TOURETTE'S SYNDROME & RELATED DISORDERS: STUDY OF HIGH DENSITY FAMILIES

该项目的长期目标是获得更好的 了解遗传和环境因素在其中的作用 发展性神经精神障碍的研究 抽动秽语综合征（TS）。来的研究 在过去的十年里，我们在认识上取得了一些显著的进展， TS和相关条件：1）有一个更大范围的表型 包括慢性抽动和强迫症在内的TS表达）; 2）TS和相关 疾病比以前想象的要普遍得多; 3） 该综合征似乎是作为常染色体显性性状传播的。 此外，TS和相关疾病的患病率及其 对那些受折磨的人的衰弱影响使这些条件成为主要的 公共卫生问题。了解TS的遗传学和相关的 行为将直接受益于患者关注 在他们的家庭中复发;最终，澄清遗传学 这些情况可以阐明其发病机理。我们工作的结果 提示：1）TS在家庭内传播的模式 符合常染色体显性遗传; 2）有一个 TS与强迫症的病因关系; 3）家庭环境是 与其他相关行为的表达相关联;以及4） 具体的环境因素可能与 病在本项目中，我们的目标是具体研究以下方面的作用： 基因和环境在TS的表达和相关行为中的作用。 我们计划对未受影响的幼儿进行一项前瞻性研究， 确定家庭进行连锁研究，招募约60名 在这些高风险地区， 密度家族这些数据将使我们有可能描述更多 完全理解TS和其他性状之间的关系。 这项研究还将有助于确定重要的“非遗传”因素， TS和相关疾病的发作和可变表达。因此，在本发明中， 这项前瞻性研究样本的数据将有助于确定具体的 与变量表达相关的遗传和环境因素 的TS。此外，这些家庭中的所有成年人和青少年将被 重新评价以更新诊断信息并收集持续的 表型数据的测量，将被纳入随后的 数据分析旨在更好地描述遗传表型， 这些家庭。三种类型的信息将从所有 家庭成员：1）通过直接结构化收集的诊断数据 评估; 2）神经心理学数据，侧重于以下领域 注意力、抑制力和强迫性; 3）家庭的测量 环境和家庭功能。这些新数据将被纳入 表型分析旨在更好地了解遗传TS 表型以及连锁分析，旨在检查假说， 一个假设的基因或该表型的基因与 已知的多态标记。

The long term objective of this project is to obtain a better understanding of the role of genetic and environmental factors in developmental neuropsychiatric disorders through the study of the specific disorder, Gilles de la Tourette's syndrome (TS). Research over the last decade has led to several notable advances in our understanding of TS and related conditions: 1) there is a greater range of phenotypic expression for TS including chronic tics and OCD); 2) TS and related disorders are much more common than had previously been thought; and 3) the syndrome appears to be transmitted as an autosomal dominant trait. Furthermore,the prevalence of TS and associated illnesses and their debilitating effects on those afflicted makes these conditions a major public health problem. Understanding the genetics of TS and associated behaviors will be of direct benefit to patients concerned about recurrence in their families; ultimately, clarifying the genetics of these conditions may elucidate their pathogenesis. Findings from our work suggest: 1) that TS is transmitted within families in a pattern consistent with autosomal dominant inheritance; 2) that there is an etiologic relationship between TS and OCD; 3) that family environment is associated with the expression of other associated behaviors; and 4) that specific environmental factors may be related to the severity of the illness. In this Project, we aim to examine specifically the role of genes and environment in the expression of TS and associated behaviors. We plan to conduct a prospective study of young unaffected children in families ascertained for linkage studies, enrolling approximately 60 additional children at risk to TS and associated conditions in these high density families. These data will make it possible to characterize more completely the nature of the relationship between TS and other traits. This study will also help to identify "non-genetic" factors important for the onset and variable expressions of TS and related disorders. Thus, data from this prospective study sample will help identify specific genetic and environmental factors associated with the variable expression of TS. In addition, all adults and adolescents in these families will be re-evaluated to update diagnostic information and to collect continuous measures of phenotypic data that will be incorporated into subsequent data analyses designed to delineate better the inherited phenotype in these families. Three types of information will be obtained from all family members: 1) diagnostic data collected via direct structured assessments; 2) neuropsychological data focusing on the domains of attention, inhibition, and compulsivity; and 3) measures of home environment and family functioning. These new data will be incorporated into phenotypic analyses designed to understand better the inherited TS phenotype as well as linkage analyses designed to examine hypotheses of genetic linkage of a hypothetical gene or genes for this phenotype to known polymorphic makers.