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.
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.
Authors: Wissam Deeb; Peter J Rossi; Mauro Porta; Veerle Visser-Vandewalle; Domenico Servello; Peter Silburn; Terry Coyne; James F Leckman; Thomas Foltynie; Marwan Hariz; Eileen M Joyce; Ludvic Zrinzo; Zinovia Kefalopoulou; Marie-Laure Welter; Carine Karachi; Luc Mallet; Jean-Luc Houeto; Joohi Shahed-Jimenez; Fan-Gang Meng; Bryan T Klassen; Alon Y Mogilner; Michael H Pourfar; Jens Kuhn; L Ackermans; Takanobu Kaido; Yasin Temel; Robert E Gross; Harrison C Walker; Andres M Lozano; Suketu M Khandhar; Benjamin L Walter; Ellen Walter; Zoltan Mari; Barbara K Changizi; Elena Moro; Juan C Baldermann; Daniel Huys; S Elizabeth Zauber; Lauren E Schrock; Jian-Guo Zhang; Wei Hu; Kelly D Foote; Kyle Rizer; Jonathan W Mink; Douglas W Woods; Aysegul Gunduz; Michael S Okun Journal: Front Neurosci Date: 2016-04-25 Impact factor: 4.677