What is Tourette Syndrome?
Tourette syndrome (TS) is a neurological disorder characterized by repetitive, stereotyped, involuntary movements and vocalizations called tics. The disorder is named for Dr. Georges Gilles de la Tourette, the pioneering French neurologist who in 1885 first described the condition in an 86-year-old French noblewoman.
The early symptoms of TS are almost always noticed first in childhood, with the average onset between the ages of 7 and 10 years. TS occurs in people from all ethnic groups; males are affected about three to four times more often than females. It is estimated that 200,000 Americans have the most severe form of TS, and as many as one in 100 exhibit milder and less complex symptoms such as chronic motor or vocal tics or transient tics of childhood. Although TS can be a chronic condition with symptoms lasting a lifetime, most people with the condition experience their worst symptoms in their early teens, with improvement occurring in the late teens and continuing into adulthood.
How does Tourette’s Syndrome Progress?
Tics come and go over time, varying in type, frequency, location, and severity. The first symptoms usually occur in the head and neck area and may progress to include muscles of the trunk and extremities. Motor tics generally precede the development of vocal tics and simple tics often precede complex tics. Most patients experience peak tic severity before the mid-teen years with improvement for the majority of patients in the late teen years and early adulthood. Approximately 10 percent of those affected have a progressive or disabling course that lasts into adulthood.
Can people with Tourette’s Syndrome control their tics?
Although the symptoms of Tourette’s Syndrome are involuntary, some people can sometimes suppress, camouflage, or otherwise manage their tics in an effort to minimize their impact on functioning. However, people with Tourette’s Syndrome often report a substantial buildup in tension when suppressing their tics to the point where they feel that the tic must be expressed. Tics in response to an environmental trigger can appear to be voluntary or purposeful but are not.
What causes Tourette’s Syndrome?
Although the cause of Tourette’s Syndrome is unknown, current research points to abnormalities in certain brain regions (including the basal ganglia, frontal lobes, and cortex), the circuits that interconnect these regions, and the neurotransmitters (dopamine, serotonin, and norepinephrine) responsible for communication among nerve cells. Given the often complex presentation of Tourette’s Syndrome, the cause of the disorder is likely to be equally complex.
What disorders are associated with Tourette’s Syndrome?
Many with Tourette’s Syndrome experience additional neurobehavioral problems including inattention; hyperactivity and impulsivity (attention deficit hyperactivity disorder-ADHD) and related problems with reading, writing, and arithmetic; and obsessive-compulsive symptoms such as intrusive thoughts/worries and repetitive behaviors. For example, worries about dirt and germs may be associated with repetitive hand-washing, and concerns about bad things happening may be associated with ritualistic behaviors such as counting, repeating, or ordering and arranging. People with Tourette’s Syndrome have also reported problems with depression or anxiety disorders, as well as other difficulties with living, that may or may not be directly related to Tourette’s Syndrome. Given the range of potential complications, people with Tourette’s Syndrome are best served by receiving medical care that provides a comprehensive treatment plan.
Neurofeedback For Tourette’s – Offering Hope
By Dr. Clare Albright
When many people hear “Tourette’s” it often ushers forth thoughts of some seemingly out of control human being spewing an incessant stream of profanity. (The medical definition for this is coprolalia). In truth, the repetitious utterance of words vulgar words is symptom only found in a relatively small portion (10%) of those with the disorder.
As is the case with autism, the exact cause of Tourette’s syndrome has yet to be discovered. There is, however, a significant genetic factor involved; a mother or father with Tourette’s syndrome has a 50/50 chance of passing the gene on to a child.
One useful way of thinking about what’s going on with the sudden jerks or “tics” that someone with Tourette’s may suffer dozens, even hundreds of times a day, is to think about a lamp with a faulty switch. You touch the switch, and the light flickers on and off. Even the slightest touch will cause the light bulb to engage in an apparent dance of indecision, committing to nothing, but determined to do something- anything- until it finds itself doing something else. The point is, it’s not the light bulb that’s at fault, even though that’s what is being noticed.
In much the same way, we find the person with Tourette’s (or the person sitting next to them) wanting to control the arm, the leg, the facial expressions or the mouth. But just as changing the light bulb would do nothing to alleviate the challenges presented by a faulty light switch, tying down the hands or placing duct tape over the mouth of someone with Tourette’s will prove to be just as illogical, and most importantly, frustrating.
While we may not always be in a position to replace a less than perfect light switch, at least immediately, we can usually tighten the switch, or make sure that it is connecting properly. Sometimes it doesn’t take much. This is sometimes the case with Tourette’s and neurofeedback; sometimes clinicians may scratch their head in dismay at how simply the symptoms have been reduced. Trust, however, there will also be times when clinicians scratch their head, feeling somewhat confused, wondering why things aren’t happening faster.
Even though results are mixed, we are only at the beginning of the possibilities. Just think of being able to help someone who was suffering from severe Tourette’s symptoms, whose previous life was dedicated to managing their symptoms, to now have the opportunity to seek employment or get involved in a relationship. All because they have made such marked improvements with neurofeedback.
Then consider a doctor NOT telling a Tourette’s sufferer about neurofeedback, simply because there’s not enough research to support it as a mainstream form of treatment.
Understandably the costs can be a hurdle for some people but weighed against the fact that the side effects are little to none, the possibilities are endless. By utilizing the technology to improve people’s lives without the need of a lifetime of drugs, neurofeedback is a logical choice for anyone wanting some relief from their Tourette’s symptoms.
A little something on Dr. Clare Albright…
Dr. Clare Albright is a psychologist and the author of a 168 page book, “Neurofeedback: Transforming Your Life with Brain Biofeedback” and can be reached at her website: www.drclarity.com
Is Tourette’s Syndrome Inherited?
Evidence from twin and family studies suggests that Tourette Syndrome is an inherited disorder. Although early family studies suggested an autosomal dominant mode of inheritance (an autosomal dominant disorder is one in which only one copy of the defective gene, inherited from one parent, is necessary to produce the disorder), more recent studies suggest that the pattern of inheritance is much more complex. Although there may be a few genes with substantial effects, it is also possible that many genes with smaller effects and environmental factors may play a role in the development of Tourette’s Syndrome. Genetic studies also suggest that some forms of ADHD and OCD are genetically related to Tourette’s Syndrome, but there is less evidence for a genetic relationship between TS and other neurobehavioral problems that commonly co-occur with Tourette Syndrome. It is important for families to understand that genetic predisposition may not necessarily result in full-blown Tourette’s Syndrome; instead, it may express itself as a milder tic disorder or as obsessive-compulsive behaviors. It is also possible that the gene-carrying offspring will not develop any Tourette’s Syndrome symptoms.
The sex of the person also plays an important role in Tourette Syndrome gene expression. At-risk males are more likely to have tics and at-risk females are more likely to have obsessive-compulsive symptoms.
People with Tourette’s Syndrome may have genetic risks for other neurobehavioral disorders such as depression or substance abuse. Genetic counseling of individuals with Tourette Syndrome should include a full review of all potentially hereditary conditions in the family.
How is Tourette Syndrome diagnosed?
Tourette Syndrome is a diagnosis that doctors make after verifying that the patient has had both motor and vocal tics for at least 1 year. The existence of other neurological or psychiatric conditions  can also help doctors arrive at a diagnosis. Knowledgeable clinicians do not often misdiagnose common tics. But atypical symptoms or atypical presentation (for example, onset of symptoms in adulthood) may require specific specialty expertise for diagnosis. There are no blood or laboratory tests needed for diagnosis, but neuroimaging studies, such as magnetic resonance imaging (MRI), computerized tomography (CT), and electroencephalogram (EEG) scans, or certain blood tests may be used to rule out other conditions that might be confused with .
It is not uncommon for patients to obtain a formal diagnosis of Tourette’s Syndrome only after symptoms have been present for some time. The reasons for this are many. For families and physicians unfamiliar with Tourette’s Syndrome, mild and even moderate tic symptoms may be considered inconsequential, part of a developmental phase, or the result of another condition. For example, parents may think that eye blinking is related to vision problems or that sniffing is related to seasonal allergies. Many patients are self-diagnosed after they, their parents, other relatives, or friends read or hear about Tourette’s Syndrome from others.
 These include childhood-onset involuntary movement disorders such as dystonia, or psychiatric disorders characterized by repetitive behaviors/movements (for example, stereotypic behaviors in autism and compulsive behaviors in obsessive-compulsive disorder – OCD).
Controlling Tourette’s Syndrome With Neurofeedback?
By Dr. Clare Albright
Tourette’s syndrome is a difficult disease for a person to live with because they have little to no control over tics or outbursts. The most common of signs of Tourette’s is tics or twitches, which are often seen as sporadic and unexpected quick movements of the face, although the hands are also commonly affected. However, most people with Tourette’s syndrome will tell you that the vocal outbursts are the most distressing aspect of this disorder.
An individual with Tourette’s syndrome might be sitting in the classroom, the boardroom, or out shopping in public when uncontrolled cursing begins. This sudden eruption of language, which the person has no control over, is embarrassing to them and mortifying to people hearing the outburst. For this reason, some people with Tourette’s will simply stay locked up at home, which then leads to other problems such as depression.
While the exact cause of Tourette’s syndrome is still a mystery, most medical doctors and scientists believe it has to do with a breakdown of signals in the brain that control concentration and emotion. Because the criteria used for diagnosing this disease is so strict, most people believe that Tourette’s is a rare condition, but in truth, this is a relatively common disorder.
Because of the social inhibition that can result from living with Tourette’s syndrome, and how Tourette’s can lead to so much misery for the sufferer, a tremendous amount of research has gone into treatments and therapies for the disorder. One therapy that has been receiving a significant amount of attention is neurofeedback therapy. Clinical studies show great potential for the effectiveness of this intervention, which trains the patient to control brain wave frequencies, which in turn, may control and even stop the symptoms.
Interestingly, it has been discovered through this in-depth research that other conditions are often associated with Tourette’s syndrome, including attention deficit disorder, depression, obsessive-compulsive disorder, anxiety, hyper-sexuality, and other highly addictive behaviors. This new information provides even more reasons why neurofeedback appears to be a highly effective means of stopping and controlling the various symptoms of Tourette’s.
The tics of this disease usually respond quickly and favorably to neurofeedback. Another challenge is that with so many symptoms, Tourette’s requires a highly trained therapist that can determine the appropriate protocol for patients.
Therefore, therapists will identify the most troubling symptoms of Tourette’s syndrome on a patient-by-patient basis and begin the neurofeedback training there first, and then slowly move on to address additional problems. Because of this, addressing Tourette’s syndrome with neurofeedback may require more diligence and time than some other conditions, but with a determined patient and a skilled therapist, the possibilities are exciting.
Keep in mind, it is common for a Tourette’s syndrome patient to remain on medication while going through neurofeedback therapy, as the individual begins to get symptoms under control, the level of pharmaceutical management would likely decrease. If you have this disease or know of someone who does, it would be worth talking to your mental health professional about the possibilities associated with neurofeedback. For a person with Tourette’s syndrome, it could mean getting his or her life back without living in fear of doing or saying something inappropriate.
Materials from katyneurofeedback.net
Trichotillomania, Skin Picking and other Repetitive Body Checking Behaviors
If you or your child suffers from trichotillomania, skin picking or obsessive body checking, we can offer a non-medication approach, non-destructive approach to reducing and easing tension. The Neurofeedback places your brain in a much more calmer state, which reduces the tension and also interrupts the feedback loop that enhances the pulling or picking behaviors. We will use Neurotherapy to help self regulate the brain. We also combine behavioral treatments such as habit reversal and Cognitive Behavior Therapy. Your brain learns how to maintain a constant state of calm, which reduces the need for picking.
We will work together to identify sensations that lead to the urge to pull, teach you breathing techniques that help reduce muscle tension. As you observe how your brain changes and how your brain waves alter as a result of what you do, it helps build a highly successful and hope filled recovery. Neurofeedback enhances the habit reversal treatment and significantly reduces the period of zoning.