New Study on Tourette's and the Brain: Greater, Not Lesser, Motor Control
March 27th 2011 19:53
Tourette's Syndrome is a neurological disordered characterized by 'repetitive, stereotyped, involuntary movements and vocalizations called tics,' according to the National Institutes of Health (NIH). While these movements might suggest that those with the disorder have less cognitive control over their movements, a new study published in Cell Biology suggests the opposite.
The Cell Biology study has found that those with Tourette's perform 'behavioral tests of cognitive motor control more accurately and quickly than their typically developing peers do.' Stephen Jackson of The University of Nottingham and his colleagues based their study on earlier research which found that not only do children with Tourette syndrome show 'enhanced cognitive control over their motor outputs,' but that 'the degree of their enhancement is inversely related to tic severity.' That is, it seems that a person could be trained---could even train her or himself---to have better control over motor and vocal tics.
Jackson and his colleagues used magnetic resonance imaging (MRI)to investigate whether 'enhanced cognitive control abilities might be accompanied by structural and/or functional alterations in the brains of individuals with Tourettes.' This is what they found, says Science Daily:
Tourettes brain shows alterations in the white-matter connections that allow different brain areas to communicate with one another, Jackson said. Brain scans also revealed changes in activity as indicated by blood flow when people with Tourette syndrome performed an executive function task.
The structural and functional changes observed were also strongly associated with clinical measurements of tic severity and executive function. In particular, the researchers found that changes in the frontal cortex of the Tourettes brain, the region most often linked to executive function, are strongly linked to levels of tic severity and executive task performance. They interpret this as evidence that the frontal cortex of the Tourette syndrome group reorganizes to help control the motor and vocal tics.
"Children growing up with a neurological disorder may develop adaptive changes in the way that their brain is organized that will help them overcome their difficulties and gain control over their symptoms," Jackson said.
It is possible that some people may simply be more likely 'to develop a particular profile of brain white-matter connections that allows them to gain control over their tics, whereas others with a different profile may not.' Nonetheless, Jackson's research helps to explain a 'long-standing puzzle in the field,' namely, why some who have profound tics in childhood no longer have these as adults, while others have them throughout their lives.
Even more, Jackson's study has implications for those with attention deficit hyperactivity disorder (ADHD) or obsessive-compulsive disorder (OCD), as it suggests that '"brain training" approaches may help individuals gain control of symptoms associated with Tourettes and perhaps other neurological diseases.... without the need for drugs or surgeries that may carry significant adverse effects.' As the NIH also says, Tourette's is indeed associated with ADHD and OCD:
Many with TS 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.
No one in my family has Tourette's, but my son Charlie. who's on the moderate to severe end of the autism spectrum, has definite OCD tendencies, and my husband Jim has had severe ADHD. Jim has often noted to me how, having grown up in the 1960s in the days when ADHD was referred to as 'minimal brain damage' and there was no such thing as either Ritalin (to treat ADHD) or IEPs and school supports to help someone like him, he worked for years to teach himself to focus and attend, among other things. In Charlie's case, we have definitely seen how, as he has gotten older and thanks to a steady dose of education and aerobic exercise, he has gotten greater control over his motor movements, with visible improvements in his (limited) speech, his ability to solve problems and to follow directions, and to more.
That is, what heartens me about the Cell Biology study is that it suggests that those with Tourette's can change in their neurological functioning. It takes a great deal of effort, of training, but these disorders are not 'life sentences' and, in some cases, 'brain training' can indeed be as beneficial as medication.
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