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What did the project achieve?
“Our results have increased our understanding of the mechanisms involved in the formation and retention of movement tics in children with Tourette syndrome,” says Professor Georgina Jackson of the University of Nottingham. “We hope that this will lead to improved ways to assess a child’s suitability for behavioural therapy – and the development of new therapies that can stop children from developing severe lifelong tics.”
Tourette syndrome (TS) is a condition that causes a person to make involuntary sounds and movements called tics. Affecting around one in 100 school children, the tics and other symptoms will usually improve over time.1 But it’s not currently possible to predict who will get more elaborate tics that can continue into adulthood.
Professor Jackson’s team developed a simple, computer-based movement task – and used this to assess the strength and quality of habit-learning in 25 children with TS and compared these data with 23 healthy children.
“We showed that children with TS were slower to learn how to adapt their movements during the task – but this effect was found to be due to symptoms of ADHD, rather than tics,” said Professor Jackson. “More importantly, we found that children with the most severe tics take longer to forget the behaviour they had learned when it was no longer appropriate to the task.”
“Assessing the adaptability of a child’s habit learning system may be very useful for predicting who will respond to behavioural therapy – as well as those who are likely to get severe tics that continue into adulthood,” she adds. “We estimate that our computer assessment task will be available in the clinic within the next three to five years.”
The findings of this work also have implications for the development of new treatments for TS. The team is currently investigating whether non-invasive electrical brain stimulation – which has been shown to change the level of a key chemical in an area of the brain involved in movement – can be used to reduce the severity of movement tics in children with the condition.
Reference
- Stern, JS et al. Gilles de la Tourette’s syndrome and its impact in the UK. Postgraduate Medical Journal 2005; 81:12-19.
This research was completed on
Around one in every hundred children develops Tourette syndrome.1,2 They have tics, which means that they move, say something or make a sound in a sudden and involuntary way that seems to be totally without purpose. Professor Georgina Jackson, of the University of Nottingham, is studying whether children with Tourette syndrome get tics partly because they’re particularly good at learning habits. Her work could lead to better ways to assess each child’s suitability for behavioural therapies and the development of new treatments that stop children from getting severe tics that continue into adulthood. This could improve children’s lives considerably.
Action Medical Research and Great Ormond Street Hospital Children's Charity are jointly funding this research.
How are children’s lives affected now?
“At first, children with Tourette syndrome, which affects the brain and nervous system, have quite simple tics – for example, they might blink or sniff repeatedly,” says Professor Jackson. “As time goes by, children’s tics tend to become more complex. They might, for example, throw things in class or shout the same word over and over again. Complex tics can be particularly distressing as they can be painful and draw unwelcome attention to the child. To other people, it can seem as if the child is behaving in a bizarre way, or acting inappropriately, on purpose, even though they’re not.”
“Sadly, Tourette syndrome is linked to social isolation, rejection and bullying, and it can be a barrier to learning,” adds Professor Jackson. “Children can also worry about their future – around one third of children find their symptoms carry on throughout their life, but it’s not possible to predict who will be affected in this way.”
How could this research help?
The team aims to improve understanding of how children’s tics develop, and why they often get worse in the first eight years after onset.
The researchers are investigating the theory that children with Tourette syndrome are unusually good – perhaps too good – at learning habits. They’re also exploring whether it’s harder for children with Tourette syndrome to break a habit once it’s been formed. The team is assessing children’s abilities using a specially created computer game.
“Our new computer game could be useful when assessing whether behavioural therapy is suitable for a child,” says Professor Jackson. “Current treatments don’t work for everyone, and medication can have unpleasant side effects, so our findings could also help with our longer term goal of developing new treatments that stop children from getting the more elaborate tics that can continue into adulthood. Tics like this can be particularly detrimental to children’s quality of life. Treatments that stop them could be hugely beneficial.”
References
1. NHS Choices. Tourette’s syndrome. http://www.nhs.uk/Conditions/Tourette-syndrome/Pages/Introduction.aspx Website accessed 5 September 2015.
| Project Leader | Professor Georgina M Jackson BA BEd PhD |
| Project Team | Dr Maddie J Groom BSc PhDProfessor Stephen R. Jackson BA PhD |
| Project Location | Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham |
| Project duration | 2 years |
| Date awarded | 20 July 2015 |
| Project start date | 2 November 2015 |
| Project end date | 10 August 2018 |
| Grant amount | £97,651 |
| Grant code | GN2398 |
We do not provide medical advice. If you would like more information about a condition or would like to talk to someone about your health, contact NHS Choices or speak to your GP.