TY - JOUR
T1 - Neurobehavioral aspects, pathophysiology, and management of Tourette syndrome
AU - Shprecher, David R.
AU - Schrock, Lauren
AU - Himle, Michael
PY - 2014/8
Y1 - 2014/8
N2 - PURPOSE OF REVIEW: This update summarizes progress in understanding Tourette syndrome clinical characteristics, etiology, and treatment over the past year. RECENT FINDINGS: Premonitory sensory phenomena were found to have important impacts on Tourette syndrome quality of life. A rare genetic form of Tourette syndrome due to L-histidine-decarboxylase mutation, with similar features in human and rodent, has inspired new research on functional anatomy of Tourette syndrome. In response to new data, treatment guidelines have been revised to include behavioral therapy as first-line treatment. Novel dopamine receptor antagonists aripiprazole and ecopipam have shown potential efficacy - as well as tolerability concerns. Recent work has suggested efficacy and tolerability of topiramate and fluphenazine, but more rigorous studies are needed to further understand their role in Tourette syndrome management. Recent consensus guidelines explain when deep brain stimulation can be considered for severe refractory cases under a multidisciplinary team. SUMMARY: More research is needed to identify better tolerated treatments for, to understand pathophysiology or functional anatomy of, and to predict or influence longitudinal outcome of Tourette syndrome.
AB - PURPOSE OF REVIEW: This update summarizes progress in understanding Tourette syndrome clinical characteristics, etiology, and treatment over the past year. RECENT FINDINGS: Premonitory sensory phenomena were found to have important impacts on Tourette syndrome quality of life. A rare genetic form of Tourette syndrome due to L-histidine-decarboxylase mutation, with similar features in human and rodent, has inspired new research on functional anatomy of Tourette syndrome. In response to new data, treatment guidelines have been revised to include behavioral therapy as first-line treatment. Novel dopamine receptor antagonists aripiprazole and ecopipam have shown potential efficacy - as well as tolerability concerns. Recent work has suggested efficacy and tolerability of topiramate and fluphenazine, but more rigorous studies are needed to further understand their role in Tourette syndrome management. Recent consensus guidelines explain when deep brain stimulation can be considered for severe refractory cases under a multidisciplinary team. SUMMARY: More research is needed to identify better tolerated treatments for, to understand pathophysiology or functional anatomy of, and to predict or influence longitudinal outcome of Tourette syndrome.
KW - MRI
KW - Tourette syndrome
KW - attention deficit hyperactivity disorder
KW - comprehensive behavioral intervention for tics
KW - deep brain stimulation
KW - obsessive compulsive disorder
KW - tic
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U2 - 10.1097/WCO.0000000000000119
DO - 10.1097/WCO.0000000000000119
M3 - Review article
C2 - 24978639
AN - SCOPUS:84904050261
SN - 1350-7540
VL - 27
SP - 484
EP - 492
JO - Current Opinion in Neurology
JF - Current Opinion in Neurology
IS - 4
ER -