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Relationship of Tic Severity to Neuropsychological Function

Christopher Randolph, PhD; Thomas M. Hyde, MD, PhD; James M. Gold, PhD; Terry E. Goldberg, PhD; Daniel R. Weinberger, MD

Arch Neurol. 1993;50(7):725-728.

Abstract
• Objective.
—To determine whether there is a relationship between tic severity and neuropsychological function in Tourette's syndrome (TS).

Design.
—The study employed a case-control series involving monozygotic twin pairs, divided into more severe and less severe groups based on tic severity and tested with a neuropsychological battery of tests.

Setting.
—Twin pairs were recruited nationwide and evaluated in the National Institute of Mental Health Neuropsychiatric Research Hospital.

Patients.
—Twelve twin pairs (mean age, 10.5 years; range, 8 to 16 years) in which at least one member met criteria for a diagnosis of TS.

Results.
—Global neuropsychological performance was significantly worse in the twins with more severe tic symptoms, with significant differences emerging on individual tests of attention, visuospatial perception, and motor function. In each twin pair, the twin with more severe tics had poorer global neuropsychological function.

Conclusions.
—The results suggest that the nongenetic factors that influence tic severity in TS exert a similar effect on neuropsychological function, and that these two clinical manifestations of TS may share a common pathophysiologic state.

Author Affiliations
From the Clinical Brain Disorders Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Md. Dr Randolph is now with the Experimental Therapeutics Branch of the National Institute of Neurological Disorders and Stroke, Bethesda, Md.

Footnotes
Accepted for publication November 2, 1992.

Reprint requests to Experimental Therapeutics Branch, National Institute of Neurological Disorders and Stroke, Bldg 10, Room 5C104, 9000 Rockville Pike, Bethesda, MD 20892 (Dr Randolph).

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