20 results on '"Grantz H"'
Search Results
2. Functional connectivity during tic suppression predicts reductions in vocal tics following behavior therapy in children with Tourette syndrome.
- Author
-
Morand-Beaulieu S, Crowley MJ, Grantz H, Leckman JF, and Sukhodolsky DG
- Subjects
- Adult, Child, Humans, Adolescent, Severity of Illness Index, Behavior Therapy methods, Tics therapy, Tics complications, Tourette Syndrome therapy, Tic Disorders therapy
- Abstract
Background: Comprehensive Behavioral Intervention for Tics (CBIT) is recommended as a first-line treatment for Tourette syndrome in children and adults. While there is strong evidence proving its efficacy, the mechanisms of reduction in tic severity during CBIT are still poorly understood. In a recent study, our group identified a functional brain network involved in tic suppression in children with TS. We reasoned that voluntary tic suppression and CBIT may share some mechanisms and thus we wanted to assess whether functional connectivity during tic suppression was associated with CBIT outcome., Methods: Thirty-two children with TS, aged 8 to 13 years old, participated in a randomized controlled trial of CBIT v. a treatment-as-usual control condition. EEG was recorded during tic suppression in all participants at baseline and endpoint. We used a source-reconstructed EEG connectivity pipeline to assess functional connectivity during tic suppression., Results: Functional connectivity during tic suppression did not change from baseline to endpoint. However, baseline tic suppression-related functional connectivity specifically predicted the decrease in vocal tic severity from baseline to endpoint in the CBIT group. Supplementary analyses revealed that the functional connectivity between the right superior frontal gyrus and the right angular gyrus was mainly driving this effect., Conclusions: This study revealed that functional connectivity during tic suppression at baseline predicted reduction in vocal tic severity. These results suggest probable overlap between the mechanisms of voluntary tic suppression and those of behavior therapy for tics.
- Published
- 2023
- Full Text
- View/download PDF
3. Urban Human-Coyote Conflicts: Assessing Friendliness as an Indicator of Coexistence.
- Author
-
Whitley CT, Bowers MM, and Grantz H
- Abstract
Human-coyote sightings and interactions are becoming more frequent in urban areas across North and Central America. While many species have lost territory, the coyote range has expanded. Relatively recently, ecologists have coalesced around the idea that coexistence is the most promising avenue to reduce human-coyote conflict in urban areas. Despite this, calls for the eradication of coyotes continue. We apply and extend the theory of survival of the friendliest to evaluate how the media is framing coyotes and management strategies and what the implications of this framing might be. Through a content analysis of newspaper articles from three different urban areas in the US (Los Angeles, CA; Seattle, WA; and Boston, MA), from 2000 to 2022, we find that friendly language is used to promote coexistence, while unfriendly language (threat, hostile, unfriendly, and danger) is used to justify eradication. We also find considerable variation in the type of coverage and consistency with scientific consensus across cities, likely reflecting the cities' varied histories and cultural understandings of the species. Given the media's influence on the public's views of coyotes and their support for management strategies, these findings suggest that the media plays a central role in shaping coyote-human relationships and management strategies.
- Published
- 2023
- Full Text
- View/download PDF
4. Increased Alpha-Band Connectivity During Tic Suppression in Children With Tourette Syndrome Revealed by Source Electroencephalography Analyses.
- Author
-
Morand-Beaulieu S, Wu J, Mayes LC, Grantz H, Leckman JF, Crowley MJ, and Sukhodolsky DG
- Subjects
- Adolescent, Child, Humans, Electroencephalography, Brain, Parietal Lobe, Tics therapy, Tourette Syndrome therapy
- Abstract
Background: Tourette syndrome (TS) is a neurodevelopmental disorder involving chronic motor and phonic tics. Most individuals with TS can suppress their tics for at least a short period of time. Yet, the brain correlates of tic suppression are still poorly understood., Methods: In the current study, high-density electroencephalography was recorded during a resting-state and a tic suppression session in 72 children with TS. Functional connectivity between cortical regions was assessed in the alpha band (8-13 Hz) using an electroencephalography source connectivity method. Graph theory and network-based statistics were used to assess the global network topology and to identify brain regions showing increased connectivity during tic suppression., Results: Graph theoretical analyses revealed distinctive global network topology during tic suppression, relative to rest. Using network-based statistics, we found a subnetwork of increased connectivity during tic suppression (p < .001). That subnetwork encompassed many cortical areas, including the right superior frontal gyrus and the left precuneus, which are involved in the default mode network. We also found a condition-by-age interaction, suggesting age-mediated increases in connectivity during tic suppression., Conclusions: These results suggest that children with TS suppress their tics through a brain circuit involving distributed cortical regions, many of which are part of the default mode network. Brain connectivity during tic suppression also increases as youths with TS mature. These results highlight a mechanism by which children with TS may control their tics, which could be relevant for future treatment studies., (Copyright © 2021 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.)
- Published
- 2023
- Full Text
- View/download PDF
5. Evaluation of EEG biomarkers of Comprehensive Behavioral Intervention for Tics in children with Tourette syndrome.
- Author
-
Morand-Beaulieu S, Crowley MJ, Grantz H, Leckman JF, Scahill L, and Sukhodolsky DG
- Subjects
- Biomarkers, Child, Electroencephalography, Humans, Severity of Illness Index, Tic Disorders, Tics complications, Tics therapy, Tourette Syndrome therapy
- Abstract
Objective: Comprehensive Behavioral Intervention for Tics (CBIT) is a first-line treatment of Tourette syndrome (TS). However, the brain mechanisms involved in CBIT are poorly understood. Enhanced frontomesial EEG coherence during a Go/NoGo task has been suggested as a mechanism involved in voluntary tic control. In the current study, we conducted a randomized controlled trial to assess whether EEG coherence during a Go/NoGo task was associated with CBIT outcome., Methods: Thirty-two children with TS were randomly assigned to CBIT or to treatment-as-usual (TAU). Treatment outcome was assessed by a blinded evaluator with the Yale Global Tic Severity Scale (YGTSS) and the Clinical Global Impression - Improvement Scale (CGI-I). EEG was recorded during a Go/NoGo task at baseline and endpoint. EEG coherence was computed in the alpha frequency band between a priori selected channel pairs spanning the frontal and motor areas., Results: Tic severity decreased significantly in the CBIT group. However, CBIT did not impact EEG coherence and baseline EEG coherence did not predict treatment outcome., Conclusions: Although CBIT was superior to TAU on blinded clinical outcomes, EEG coherence during the Go/NoGo task was not associated with change in tic severity., Significance: The brain processes involved in the inhibition of motor responses do not appear to be involved in CBIT., (Copyright © 2022 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.)
- Published
- 2022
- Full Text
- View/download PDF
6. An integrated program of computer-presented and physical cognitive training exercises for children with attention-deficit/hyperactivity disorder.
- Author
-
Wexler BE, Vitulano LA, Moore C, Katsovich L, Smith SD, Rush C, Grantz H, Dong J, and Leckman JF
- Subjects
- Child, Cognition, Computers, Cross-Over Studies, Executive Function, Exercise, Female, Humans, Impulsive Behavior, Male, Memory, Short-Term, Attention Deficit Disorder with Hyperactivity therapy, Cognition Disorders therapy, Cognitive Behavioral Therapy methods
- Abstract
Background: This study integrated an experimental medicine approach and a randomized cross-over clinical trial design following CONSORT recommendations to evaluate a cognitive training (CT) intervention for attention deficit hyperactivity disorder (ADHD). The experimental medicine approach was adopted because of documented pathophysiological heterogeneity within the diagnosis of ADHD. The cross-over design was adopted to provide the intervention for all participants and make maximum use of data., Methods: Children (n = 93, mean age 7.3 +/- 1.1 years) with or sub-threshold for ADHD were randomly assigned to CT exercises over 15 weeks, before or after 15 weeks of treatment-as-usual (TAU). Fifteen dropped out of the CT/TAU group and 12 out of the TAU/CT group, leaving 66 for cross-over analysis. Seven in the CT/TAU group completed CT before dropping out making 73 available for experimental medicine analyses. Attention, response inhibition, and working memory were assessed before and after CT and TAU., Results: Children were more likely to improve with CT than TAU (27/66 v. 13/66, McNemar p = 0.02). Consistent with the experimental medicine hypotheses, responders improved on all tests of executive function (p = 0.009-0.01) while non-responders improved on none (p = 0.27-0.81). The degree of clinical improvement was predicted by baseline and change scores in focused attention and working memory (p = 0.008). The response rate was higher in inattentive and combined subtypes than hyperactive-impulsive subtype (p = 0.003)., Conclusions: Targeting cognitive dysfunction decreases clinical symptoms in proportion to improvement in cognition. Inattentive and combined subtypes were more likely to respond, consistent with targeted pathology and clinically relevant heterogeneity within ADHD.
- Published
- 2021
- Full Text
- View/download PDF
7. A Randomized Controlled Trial of an Integrated Brain, Body, and Social Intervention for Children With ADHD.
- Author
-
Smith SD, Vitulano LA, Katsovich L, Li S, Moore C, Li F, Grantz H, Zheng X, Eicher V, Aktan Guloksuz S, Zheng Y, Dong J, Sukhodolsky DG, and Leckman JF
- Subjects
- Behavior Therapy, Brain, Child, Child, Preschool, Humans, Memory, Short-Term, Treatment Outcome, Attention Deficit Disorder with Hyperactivity therapy
- Abstract
Objective: This study evaluated the efficacy of an Integrated Brain, Body, and Social (IBBS) intervention for children with ADHD. Treatment consisted of computerized cognitive remediation training, physical exercises, and a behavior management strategy. Method: Ninety-two children aged 5 to 9 years with ADHD were randomly assigned to 15 weeks of IBBS or to treatment-as-usual. Primary outcome measures included blinded clinician ratings of ADHD symptoms and global clinical functioning. Secondary outcome measures consisted of parent and teacher ratings of ADHD and neurocognitive tests. Results: No significant treatment effects were found on any of our primary outcome measures. In terms of secondary outcome measures, the IBBS group showed significant improvement on a verbal working memory task; however, this result did not survive correction for multiple group comparisons. Conclusion: These results suggest that expanding cognitive training to multiple domains by means of two training modalities does not lead to generalized improvement of ADHD symptomatology.
- Published
- 2020
- Full Text
- View/download PDF
8. Discrepancies between parent and child ratings of anxiety in children with autism spectrum disorder.
- Author
-
Kalvin CB, Marsh CL, Ibrahim K, Gladstone TR, Woodward D, Grantz H, Ventola P, and Sukhodolsky DG
- Subjects
- Adolescent, Child, Female, Humans, Male, Anxiety Disorders complications, Anxiety Disorders psychology, Autism Spectrum Disorder complications, Autism Spectrum Disorder psychology, Parents, Self Report statistics & numerical data
- Abstract
Co-occurring anxiety is common in children with autism spectrum disorder (ASD). However, inconsistencies across parent and child reports of anxiety may complicate the assessment of anxiety in this population. The present study examined parent and child anxiety ratings in children with ASD with and without anxiety disorders and tested the association between parent-child anxiety rating discrepancy and ASD symptom severity. Participants included children aged 8-16 years in three diagnostic groups: ASD with co-occurring anxiety disorders (ASD + Anxiety; n = 34), ASD without co-occurring anxiety disorders (ASD; n = 18), and typically developing healthy controls (TD; n = 50). Parents and children completed ratings of child anxiety using the Multidimensional Anxiety Rating Scale. Patterns of parent and child anxiety ratings differed among the three groups, with parent ratings exceeding child ratings only in the ASD + Anxiety group. Parents reported higher levels of child anxiety in the ASD + Anxiety versus ASD group, whereas children reported comparable levels of anxiety in the two groups. Among children with ASD, ASD symptom severity was positively associated with the degree to which parent ratings exceeded child ratings. Results suggest that children with ASD and co-occurring anxiety disorders endorse some anxiety symptoms but may underreport overall levels of anxiety. In addition, ASD symptom severity might increase discrepancies in parent-child anxiety ratings. These findings suggest a unique and valuable role of child anxiety ratings and suggest that both parent and child anxiety ratings should be considered in light of children's ASD symptom severity and used to guide further assessment. Autism Res 2020, 13: 93-103. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Children with autism spectrum disorder (ASD) commonly experience anxiety; yet, their perceptions of their anxiety might differ from their parents' perceptions. This study found that, while children with ASD and anxiety disorders acknowledge some anxiety, their parents report them as having higher levels of anxiety. Also, child and parent perceptions of anxiety may differ more for children with more severe ASD symptoms. How these findings may guide research and clinical practice is discussed., (© 2019 International Society for Autism Research, Wiley Periodicals, Inc.)
- Published
- 2020
- Full Text
- View/download PDF
9. Randomized, Controlled Trial of Intravenous Immunoglobulin for Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections.
- Author
-
Williams KA, Swedo SE, Farmer CA, Grantz H, Grant PJ, D'Souza P, Hommer R, Katsovich L, King RA, and Leckman JF
- Subjects
- Child, Double-Blind Method, Female, Humans, Male, Obsessive-Compulsive Disorder therapy, Streptococcus pyogenes isolation & purification, Treatment Outcome, Autoimmune Diseases drug therapy, Immunoglobulins, Intravenous therapeutic use, Streptococcal Infections drug therapy
- Abstract
Objective: Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) are hypothesized to occur as a result of cross-reactive antibodies produced in response to group A streptococcal infections. Previous research suggests that immunomodulatory therapies, such as intravenous immunoglobulin (IVIG), may lead to rapid and sustained symptom improvement in patients with PANDAS., Method: A total of 35 children meeting criteria for PANDAS and moderate to severe obsessive-compulsive disorder (OCD) were enrolled in a randomized-entry, double-blind, placebo-controlled, 6-week trial of IVIG (1 g/kg/day on 2 consecutive days), followed by optional open-label treatment for nonresponders, with follow-up at 12 and 24 weeks. Primary outcome measures were the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) and the Clinical Global Impressions-Improvement (CGI-I) rating. "Responders" were defined, a priori, by a ≥ 30% decrease in CY-BOCS total score, and a "much" or "very much" improved rating on CGI-I., Results: During the double-blind phase, the mean decrease in CY-BOCS score was 24% ± 31% in the IVIG group (n = 17) and 12% ± 27% in the placebo group (n = 18), with six responders in the IVIG group (35%) versus four (22%) in the placebo group; these differences were not statistically significant. Twenty-four participants met criteria for nonresponse to double-blind infusion and received open-label IVIG at week 6. Among all participants, the mean CY-BOCS improvement from baseline was 55% ± 33% at week 12 and 62% ± 33% at week 24., Conclusion: IVIG was safe and well tolerated. Between-group differences were smaller than anticipated, and the double-blind comparison failed to demonstrate superiority of IVIG over placebo. The observed open-label improvements indicate that future trials would benefit from larger sample sizes designed in part to aid in the identification of biomarkers predictive of a positive response to immunotherapy. Future investigations focused on the natural history of PANDAS are also warranted. Clinical trial registration information-Intravenous Immunoglobulin for PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections); http://clinicaltrials.gov/; NCT01281969ZIAMH002666., (Published by Elsevier Inc.)
- Published
- 2016
- Full Text
- View/download PDF
10. Individualized assessments in treatment research: an examination of parent-nominated target problems in the treatment of disruptive behaviors in youth with Tourette syndrome.
- Author
-
McGuire JF, Sukhodolsky DG, Bearss K, Grantz H, Pachler M, Lombroso PJ, and Scahill L
- Subjects
- Adolescent, Child, Female, Humans, Male, Reproducibility of Results, Tourette Syndrome psychology, Treatment Outcome, Parents, Psychotherapy, Tourette Syndrome therapy
- Abstract
Youth with Tourette syndrome (TS) often exhibit disruptive behaviors. Although improvement data on rating scales support the efficacy of structured psychotherapeutic interventions, there is growing interest in personalized outcome assessments. This report examined parent-nominated target problems (PTPs) as an individualized outcome measure in 48 youth with TS and disruptive behaviors, who participated in one of two randomized psychotherapy trials. At baseline, parents described two primary problems to an independent evaluator who generated a structured narrative for each problem. These narratives were reviewed and updated at endpoint. When rated by five treatment-blind judges, the PTP rating demonstrated excellent reliability and good convergent validity with the Disruptive Behavior Rating Scale (DBRS). The PTP rating exhibited comparable treatment effects to the DBRS, and accounted for additional variance in global treatment outcome. The PTP rating serves a reliable, valid, and sensitive personalized assessment in research trials that provides complementary information to standardized rating scales.
- Published
- 2014
- Full Text
- View/download PDF
11. Tourette syndrome in youth with and without obsessive compulsive disorder and attention deficit hyperactivity disorder.
- Author
-
Lebowitz ER, Motlagh MG, Katsovich L, King RA, Lombroso PJ, Grantz H, Lin H, Bentley MJ, Gilbert DL, Singer HS, Coffey BJ, Kurlan RM, and Leckman JF
- Subjects
- Adolescent, Child, Comorbidity, Female, Humans, Male, Tourette Syndrome physiopathology, Attention Deficit Disorder with Hyperactivity epidemiology, Obsessive-Compulsive Disorder epidemiology, Tourette Syndrome epidemiology
- Abstract
Chronic tic disorders (TD) are consistently found to have high rates of comorbidity with obsessive-compulsive disorder (OCD) and attention deficit hyperactivity disorder (ADHD). The purpose of this study is to compare the severity of TD only to TD with comorbid OCD or ADHD based on severity of tics, measures of psychopathology and additional comorbid diagnoses. Baseline data from 158 youth with a chronic TD who participated in two longitudinal studies were examined. Fifty-three percent (N = 85) of the youth also met criteria for a diagnosis of OCD, 38.6 % (n = 61) met criteria for ADHD and 24.1 % (N = 38) met criteria for both. Measures of interest addressed severity of tics, symptoms of anxiety, depression, ADHD, psychosocial stress, global functioning and the presence of comorbid diagnoses. Youth with comorbid TD and OCD were characterized by more severe tics, increased levels of depressive and anxious symptoms, heightened psychosocial stress and poorer global functioning. Youth with comorbid TD and ADHD did not differ from those with TD alone on measures of tic severity, but experienced greater psychosocial stress and poorer global functioning. Subjects with comorbid TD and OCD had more internalizing disorders than those without OCD, while those with comorbid ADHD were more likely to meet criteria for oppositional defiant disorder. TD with OCD is a more severe subtype of TD than TD without OCD. TD with ADHD is associated with higher psychosocial stress and more externalizing behaviors. Further research is needed into the underlying relationships between these closely associated conditions.
- Published
- 2012
- Full Text
- View/download PDF
12. Streptococcal upper respiratory tract infections and exacerbations of tic and obsessive-compulsive symptoms: a prospective longitudinal study.
- Author
-
Leckman JF, King RA, Gilbert DL, Coffey BJ, Singer HS, Dure LS 4th, Grantz H, Katsovich L, Lin H, Lombroso PJ, Kawikova I, Johnson DR, Kurlan RM, and Kaplan EL
- Subjects
- Adolescent, Case-Control Studies, Child, Double-Blind Method, Female, Humans, Male, Prospective Studies, Severity of Illness Index, United States, Obsessive-Compulsive Disorder microbiology, Respiratory Tract Infections complications, Streptococcal Infections complications, Streptococcus pyogenes, Tourette Syndrome microbiology
- Abstract
Objective: The objective of this blinded, prospective, longitudinal study was to determine whether new group A β hemolytic streptococcal (GABHS) infections are temporally associated with exacerbations of tic or obsessive-compulsive (OC) symptoms in children who met published criteria for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS). A group of children with Tourette syndrome and/or OC disorder without a PANDAS history served as the comparison (non-PANDAS) group., Method: Consecutive clinical ratings of tic and OC symptom severity were obtained for 31 PANDAS subjects and 53 non-PANDAS subjects. Clinical symptoms and laboratory values (throat cultures and streptococcal antibody titers) were evaluated at regular intervals during a 25-month period. Additional testing occurred at the time of any tic or OC symptom exacerbation. New GABHS infections were established by throat swab cultures and/or recent significant rise in streptococcal antibodies. Laboratory personnel were blinded to case or control status, clinical (exacerbation or not) condition, and clinical evaluators were blinded to the laboratory results., Results: No group differences were observed in the number of clinical exacerbations or the number of newly diagnosed GABHS infections. On only six occasions of a total of 51 (12%), a newly diagnosed GABHS infection was followed, within 2 months, by an exacerbation of tic and/or OC symptoms. In every instance, this association occurred in the non-PANDAS group., Conclusions: This study provides no evidence for a temporal association between GABHS infections and tic/OC symptom exacerbations in children who meet the published PANDAS diagnostic criteria., (Copyright © 2011 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.)
- Published
- 2011
- Full Text
- View/download PDF
13. Streptococcal upper respiratory tract infections and psychosocial stress predict future tic and obsessive-compulsive symptom severity in children and adolescents with Tourette syndrome and obsessive-compulsive disorder.
- Author
-
Lin H, Williams KA, Katsovich L, Findley DB, Grantz H, Lombroso PJ, King RA, Bessen DE, Johnson D, Kaplan EL, Landeros-Weisenberger A, Zhang H, and Leckman JF
- Subjects
- Adolescent, Anti-Bacterial Agents therapeutic use, Attention Deficit Disorder with Hyperactivity diagnosis, Attention Deficit Disorder with Hyperactivity epidemiology, Child, Depressive Disorder diagnosis, Depressive Disorder epidemiology, Depressive Disorder psychology, Female, Forecasting, Humans, Male, Obsessive-Compulsive Disorder diagnosis, Obsessive-Compulsive Disorder psychology, Predictive Value of Tests, Prospective Studies, Psychology, Respiratory Tract Infections drug therapy, Severity of Illness Index, Streptococcal Infections drug therapy, Tourette Syndrome diagnosis, Tourette Syndrome epidemiology, Life Change Events, Obsessive-Compulsive Disorder epidemiology, Respiratory Tract Infections epidemiology, Respiratory Tract Infections microbiology, Streptococcal Infections complications, Streptococcal Infections epidemiology, Tics epidemiology
- Abstract
Background: One goal of this prospective longitudinal study was to identify new group A beta-hemolytic streptococcal infections (GABHS) in children and adolescents with Tourette syndrome (TS) and/or obsessive-compulsive disorder (OCD) compared with healthy control subjects. We then examined the power of GABHS infections and measures of psychosocial stress to predict future tic, obsessive-compulsive (OC), and depressive symptom severity., Methods: Consecutive ratings of tic, OC, and depressive symptom severity were obtained for 45 cases and 41 matched control subjects over a 2-year period. Clinical raters were blinded to the results of laboratory tests. Laboratory personnel were blinded to case or control status and clinical ratings. Structural equation modeling for unbalanced repeated measures was used to assess the sequence of new GABHS infections and psychosocial stress and their impact on future symptom severity., Results: Increases in tic and OC symptom severity did not occur after every new GABHS infection. However, the structural equation model found that these newly diagnosed infections were predictive of modest increases in future tic and OC symptom severity but did not predict future depressive symptom severity. In addition, the inclusion of new infections in the model greatly enhanced, by a factor of three, the power of psychosocial stress in predicting future tic and OC symptom severity., Conclusions: Our data suggest that a minority of children with TS and early-onset OCD were sensitive to antecedent GABHS infections. These infections also enhanced the predictive power of current psychosocial stress on future tic and OC symptom severity., (Copyright 2010 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.)
- Published
- 2010
- Full Text
- View/download PDF
14. Decreased number of parvalbumin and cholinergic interneurons in the striatum of individuals with Tourette syndrome.
- Author
-
Kataoka Y, Kalanithi PS, Grantz H, Schwartz ML, Saper C, Leckman JF, and Vaccarino FM
- Subjects
- Adult, Aged, Biomarkers metabolism, Caudate Nucleus metabolism, Caudate Nucleus pathology, Caudate Nucleus physiopathology, Cell Count, Cell Death physiology, Cell Shape physiology, Choline O-Acetyltransferase metabolism, Corpus Striatum pathology, Corpus Striatum physiopathology, Humans, Interneurons pathology, Male, Middle Aged, Nerve Degeneration metabolism, Nerve Degeneration pathology, Nerve Degeneration physiopathology, Putamen metabolism, Putamen pathology, Putamen physiopathology, Tourette Syndrome pathology, Tourette Syndrome physiopathology, Acetylcholine metabolism, Corpus Striatum metabolism, Interneurons metabolism, Parvalbumins metabolism, Tourette Syndrome metabolism
- Abstract
Corticobasal ganglia neuronal ensembles bring automatic motor skills into voluntary control and integrate them into ongoing motor behavior. A 5% decrease in caudate (Cd) nucleus volume is the most consistent structural finding in the brain of patients with Tourette syndrome (TS), but the cellular abnormalities that underlie this decrease in volume are unclear. In this study the density of different types of interneurons and medium spiny neurons (MSNs) in the striatum was assessed in the postmortem brains of 5 TS subjects as compared with normal controls (NC) by unbiased stereological analyses. TS patients demonstrated a 50%-60% decrease of both parvalbumin (PV)+ and choline acetyltransferase (ChAT)+ cholinergic interneurons in the Cd and the putamen (Pt). Cholinergic interneurons were decreased in TS patients in the associative and sensorimotor regions but not in the limbic regions of the striatum, such that the normal gradient in density of cholinergic cells (highest in associative regions, intermediate in sensorimotor and lowest in limbic regions) was abolished. No significant difference was present in the densities of medium-sized calretinin (CR)+ interneurons, MSNs, and total neurons. The selective deficit of PV+ and cholinergic striatal interneurons in TS subjects may result in an impaired cortico/thalamic control of striatal neuron firing in TS.
- Published
- 2010
- Full Text
- View/download PDF
15. Repetitive Transcranial Magnetic Stimulation of the Supplementary Motor Area in the treatment of Tourette Syndrome: report of two cases.
- Author
-
Mantovani A, Leckman JF, Grantz H, King RA, Sporn AL, and Lisanby SH
- Subjects
- Adolescent, Adult, Attention Deficit Disorder with Hyperactivity complications, Attention Deficit Disorder with Hyperactivity psychology, Depressive Disorder, Major complications, Depressive Disorder, Major psychology, Humans, Male, Obsessive-Compulsive Disorder complications, Obsessive-Compulsive Disorder psychology, Psychiatric Status Rating Scales, Tourette Syndrome psychology, Motor Cortex physiology, Tourette Syndrome therapy, Transcranial Magnetic Stimulation
- Published
- 2007
- Full Text
- View/download PDF
16. Psychosocial stress predicts future symptom severities in children and adolescents with Tourette syndrome and/or obsessive-compulsive disorder.
- Author
-
Lin H, Katsovich L, Ghebremichael M, Findley DB, Grantz H, Lombroso PJ, King RA, Zhang H, and Leckman JF
- Subjects
- Adolescent, Child, Demography, Female, Humans, Male, Models, Psychological, Obsessive-Compulsive Disorder diagnosis, Prospective Studies, Psychology, Severity of Illness Index, Time Factors, Tourette Syndrome diagnosis, Obsessive-Compulsive Disorder epidemiology, Obsessive-Compulsive Disorder psychology, Social Behavior, Stress, Psychological epidemiology, Stress, Psychological psychology, Tourette Syndrome epidemiology, Tourette Syndrome psychology
- Abstract
Background: The goals of this prospective longitudinal study were to monitor levels of psychosocial stress in children and adolescents with Tourette syndrome (TS) and/or obsessive-compulsive disorder (OCD) compared to healthy control subjects and to examine the relationship between measures of psychosocial stress and fluctuations in tic, obsessive-compulsive (OC), and depressive symptom severity., Methods: Consecutive ratings of tic, OC and depressive symptom severity were obtained for 45 cases and 41 matched healthy control subjects over a two-year period. Measures of psychosocial stress included youth self-report, parental report, and clinician ratings of long-term contextual threat. Structural equation modeling for unbalanced repeated measures was used to assess the temporal sequence of psychosocial stress with the severity of tic, OC and depressive symptoms., Results: Subjects with TS and OCD experienced significantly more psychosocial stress than did the controls. Estimates of psychosocial stress were predictive of future depressive symptoms. Current levels of psychosocial stress were also a significant predictor of future OC symptom severity, but not vice versa. Current OC symptom severity was a predictor of future depressive symptom severity, but not vice versa. Current levels of psychosocial stress and depression were independent predictors of future tic severity, even after controlling for the effect of advancing chronological age., Conclusions: The impact of antecedent psychosocial adversity is greater on future depressive symptoms than for tic and/or OC symptoms. Worsening OC symptoms are also a predictor of future depressive symptoms. Advancing chronological age is robustly associated with reductions in tic severity.
- Published
- 2007
- Full Text
- View/download PDF
17. Altered parvalbumin-positive neuron distribution in basal ganglia of individuals with Tourette syndrome.
- Author
-
Kalanithi PS, Zheng W, Kataoka Y, DiFiglia M, Grantz H, Saper CB, Schwartz ML, Leckman JF, and Vaccarino FM
- Subjects
- Adult, Aged, Caudate Nucleus pathology, Cell Count, Cell Movement physiology, Globus Pallidus pathology, Humans, Interneurons chemistry, Middle Aged, Neurons pathology, gamma-Aminobutyric Acid, Basal Ganglia pathology, Neurons chemistry, Parvalbumins analysis, Tourette Syndrome pathology
- Abstract
Tourette syndrome (TS) is a childhood neuropsychiatric disorder characterized by motor and vocal tics. Imaging studies found alterations in caudate (Cd) and putamen volumes. To investigate possible alterations in cell populations, postmortem basal ganglia tissue from individuals with TS and normal controls was analyzed by using unbiased stereological techniques. A markedly higher total neuron number was found in the globus pallidus pars interna (GPi) of TS. In contrast, a lower neuron number and density was observed in the globus pallidus pars externa and in the Cd. An increased number and proportion of the GPi neurons were positive for the calcium-binding protein parvalbumin in tissue from TS subjects, whereas lower densities of parvalbumin-positive interneurons were observed in both the Cd and putamen of TS subjects. This change is consistent with a developmental defect in tangential migration of some GABAergic neurons. The imbalance in striatal and GPi inhibitory neuron distribution suggests that the functional dynamics of cortico-striato-thalamic circuitry are fundamentally altered in severe, persistent TS.
- Published
- 2005
- Full Text
- View/download PDF
18. Increased serum levels of interleukin-12 and tumor necrosis factor-alpha in Tourette's syndrome.
- Author
-
Leckman JF, Katsovich L, Kawikova I, Lin H, Zhang H, Krönig H, Morshed S, Parveen S, Grantz H, Lombroso PJ, and King RA
- Subjects
- Adolescent, Case-Control Studies, Child, Cytokines blood, Enzyme-Linked Immunosorbent Assay methods, Female, Humans, Longitudinal Studies, Male, Prospective Studies, Interleukin-12 blood, Tourette Syndrome blood, Tumor Necrosis Factor-alpha metabolism
- Abstract
Background: The hypothesis that common infections can modulate the onset and course of tic disorders and early-onset obsessive-compulsive disorder (OCD) in pediatric populations is longstanding. To date, most investigations have focused on the hypothesis of molecular mimicry and humoral immune responses. This study was carried out to investigate whether cytokines associated with the innate immune response or T cell activation were altered under baseline conditions and during periods of symptom exacerbation., Methods: Forty-six patients with Tourette's syndrome and/or early-onset OCD, aged 7-17 years, and 31 age-matched control subjects participated in a prospective longitudinal study. Ratings of clinical severity and serum were collected at regular intervals, and serum concentrations of 10 cytokines were measured repeatedly., Results: Interleukin-12 and tumor necrosis factor alpha concentrations at baseline were elevated in patients compared with control subjects. Both of these markers were further increased during periods of symptom exacerbation., Conclusions: These findings suggest that symptom exacerbations are associated with an inflammatory process propagated by systemic and local cytokine synthesis that might involve the central nervous system. We conclude that, in the future, longitudinal studies of children with neuropsychiatric disorders should examine the involvement of innate and T cell immunity.
- Published
- 2005
- Full Text
- View/download PDF
19. Development of the Yale Children's Global Stress Index (YCGSI) and its application in children and adolescents ith Tourette's syndrome and obsessive-compulsive disorder.
- Author
-
Findley DB, Leckman JF, Katsovich L, Lin H, Zhang H, Grantz H, Otka J, Lombroso PJ, and King RA
- Subjects
- Adolescent, Child, Chronic Disease, Female, Follow-Up Studies, Humans, Male, Prospective Studies, Psychometrics, Reproducibility of Results, Severity of Illness Index, Obsessive-Compulsive Disorder diagnosis, Surveys and Questionnaires, Tourette Syndrome diagnosis
- Abstract
Objective: The Yale Children's Global Stress Index (YCGSI) is a new clinical rating instrument designed to provide objective global clinician ratings of psychosocial stress in studies of children and adolescents. This study was designed to evaluate the psychometric properties of the YCGSI., Method: Independent ratings of clinical severity and psychosocial stress were obtained at two time points separated by 4 months from 33 subjects with Tourette's syndrome (TS) and/or early-onset obsessive-compulsive disorder (OCD), aged 7 to 17 years, and 25 age-matched control subjects. Parents and children were interviewed separately. Multiple measures of stress were obtained including the YCGSI and the Daily Life Stressors Scale (DLSS)., Results: Data support the interrater reliability and convergent and divergent validity of the YCGSI. At both time points, children and adolescents with TS and OCD had, on average, experienced significantly more psychosocial stress than did the controls. Cross-sectional ratings of tic and obsessive-compulsive symptom severity did not correlate with the YCGSI, but did correlate with self-report ratings of stress on the DLSS. In contrast, ratings on the YCGSI were associated with clinician ratings of depression., Conclusions: The YCGSI has acceptable psychometric properties. Children and adolescents with TS and OCD appear to be at increased risk of experiencing higher levels of psychosocial stress and adversities compared with their peers in the community. Future studies need to examine the possible differential contributions of distinctive forms of stress on the intramorbid course of these disorders.
- Published
- 2003
- Full Text
- View/download PDF
20. Assessment of symptom exacerbations in a longitudinal study of children with Tourette's syndrome or obsessive-compulsive disorder.
- Author
-
Lin H, Yeh CB, Peterson BS, Scahill L, Grantz H, Findley DB, Katsovich L, Otka J, Lombroso PJ, King RA, and Leckman JF
- Subjects
- Adolescent, Age Factors, Algorithms, Child, Connecticut, Female, Humans, Male, Models, Psychological, Obsessive-Compulsive Disorder psychology, Prospective Studies, Risk Factors, Sensitivity and Specificity, Tourette Syndrome psychology, Obsessive-Compulsive Disorder diagnosis, Psychiatric Status Rating Scales, Tourette Syndrome diagnosis
- Abstract
Objectives: The severity of tic and obsessive-compulsive (OC) symptoms varies over time. Consequently, how do we, as clinicians, know when a change in symptom severity occurs that falls outside of the normal range of fluctuation? The goal of this study was to describe the level of symptom severity fluctuation over time and to establish an objective, prospective, and quantitative method for identifying symptom exacerbations in children with Tourette's syndrome, obsessive-compulsive disorder (OCD), or both. A second major aim was to assess whether fluctuations in tic and OC symptom severity covaried with one another., Method: Monthly consecutive Yale Global Tic Severity Scale and Children's Yale-Brown Obsessive Compulsive Scale scores were prospectively obtained in 64 children diagnosed with Tourette's syndrome and/or OCD for periods ranging from 3 to 39 months. Exacerbation thresholds were estimated by using state-of-the-art bootstrap methods. These thresholds were then independently evaluated by asking two expert clinicians to identify, retrospectively, clinically significant exacerbations based on a review of all available clinical and research records., Results: The severity of tic and OC symptoms displayed a high degree of intrasubject variability. Exacerbation thresholds, which incorporated the change score from the previous month and the current symptom score, provided the best agreement with those of expert clinicians. When both tic and OC symptoms were present, they showed a significant degree of covariation., Conclusions: Evidence-based treatments are coming of age. The use of valid, clinician-rated severity scales will likely become a standard part of clinical practice. Bootstrapping methods may provide a quantitative and convenient way to obtain clinically valid thresholds to assess tic and OC symptom exacerbations. This method has the potential to be applied to other symptom domains where exacerbation thresholds are needed.
- Published
- 2002
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.