Neurobiology of Behavior Therapy for Children with Tourette Syndrome

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DESCRIPTION (provided by applicant): This Mentored Research Scientist Development Award (K01) application outlines a program of career development spanning the fields of behavioral therapy and developmental neurophysiology, with a specific focus on Tourette Syndrome (TS). The short-term objective of this application is to develop expertise in the state-of-the-art methods of electrophysiology through a program of focused training and by conducting a study of the effects of a behavior therapy for tic reduction on mesial-frontal EEG alpha coherence in children with TS. The long-term objective of this K01 is to develop an independent program of research that identifies neurobiological markers and mechanisms of behavioral interventions for child neuropsychiatric disorders. By training, I am a clinical psychologist with expertise in child behavior therapy. I have also completed a three year NIMH funded postdoctoral research fellowship in childhood neuropsychiatric disorders at the Yale Child Study Center and conducted small scale clinical studies in children with TS. I was appointed Associate Research Scientist in the Child Study Center in July of 2003. Since that time, I have become involved in two lines of research that stimulated the preparation of this career award: 1) multi- site efficacy studies of behavior therapy for tic reduction conducted by the Behavioral Sciences Consortium (BSC) and 2) studies of fronto-striatal function in TS conducted in the Yale developmental electrophysiology lab. This KO1 would allow me to develop skills and acquire knowledge necessary to successfully contribute to the interface between behavioral science and basic neuroscience. I am fortunate to have an outstanding group of mentors and advisors to provide guidance with respect to required training in experimental methods in neurophysiology, developmental neuroscience, and the design and conduct of clinical research. The research plan presented in this application is a randomized controlled study of structured behavior therapy for tic reduction in 36 children, aged 8-12, with TS. This application builds on findings that neuropsychological measures of motor inhibition can predict response to behavior therapy and that increases in mesial-frontal EEG alpha coherence can be associated with successful tic suppression. The proposed study is designed to gain insight into the neurobiological mechanisms of behavior therapy for tic reduction by evaluating the association between tic reduction and EEG alpha coherence during and after the treatment.