Gilles de la Tourette's syndrome. A review of clinical and research studies and consideration of future directions for investigation
E. D. Caine
Tourette syndrome (TS) is a complex neurobehavioral disorder that has
recently become a topic for clinical, genetic, neurochemical, and
therapeutic research. Substantial progress has been made defining the
clinical features of the disorder, establishing its familial nature, and
documenting its response to pharmacotherapeutic intervention. Despite these
advances, significant problems remain. The separation between TS and other
syndromes is imprecise, and there are no uniformly accepted criteria for
measuring response to treatment. Although family studies are promising, no
mechanism of genetic transmission has been defined and the number of
available revealing kindred for future DNA linkage studies is small.
Clinical neurochemical investigations have been hampered by poor design and
small subject samples; detailed postmortem neurochemical and pathological
studies of brains from patients with TS have not been undertaken thus far.
Careful application of newer research technologies combined with
appropriately chosen subjects with TS may add to our understanding of the
physiologic, anatomic, and genetic factors that contribute to this
intriguing disorder. Future postmortem central nervous system studies will
be essential.
