Tourette Syndrome research at WMU explores tic suppression

By JP Gaylord
News Writer
November 04, 2004


The psychology department at Western Michigan University begun a
study that will extend through mid-2005 on Tourette Syndrome and the
suppression of its related tics.

Jim Carr, associate professor of psychology at WMU, will be the
principal investigator in a study focusing on children with the
syndrome. WMU will be working as a data collection site along with
North Dakota State University and the University of Wisconsin at
Milwaukee.

"What we're looking to do is find out how children can voluntarily
stop their own tics," he said.

Tics are involuntary motor movements. Tourette Syndrome can involve
vocal and motor movements simultaneously.

"They're more complex than a simple tic," said Wayne Fuqua, chairman
of the department of psychology at WMU.

The study will use children as its subjects in order to deepen
knowledge on their ability to suppress their own tics.

Suppression is also known as habit reversal and involves a fairly
simple, self-administered intervention, Fuqua said.

Suppression techniques, Carr said, will be tested in both adults and
children.

"We're relatively confident about adults, but we're really
unconfident about younger children," he said.

There are a number of treatments that involve suppression, he said,
but researchers don't know what happens to children after they stop
suppressing.

The study will find out if tics come back after suppression is
stopped and if they come back more intensely, which is known as a
rebound effect, Fuqua said.

The study is not meant to be a treatment study, but researchers hope
that the knowledge they come away with will be able to influence the
development of future treatment methods.

Researchers will be doing a number of assessments and interviews
with the participants of the study about their tics and history,
Carr said.

The study qualified as a greater than minimal risk study, and needed
to be approved by the Human Subjects Institutional Review Board
(HSIRB) because of the vulnerable population that is being targeted
and the use of a new therapy that has not yet been tested.

The protocol for the study was approved by both the University of
Wisconsin at Milwaukee HSIRB and the WMU HSIRB, said Vicki Janson,
research compliance coordinator at the WMU HSIRB.

"Anything with more than a minimal risk needed to be approved by the
12-member board," she said.

After some suggested revisions, the study's protocol was modified
and then it was approved, she said. A study with minimal risk
involves no risk beyond what a normal person would face in daily
activities if he lives prudently.

The cause of Tourette Syndrome is not fully known to researchers.

"It clearly has some familial and genetic influences," Fuqua
said. "Genetics probably reflect a propensity or a risk for it."

The syndrome tends to emerge in adolescence and early childhood, he
said, beginning with simple motor tics that become more complicated
as a person ages.

"It's very common for people with Tourette Syndrome to have a large
set of tics," Fuqua said.

The severity of the tics can have a major impact on daily life.

"Sometimes they are so severe that they attract attention," Fuqua
said. "They end up with social ostracism."

Tourette Syndrome can also affect the ability to do a job depending
on the frequency, severity and controllability of the tics, he said.

Treatment options involve either behavioral or pharmacological
treatments.

"There's pretty good evidence that behavioral treatments work,"
Fuqua said.

All of the data collection at WMU will take place in Wood Hall.

"We have a history of researching Tourette Syndrome at WMU," Carr
said. "More researchers in psychology have been interested in
Tourette Syndrome."

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