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The New Tics Study: A Novel Approach to Pathophysiology and Cause of Tic Disorders

新抽动研究：抽动障碍病理生理学和病因的新方法

基本信息

批准号：
10198671
负责人：
KEVIN J BLACK
金额：
$ 62.65万
依托单位：
WASHINGTON UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-06-09 至 2023-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10198671
关键词：
Advertisements Age Anniversary Appearance Attention Attention deficit hyperactivity disorder Biological Markers Brain Brain imaging Budgets Child Childhood Chronic Clinical Clinical Data Data Data Set Development Diagnosis Disease Disease remission Enrollment Epidemiology Etiology Evaluation Family history of Follow-Up Studies Functional Magnetic Resonance Imaging Functional disorder Gilles de la Tourette syndrome Image Investigation Laboratories Life Machine Learning Magnetic Resonance Imaging Measures Methods Motor Movement Neuropsychology Noise Outcome Patients Perfusion Phase Physiology Population Preparation Prevention Process Prognosis Prospective Studies Psychiatric Diagnosis Public Health Publishing Quality Control Research Research Design Rest Retrospective Studies Sampling Severities Standardization Structure Symptoms Testing Tic disorder Time brain abnormalities caudate nucleus comparison group critical period dexterity follow-up habit learning high risk improved inattention interest machine learning method medical attention novel novel strategies outcome prediction phenomenological models prospective public health relevance recruit research clinical testing secondary analysis support vector machine tic suppression vector

项目摘要

Project Abstract At least 20% of all children have tics at some time in their life, making tic disorders a subject of substantial public health interest. However, only about 3% of all children have tics that last for a year or more. Thus chronic tic disorders, including Tourette syndrome, can be conceptualized as a two- step process: tics start, and then they fail to remit. By the numbers, the second part of this process is the more unusual and perhaps more closely related to disease, yet surprisingly, almost no research has examined this critical period after a first tic appears but before it is clear whether the child will go on to have a chronic tic disorder. Therefore prior research that has identified abnormalities of brain structure and function in children with TS generally does not clarify whether these abnormalities are related to tic appearance or to the more important process of tic disappearance. Furthermore, tic disappearance can be observed prospectively, allowing powerful within-subject analyses to test whether features of brain structure or function shortly after tic onset predict remission of tics before TS is diagnosable, and whether such features are state-related or more durable markers of vulnerability to tics. Colleagues in the TS field have agreed that such studies would be valuable, but have suspected that recruitment would be extremely difficult. However, we have now demonstrated enrollment of subjects with New Tics (defined as beginning within the previous 6 months, median 3.6 months) at a rate of 16 subjects per year when recruitment efforts were at their peak—though still on a shoestring budget without full staffing or media advertisements. We have implemented subject preparation and quality control methods that have allowed us to acquire structural and functional MRI data of high quality in many subjects. We now propose to enroll an additional 70 subjects with New Tics and characterize them carefully at baseline and at the 1-year anniversary of tic onset (when TS can first be diagnosed). Both time points will include clinical data, structural and functional MRI, and neuropsychological measures including ability to suppress tics. We expect that complete data will be available for 55-70 subjects (including those already collected), since MRI is sensitive to movement and we are selecting for subjects with tics and additional difficulty holding still (about half of children with tics also have ADHD). We will compare baseline data from this sample to matched tic-free control subjects, and to matched subjects who already have TS or a chronic tic disorder (leveraging existing data in our laboratories to provide some of the clinical and MRI data for these groups). Analyses will include tests of specific a priori hypotheses as well as machine learning analyses of the complete dataset. These comparisons will allow us to discover whether imaging differences in children with TS are present long before TS can be diagnosed, whether they fade when tics improve, and whether they predict outcome in children with new tics. Investigation of this “pre-Tourette” population opens an entirely new window for etiologic discovery in tic disorders. It may also have important clinical consequences, if the results identify which newly- ticcing children are at highest risk for development of a chronic tic disorder.

项目摘要