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Clarke RA, Furlong TM, Eapen V. Tourette Syndrome Risk Genes Regulate Mitochondrial Dynamics, Structure, and Function. Front Psychiatry 2020; 11:556803. [PMID: 33776808 PMCID: PMC7987655 DOI: 10.3389/fpsyt.2020.556803] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 11/23/2020] [Indexed: 11/13/2022] Open
Abstract
Gilles de la Tourette syndrome (GTS) is a neurodevelopmental disorder characterized by motor and vocal tics with an estimated prevalence of 1% in children and adolescents. GTS has high rates of inheritance with many rare mutations identified. Apart from the role of the neurexin trans-synaptic connexus (NTSC) little has been confirmed regarding the molecular basis of GTS. The NTSC pathway regulates neuronal circuitry development, synaptic connectivity and neurotransmission. In this study we integrate GTS mutations into mitochondrial pathways that also regulate neuronal circuitry development, synaptic connectivity and neurotransmission. Many deleterious mutations in GTS occur in genes with complementary and consecutive roles in mitochondrial dynamics, structure and function (MDSF) pathways. These genes include those involved in mitochondrial transport (NDE1, DISC1, OPA1), mitochondrial fusion (OPA1), fission (ADCY2, DGKB, AMPK/PKA, RCAN1, PKC), mitochondrial metabolic and bio-energetic optimization (IMMP2L, MPV17, MRPL3, MRPL44). This study is the first to develop and describe an integrated mitochondrial pathway in the pathogenesis of GTS. The evidence from this study and our earlier modeling of GTS molecular pathways provides compounding support for a GTS deficit in mitochondrial supply affecting neurotransmission.
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Affiliation(s)
- Raymond A Clarke
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.,Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | - Teri M Furlong
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Valsamma Eapen
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.,Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.,South West Sydney Local Health District, Liverpool Hospital, Liverpool, NSW, Australia
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Fernandez TV, State MW, Pittenger C. Tourette disorder and other tic disorders. HANDBOOK OF CLINICAL NEUROLOGY 2018; 147:343-354. [PMID: 29325623 DOI: 10.1016/b978-0-444-63233-3.00023-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Tourette disorder is a developmental neuropsychiatric condition characterized by vocal and motor tics that can range in severity from mild to disabling. It represents one end of a spectrum of tic disorders and is estimated to affect 0.5-0.7% of the population. Accumulated evidence supports a substantial genetic contribution to disease risk, but the identification of genetic variants that confer risk has been challenging. Positive findings in candidate gene association studies have not replicated, and genomewide association studies have not generated signals of genomewide significance, in large part because of inadequate sample sizes. Rare mutations in several genes have been identified, but their causality is difficult to establish. As in other complex neuropsychiatric disorders, it is likely that Tourette disorder risk involves a combination of common, low-effect and rare, larger-effect variants in multiple genes acting together with environmental factors. With the ongoing collection of larger patient cohorts and the emergence of affordable high-throughput genomewide sequencing, progress is expected to accelerate in coming years.
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Affiliation(s)
- Thomas V Fernandez
- Child Study Center, Yale School of Medicine, New Haven, CT, United States
| | - Matthew W State
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States
| | - Christopher Pittenger
- Child Study Center, Yale School of Medicine, New Haven, CT, United States; Department of Psychiatry, Yale University, New Haven, CT, United States.
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Chutko LS, Surushkina SY, Anisimova TI. Emotional disorders in adolescents with Tourette's syndrome and in their mothers. Zh Nevrol Psikhiatr Im S S Korsakova 2018; 118:56-59. [DOI: 10.17116/jnevro201811811156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Robertson MM. Tourette syndrome in children and adolescents: aetiology, presentation and treatment. BJPSYCH ADVANCES 2016. [DOI: 10.1192/apt.bp.114.014092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SummaryTourette syndrome is a complex neuropsychiatric disorder of juvenile onset, characterised by motor and phonic tics. It is associated with a number of comorbid psychiatric conditions and a reduced quality of life in the young person and with parenting stress, caregiver burden and psychopathology in the parents. The global prevalence (about 1%) is higher than previously thought, with a strong male preponderance. Evidence is emerging that Tourette syndrome is not a unified disorder; rather, it encompasses a number of subtypes, characterised by complexity of tics and the simultaneous presence of other behaviours or disorders. This article discusses the aetiology of the syndrome, and examines its clinical features and comorbid psychiatric conditions and psychopathologies. Assessment and diagnosis are also discussed. Psychoeducation is a cornerstone of management, augmented with behavioural and/or pharmacological treatments. Newer therapies, such as deep brain stimulation, offer tantalising possibilities, but further research is still needed.
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Black KJ, Jankovic J, Hershey T, McNaught KSP, Mink JW, Walkup J. Progress in research on Tourette syndrome. J Obsessive Compuls Relat Disord 2014; 3:359-362. [PMID: 25436182 PMCID: PMC4243166 DOI: 10.1016/j.jocrd.2014.03.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Tourette syndrome (TS) is a heritable neuropsychiatric disorder commonly complicated by obsessions and compulsions, but defined by frequent unwanted movements (motor tics) and vocalizations (phonic tics) that develop in childhood or adolescence. In recent years, research on TS has progressed rapidly on several fronts. Inspired by the Fifth International Scientific Symposium on Tourette Syndrome, the articles in this special issue review advances in the phenomenology, epidemiology, genetics, pathophysiology, and treatment of TS.
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Affiliation(s)
- Kevin J. Black
- Departments of Psychiatry, Neurology, Radiology, and Anatomy & Neurobiology, Washington University School of Medicine, St. Louis, MO
| | - Joseph Jankovic
- Department of Neurology, Baylor College of Medicine, Houston, Texas
| | - Tamara Hershey
- Departments of Psychiatry, Neurology, and Radiology, Washington University School of Medicine, and Department of Psychology, Washington University, St. Louis, MO
| | | | - Jonathan W. Mink
- Departments of Neurology, Neurobiology and Anatomy, Brain and Cognitive Sciences, and Pediatrics, University of Rochester, Rochester, NY
| | - John Walkup
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Weill Cornell Medical College and New York-Presbyterian Hospital, New York, NY
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Paschou P. The genetic basis of Gilles de la Tourette Syndrome. Neurosci Biobehav Rev 2013; 37:1026-39. [DOI: 10.1016/j.neubiorev.2013.01.016] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Revised: 01/02/2013] [Accepted: 01/07/2013] [Indexed: 12/18/2022]
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Ali F, Morrison KE, Cavanna AE. The complex genetics of Gilles de la Tourette syndrome: implications for clinical practice. ACTA ACUST UNITED AC 2013. [DOI: 10.2217/npy.13.25] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Paschou P, Fernandez TV, Sharp F, Heiman GA, Hoekstra PJ. Genetic susceptibility and neurotransmitters in Tourette syndrome. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2013; 112:155-77. [PMID: 24295621 DOI: 10.1016/b978-0-12-411546-0.00006-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Family studies have consistently shown that Tourette syndrome (TS) is a familial disorder and twin studies have clearly indicated a genetic contribution in the etiology of TS. Whereas early segregation studies of TS suggested a single-gene autosomal dominant disorder, later studies have pointed to more complex models including additive and multifactorial inheritance and likely interaction with genetic factors. While the exact cellular and molecular base of TS is as yet elusive, neuroanatomical and neurophysiological studies have pointed to the involvement of cortico-striato-thalamocortical circuits and abnormalities in dopamine, glutamate, gamma-aminobutyric acid, and serotonin neurotransmitter systems, with the most consistent evidence being available for involvement of dopamine-related abnormalities, that is, a reduction in tonic extracellular dopamine levels along with hyperresponsive spike-dependent dopamine release, following stimulation. Genetic and gene expression findings are very much supportive of involvement of these neurotransmitter systems. Moreover, intriguingly, genetic work on a two-generation pedigree has opened new research pointing to a role for histamine, a so far rather neglected neurotransmitter, with the potential of the development of new treatment options. Future studies should be aimed at directly linking neurotransmitter-related genetic and gene expression findings to imaging studies (imaging genetics), which enables a better understanding of the pathways and mechanisms through which the dynamic interplay of genes, brain, and environment shapes the TS phenotype.
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Affiliation(s)
- Peristera Paschou
- Department of Molecular Biology and Genetics, Democritus University of Thrace, Alexandroupoli, Greece
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Pathogenetic model for Tourette syndrome delineates overlap with related neurodevelopmental disorders including Autism. Transl Psychiatry 2012; 2:e158. [PMID: 22948383 PMCID: PMC3565204 DOI: 10.1038/tp.2012.75] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Tourette syndrome (TS) is a highly heritable neuropsychiatric disorder characterised by motor and vocal tics. Despite decades of research, the aetiology of TS has remained elusive. Recent successes in gene discovery backed by rapidly advancing genomic technologies have given us new insights into the genetic basis of the disorder, but the growing collection of rare and disparate findings have added confusion and complexity to the attempts to translate these findings into neurobiological mechanisms resulting in symptom genesis. In this review, we explore a previously unrecognised genetic link between TS and a competing series of trans-synaptic complexes (neurexins (NRXNs), neuroligins (NLGNs), leucine-rich repeat transmembrane proteins (LRRTMs), leucine rich repeat neuronals (LRRNs) and cerebellin precursor 2 (CBLN2)) that links it with autism spectrum disorder through neurodevelopmental pathways. The emergent neuropathogenetic model integrates all five genes so far found to be uniquely disrupted in TS into a single pathogenetic chain of events described in context with clinical and research implications.
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Guo Y, Deng X, Jankovic J, Su L, Zhang J, Le W, Xu H, Yang Z, Tang J, Kuang S, Deng H. Mutation screening of the HTR2B gene in patients with Tourette syndrome. Neurosci Lett 2012; 526:150-3. [DOI: 10.1016/j.neulet.2012.08.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Revised: 08/06/2012] [Accepted: 08/08/2012] [Indexed: 01/25/2023]
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State MW. The genetics of Tourette disorder. Curr Opin Genet Dev 2011; 21:302-9. [PMID: 21277193 DOI: 10.1016/j.gde.2011.01.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2010] [Revised: 01/03/2011] [Accepted: 01/04/2011] [Indexed: 12/21/2022]
Abstract
Tourette disorder (TD) is a childhood onset neuropsychiatric syndrome defined by persistent motor and vocal tics. Despite a long-standing consensus for a strong genetic contribution, the pace of discovery compared to other disorders of similar prevalence has been slow, due in part to a paucity of studies and both clinical heterogeneity and a complex genetic architecture. However, the potential for rapid progress is high. Recent rare variant findings have pointed to the importance of copy number variation, the overlap of risks among distinct diagnostic entities, the contribution of novel molecular mechanisms, and the value of family based studies. Finally, analysis of a cohort of sufficient size to identify common polymorphisms of plausible effect is underway, promising key information regarding the contribution of common alleles to TD.
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Affiliation(s)
- Matthew W State
- Department of Child Psychiatry, Yale University School of Medicine, New Haven, CT 06520, United States.
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The genetics of obsessive-compulsive disorder and Tourette syndrome: an epidemiological and pathway-based approach for gene discovery. J Am Acad Child Adolesc Psychiatry 2010; 49:810-9, 819.e1-2. [PMID: 20643314 DOI: 10.1016/j.jaac.2010.04.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2009] [Revised: 04/27/2010] [Accepted: 04/28/2010] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To provide a contemporary perspective on genetic discovery methods applied to obsessive-compulsive disorder (OCD) and Tourette syndrome (TS). METHOD A review of research trends in genetics research in OCD and TS is conducted, with emphasis on novel approaches. RESULTS Genome-wide association studies (GWAS) are now in progress in OCD and TS and will provide a platform for future discovery of common gene variants. Optimally, newer next-generation genome sequencing methods can also be used to detect larger effect genes (rare gene variants), taking advantage of pedigrees. Studies of gene networks or sets rather than individual genes will be required to elucidate biological etiology, as neural systems appear to act redundantly. Newer phenotyping strategies, such as symptom-based subtypes, cross-disorder latent class types, and intermediate phenotypes (endophenotypes) will need to be developed and tested to better align clinical and physiological measures with genetic architecture. CONCLUSION Although genetics research has made significant advances based on computational strength and bioinformatics advances, newer approaches to phenotyping and judicious study of gene etiological networks will be needed to uncover the genetic etiology of OCD and TS.
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Walkup JT, Ferrão Y, Leckman JF, Stein DJ, Singer H. Tic disorders: some key issues for DSM-V. Depress Anxiety 2010; 27:600-10. [PMID: 20533370 DOI: 10.1002/da.20711] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
This study provides a focused review of issues that are relevant to the nosology of the tic disorders and presents preliminary recommendations to be considered for DSM-V. The recommended changes are designed to clarify and simplify the diagnostic criteria, reduce the use of the residual category, tic disorder not otherwise specified, and are not intended to alter substantially clinical practice or the continuity of past and future research. Specific recommendations include: (1) a more precise definition of motor and vocal tics; (2) simplification of the duration criterion for the tic disorders; (3) revising the term "transient tic disorder" for those with tic symptoms of less than 12-month duration; (4) establishing new tic disorder categories for those with substance induced tic disorder and tic disorder due to a general medical condition; and (5) including a motor tic only and vocal tic only specifier for the chronic motor or vocal tic disorder category.
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Affiliation(s)
- John T Walkup
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Weill Cornell Medical College, New York, New York 10065, USA.
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