Tourette SyndromeNCT00033995
Study of Tics in Patients With Tourette's Syndrome and Chronic Motor Tic Disorder
An observational study of Tourette Syndrome and Tic Disorders, run by National Institute of Neurological Disorders and Stroke (NINDS) at 1 site in United States.
Trial summary
This study will investigate which areas of the brain are primarily involved in and responsible for tics in patients with Tourette's syndrome and chronic motor disorder. Tourette's syndrome is a neuropsychiatric disorder characterized by motor and vocal tics and is associated with behavioral and emotional disturbances… Read more about this study
- Who is it for?
- Ages 18 to 65 yearsHealthy volunteers can take part
- Conditions the study is for
- Tourette Syndrome, Tic Disorders
- How many people
- 46 participants
- Where
- 1 siteUnited States
- Study dates
- 17 Apr 2002to 17 Feb 2009
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 65 years
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Patients will have clinically documented Tourette's syndrome or chronic motor tic disorder as defined by DSM-IV-TR and evaluation of tic severity using the Yale Tic Scale. This criterion will be established by preliminary screening in the NINDS Movement Disorders Outpatient Clinic. Regarding co-morbid disorders such as ADHD and OCD, we will accept a mild degree of ADHD and mild to moderate degree of OCD. These disorders will be established by a psychiatrist using below listed scales and criteria. In order to participate in this study, patients will be asked to stop any medication that can influence the central nervous system for 2 weeks prior to exam. Patients taking fluoxetine will be asked to stop it 4 weeks prior to the exam. Stopping the medications for Tourette syndrome or tics, OCD and ADHD may lead to worsening of their symptoms.
- Any changes to patients' medication must first be discussed with their doctor and only this doctor will be responsible for tapering the medication.
- Patients will be asked to abstain from alcohol for one week before the study.
- Patients will be in age ranges 18 to 65. Patients may be male or female. Female patients of child-bearing potential will have a pregnancy test and specific interview prior to the study to ensure that pregnant patients will not participate in the study. Patients will be asked to stop any medication that can influence central nervous system (CNS) for one week prior to exam.
- Twenty three normal controls will be included; controls will be screened in the NINDS Movement Disorders Outpatient Clinic, and will have neurological and physical examination. Controls with chronic illnesses, taking any medication that affects the CNS will be excluded.
Who cannot join
- Patients younger than 18 or older than 65 years old will be excluded from the study. We are excluding patients older than 65 years because of possibility of age-related neurological disorders such as stroke and dementia.
- Patients with MRI findings consistent with brain tumors, strokes, trauma or AVMs will be excluded.
- Patients with progressive neurological disorders other than TS or chronic motor tic disorder and significant other pathology will be excluded.
- Patients with a history of significant medical disorders, or requiring chronic treatment with other drugs, which cannot be stopped, will be excluded.
- Patients with cancer will be excluded.
- Patients not capable of giving an informed consent will be excluded.
- Patients who are pregnant will be excluded.
Trial locations and contacts
1 site in 1 country.
United States1 site
National Institutes of Health Clinical Center, 9000 Rockville Pike
Bethesda, Maryland, 20892
About this study
Official title: Study of Tics in Patients With Tourette's Syndrome and Chronic Motor Tic Disorder With [15O]H2O PET in Awake and in Sleep States
This study will investigate which areas of the brain are primarily involved in and responsible for tics in patients with Tourette's syndrome and chronic motor disorder. Tourette's syndrome is a neuropsychiatric disorder characterized by motor and vocal tics and is associated with behavioral and emotional disturbances, including symptoms of attention deficit hyperactivity disorder and obsessive-compulsive disorder. Chronic motor disorder has the same characteristics as Tourette's syndrome, except that patients do not have vocal tics.
Healthy normal volunteers and patients with Tourette's syndrome or chronic motor tic disorder between 18 and 65 years of age may be eligible for this study. Candidates will be screened with a medical history and physical and neurological examinations.
Read more
Participants will undergo positron emission tomography (PET) scanning to study tics under three conditions- spontaneous tics, suppression of tics, and sleep-to determine which areas of the brain are responsible for generation of tics. For this procedure, the subject is injected with H215O, a radioactive substance similar to water. A special camera detects the radiation emitted by the H215O, allowing measurement of brain blood flow. Subjects will receive up to 20 injections of H215O during the scanning.
Participants will be asked not to sleep the entire night before the test. Before the scan, both patients and volunteers will have EEG electrodes placed on their heads to record the electrical activity of their brains. Patients will also have EMG electrodes placed in areas of the body where tics occur. A small catheter (plastic tube) will be placed in an arm vein for injecting the radioactive tracers, and a mask will be placed on the face to help keep the head still during scanning. The mask has large openings for eyes, nose and mouth, so that it does not interfere with talking or breathing. The entire test takes about 4 hours. During this time, the subject will sleep for 1.5 hours either at the beginning or end of the scan. For the other 2.5 hours, scans will be done every 10 minutes for 1 minute under the different conditions of tic suppression or release of tics.
On a separate day, participants will also undergo magnetic resonance imaging (MRI), a diagnostic test that uses a magnetic field and radio waves to produce images of the brain. For this procedure, the subject lies still on a stretcher that is moved into the scanner (a narrow cylinder containing the magnet). ...
Read the detailed description
The purpose of this study is to determine the areas of the brain responsible for tics in patients with Tourette's syndrome and chronic motor tic disorder using [15O]H2O. Previous neuroimaging studies have looked at brain activity during tics using functional magnetic resonance imaging (fMRI), and positron emission tomography (PET), but a major drawback of these studies lay in the difficulty distinguishing between the activity in the brain responsible for tic generation versus activity in motor-related structures due to tic movements. We plan to overcome this difficulty in our paradigm using two rest conditions without any movement. One is a state when patients suppress their tics and the second is sleep state, when tics usually cease or are at least very infrequent. 23 adult patients with a DSM-IV-TR (American Psychiatric Association 2000) diagnosis of a tic disorder and frequent tics will be studied. These two rest states will be compared with a condition where tics are allowed to occur spontaneously. The differential activation of brain areas between these three conditions should help to elucidate/define the regions of the brain responsible for generation of tics.
- Conditions
- Tourette Syndrome, Tic Disorders
- Keywords
- Tics, Basal Ganglia, Neuroimaging, Sleep, Suppression of Tics, Tourette Syndrome, Tourette's Syndrome, Tic Disorder, Healthy Volunteer, HV, Normal Control
- Medical subject headings
- Tourette Syndrome, Tic Disorders, Tics
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted19 Apr 2002 (estimated)
- Study start17 Apr 2002
- Study completion17 Feb 2009
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Tourette SyndromeStudies of the same condition, open and under way.
- More trials run by National Institute of Neurological Disorders and Stroke (NINDS)The sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Enrolment
- 46 participants
Sponsor and investigators
- Sponsor type
- US National Institutes of Health
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00033995
- Sponsor's protocol ID
- 020175
- Other IDs
- 02-N-0175
- Status last verified
- 17 Feb 2009
- First submitted
- 18 Apr 2002
- Last updated
- 2 Jul 2017
- Results posted
- No
Publications
Braun AR, Stoetter B, Randolph C, Hsiao JK, Vladar K, Gernert J, Carson RE, Herscovitch P, Chase TN. The functional neuroanatomy of Tourette's syndrome: an FDG-PET study. I. Regional changes in cerebral glucose metabolism differentiating patients and controls. Neuropsychopharmacology. 1993 Dec;9(4):277-91. doi: 10.1038/npp.1993.64.
PubMed 8305128Brett PM, Curtis D, Robertson MM, Gurling HM. The genetic susceptibility to Gilles de la Tourette syndrome in a large multiple affected British kindred: linkage analysis excludes a role for the genes coding for dopamine D1, D2, D3, D4, D5 receptors, dopamine beta hydroxylase, tyrosinase, and tyrosine hydroxylase. Biol Psychiatry. 1995 Apr 15;37(8):533-40. doi: 10.1016/0006-3223(94)00161-U.
PubMed 7619976Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischmann RL, Hill CL, Heninger GR, Charney DS. The Yale-Brown Obsessive Compulsive Scale. I. Development, use, and reliability. Arch Gen Psychiatry. 1989 Nov;46(11):1006-11. doi: 10.1001/archpsyc.1989.01810110048007.
PubMed 2684084
Study at a glance
From the registry record, last updated by the sponsor on 2 Jul 2017. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Study of Tics in Patients With Tourette's Syndrome and Chronic Motor Tic Disorder With [15O]H2O PET in Awake and in Sleep States
- ClinicalTrials.gov ID
- NCT00033995
- Acronym / sponsor ID
- 020175
- Conditions
- Tourette Syndrome, Tic Disorders
- Keywords
- Tics, Basal Ganglia, Neuroimaging, Sleep, Suppression of Tics, Tourette Syndrome, Tourette's Syndrome, Tic Disorder
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 46 participants
- Lead sponsor
- National Institute of Neurological Disorders and Stroke (NINDS)US National Institutes of Health
- Study start
- 17 Apr 2002
- Study completion
- 17 Feb 2009
- First posted
- 19 Apr 2002 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study will investigate which areas of the brain are primarily involved in and responsible for tics in patients with Tourette's syndrome and chronic motor disorder. Tourette's syndrome is a neuropsychiatric disorder characterized by motor and vocal tics and is associated with behavioral and emotional disturbances, including symptoms of attention deficit hyperactivity disorder and obsessive-compulsive disorder. Chronic motor disorder has the same characteristics as Tourette's syndrome, except that patients do not have vocal tics.
Healthy normal volunteers and patients with Tourette's syndrome or chronic motor tic disorder between 18 and 65 years of age may be eligible for this study. Candidates will be screened with a medical history and physical and neurological examinations.
Participants will undergo positron emission tomography (PET) scanning to study tics under three conditions- spontaneous tics, suppression of tics, and sleep-to determine which areas of the brain are responsible for generation of tics. For this procedure, the subject is injected with H215O, a radioactive substance similar to water. A special camera detects the radiation emitted by the H215O, allowing measurement of brain blood flow. Subjects will receive up to 20 injections of H215O during the scanning.
Participants will be asked not to sleep the entire night before the test. Before the scan, both patients and volunteers will have EEG electrodes placed on their heads to record the electrical activity of their brains. Patients will also have EMG electrodes placed in areas of the body where tics occur. A small catheter (plastic tube) will be placed in an arm vein for injecting the radioactive tracers, and a mask will be placed on the face to help keep the head still during scanning. The mask has large openings for eyes, nose and mouth, so that it does not interfere with talking or breathing. The entire test takes about 4 hours. During this time, the subject will sleep for 1.5 hours either at the beginning or end of the scan. For the other 2.5 hours, scans will be done every 10 minutes for 1 minute under the different conditions of tic suppression or release of tics.
On a separate day, participants will also undergo magnetic resonance imaging (MRI), a diagnostic test that uses a magnetic field and radio waves to produce images of the brain. For this procedure, the subject lies still on a stretcher that is moved into the scanner (a narrow cylinder containing the magnet). ...
Detailed description
The purpose of this study is to determine the areas of the brain responsible for tics in patients with Tourette's syndrome and chronic motor tic disorder using [15O]H2O. Previous neuroimaging studies have looked at brain activity during tics using functional magnetic resonance imaging (fMRI), and positron emission tomography (PET), but a major drawback of these studies lay in the difficulty distinguishing between the activity in the brain responsible for tic generation versus activity in motor-related structures due to tic movements. We plan to overcome this difficulty in our paradigm using two rest conditions without any movement. One is a state when patients suppress their tics and the second is sleep state, when tics usually cease or are at least very infrequent. 23 adult patients with a DSM-IV-TR (American Psychiatric Association 2000) diagnosis of a tic disorder and frequent tics will be studied. These two rest states will be compared with a condition where tics are allowed to occur spontaneously. The differential activation of brain areas between these three conditions should help to elucidate/define the regions of the brain responsible for generation of tics.
Study design
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Patients will have clinically documented Tourette's syndrome or chronic motor tic disorder as defined by DSM-IV-TR and evaluation of tic severity using the Yale Tic Scale. This criterion will be established by preliminary screening in the NINDS Movement Disorders Outpatient Clinic. Regarding co-morbid disorders such as ADHD and OCD, we will accept a mild degree of ADHD and mild to moderate degree of OCD. These disorders will be established by a psychiatrist using below listed scales and criteria. In order to participate in this study, patients will be asked to stop any medication that can influence the central nervous system for 2 weeks prior to exam. Patients taking fluoxetine will be asked to stop it 4 weeks prior to the exam. Stopping the medications for Tourette syndrome or tics, OCD and ADHD may lead to worsening of their symptoms.
- Any changes to patients' medication must first be discussed with their doctor and only this doctor will be responsible for tapering the medication.
- Patients will be asked to abstain from alcohol for one week before the study.
- Patients will be in age ranges 18 to 65. Patients may be male or female. Female patients of child-bearing potential will have a pregnancy test and specific interview prior to the study to ensure that pregnant patients will not participate in the study. Patients will be asked to stop any medication that can influence central nervous system (CNS) for one week prior to exam.
- Twenty three normal controls will be included; controls will be screened in the NINDS Movement Disorders Outpatient Clinic, and will have neurological and physical examination. Controls with chronic illnesses, taking any medication that affects the CNS will be excluded.
Key exclusion criteria (7 listed)
- Patients younger than 18 or older than 65 years old will be excluded from the study. We are excluding patients older than 65 years because of possibility of age-related neurological disorders such as stroke and dementia.
- Patients with MRI findings consistent with brain tumors, strokes, trauma or AVMs will be excluded.
- Patients with progressive neurological disorders other than TS or chronic motor tic disorder and significant other pathology will be excluded.
- Patients with a history of significant medical disorders, or requiring chronic treatment with other drugs, which cannot be stopped, will be excluded.
- Patients with cancer will be excluded.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Not reported in the source record.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 2 Jul 2017.
- Background: PubMed 8305128Braun AR, Stoetter B, Randolph C, Hsiao JK, Vladar K, Gernert J, Carson RE, Herscovitch P, Chase TN. The functional neuroanatomy of Tourette's syndrome: an FDG-PET study. I. Regional changes in cerebral glucose metabolism differentiating patients and controls. Neuropsychopharmacology. 1993 Dec;9(4):277-91. doi: 10.1038/npp.1993.64.
- Background: PubMed 7619976Brett PM, Curtis D, Robertson MM, Gurling HM. The genetic susceptibility to Gilles de la Tourette syndrome in a large multiple affected British kindred: linkage analysis excludes a role for the genes coding for dopamine D1, D2, D3, D4, D5 receptors, dopamine beta hydroxylase, tyrosinase, and tyrosine hydroxylase. Biol Psychiatry. 1995 Apr 15;37(8):533-40. doi: 10.1016/0006-3223(94)00161-U.
- Background: PubMed 2684084Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischmann RL, Hill CL, Heninger GR, Charney DS. The Yale-Brown Obsessive Compulsive Scale. I. Development, use, and reliability. Arch Gen Psychiatry. 1989 Nov;46(11):1006-11. doi: 10.1001/archpsyc.1989.01810110048007.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Tourette Syndrome and Tic Disorders, run by National Institute of Neurological Disorders and Stroke (NINDS) at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 2 Jul 2017. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00033995, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Jul 2017.