJ, Koller JM, Robichaux-Viehoever A, Bihun EC, Schlaggar BL, Black KJ.
Reward enhances tic suppression in children within months of tic disorder onset.
Dev Cogn Neurosci. 2014 Aug 28. pii: S1878-9293(14)00056-5. doi: 10.1016/j.dcn.2014.08.005. [Epub ahead of print]