What is the Cause of Tourette’s Syndrome? Is it Genetic? Is There a Cure?

What is the cause of Tourette’s Syndrome? Is it genetic? Is there a cure? These are the questions I am most interested in exploring. Why do you ask? A friend of mine has Tourette’s, but his symptoms have improved over the years because of his medication. His tics occurred quite frequently before he was put on medication. He had a hard time controlling his tics, thus making it hard for him to concentrate in school, keeping friends he made, and so on. I want to know what this disorder is that caused him to have those uncontrollable impulses; is it possible that it is genetic; and how exactly do the treaments work that are currently available?

To being with, I explore the possible causes of Tourette’s syndrome. I found that there is no definite answer as to what the exact cause, but a great deal of research has shown that Tourette’s is due to an imbalance of certain chemicals within the brain (9). The neurotransmitters that play a primary role in this imbalance are said to be dopamine, serotonin, and norepinephrine (9). The role of norepinephrine is a neurotransmitter that stimulates or suppresses the other neurons in the brain (9). If this neurotransmitter is for some reason unable to do this, there is an overload of dopamine in the brain that will result in the involuntary movements of the nerve (9). It is said, “A gene mutation in the DRD2 gene causes the D2 receptors to function abnormally. The hypersensitive dopamine D2 receptors, in turn, cause the over-activity of the dopaminergic neuron” (9). Serotonin is what controls one’s sleep and many cases of Tourette’s have shown that there has been a great deal of trouble with sleeping without interruptions; this meaning that there is most likely a defect in the serotonin (9). As a result, a person’s tics are severe or mild depending on the severity of the imbalance of those chemical in the brain.

I find the above causes to be a good story because many studies have shown the same results. As studied in class, the more a theory is tested, the ‘less wrong’ it becomes. A great deal of the research I did supported the story above but new questions are arising in the field asking if there could possibly be a Tourette’s Syndrome gene. This is quite fascinating because scientists say that if a gene that exists, it will help with learning more about the disease, and helping to identify treatments (6). It is understandable that the cure will not be easily identified, but such a discovery could help a great deal of people who have Tourette’s who are not able to control their tics even with the treatments that are presently available.

This brought me to my next question, is it genetic? The disease is inherited in most cases but there are cases where the disease will randomly appear without any trace of it in any previous family member(s) (1). It is said that a 50 percent chance exists of passing the gene to one’s child (1). One study that was discussed throughout various articles was the study done on 5 pairs of twins; this is a prime example that supports the statement that Tourette’s is inherited. In the 5 pairs of identical twins, each twin had received the gene but one of the twins had a severe case of Tourette’s while the other twin had a moderate case of Tourette’s (2). The study explained that in the twin with the severe symptoms, it could be seen that in the front of the caudate nucleus there was a super-sensitivity of the dopamine receptors (D2) (2). The study also explained that the severity of the syndrome within each twin could have resulted from prenatal damage (2). This is quite interesting because the study showed that even though the same gene was passed, the severity of it in each twin varied. It is possible for a parent who does not show symptoms of the disorder to pass it on to their child who may have a mild or severe case. Also, there is a possibility where the disorder may not run in the family but a child will unexpectedly have Tourette’s; although the possibility of this happening is small (1). I discovered that in my friend’s case, the gene was passed down from one of his parent’s and there had a been a history of family members with Tourette’s.

I wanted to stop for a moment to question if race or gender may play a role in the people who acquire the gene. From the research I found, it is possible for anyone to get Tourette’s, regardless of race or cultural background. As one study put it, “TS is found in all cultures and racial groups…it is increasingly recognized as being a relatively common disorder” (8). Therefore, it is possible that anyone could possibly have the disease depending on if their parent(s) had Tourette’s. Men are approximately three to four times more likely to inherit the disease and to have tics than women (4). I wonder if it would make a difference if the gene was passed down from a mother who did not have a severe case of Tourette’s to her son or from a father who had a severe case of Tourette’s to his daughter. Would it be possible for the son to acquire a mild or severe case of Tourette’s or for him to have tics whereas the mother may not have had tics? Or, would it be possible for the father to pass it on to his daughter, and the daughter show no symptoms of the disorder? It could be possible for a pattern to exist or for the symptoms to randomely differ within different families.

This led me to my final question of whether a treatment exists for Tourette’s. There are various treatments that exist that can either suppress or stimulate the neurotransmitters that could be potential causes of Tourette’s. Popular drugs such as haloperidol (Haldol), fluphenazine, and pimozide, are used to help with the symptoms of Tourette’s (5). The drugs work to control the activity of dopamine (5). Throughout my research, it became evident that these drugs worked for a great number of people in helping with their symptoms. My friend has used Haldol since the age of 6 and it has helped him a great deal in suppressing his symptoms.

Another treatment I read about in one of the articles seems worthy of mention because it was an interesting study. At the University of South Florida, researchers conducted an experiment using a low dose nicotine patch (7 milligrams) on patients who were not responding positively to the Haldol drug (3). The patients continued taking Haldol but also wore the nicotine patches (3). The results of the experiment showed that the patients responded with an average of 45 percent better reaction to the drug (3). There is no clear answer for why the nicotine helped the tics in a person with Tourette’s. However, it is suggested that the nicotine may help in the shutting off of the brain receptors that play a role in causing tics when it is very active or the stimulating of the receptors if they are inactive (3). The study done by Paul R. Sanberg showed a decrease in symptoms in 80 percent of his patients and that the effects were long-term (7). This was an amazing study because it was incredible that such a substance as nicotine which has been condemned for many years shows to be beneficial. I still believe that further research should be done on this because it seems as if it is a fairly new experiment.

There is still a great deal of research being done in relation to Tourette’s syndrome because there are still a great deal of answers that remain unclear. I don’t know if there will be a solid cure that will work for everyone because many people’s cases of Tourette’s are different. The treatments that are available now are helping a great deal with suppressing the symptoms but I believe there will always be different factors within different people that may not respond well to the ‘popular’ medicine or need more than just the available drugs.

I believe the knowledge of such a syndrome is significant because it affects a great deal of people. The more knowledge the general public has, the less likely they will be to make conceptions such as it being the ‘cursing disease’. My friend believes that this knowledge is an essential part of general awareness; this and the fact that most people with Tourette’s feel uncomfortable as it is without strange looks, comments, or snickering from various people…

“For the people who say they wish they had TS, I would gladly give it to them...nothing would make me happier than to get rid of this damn thing and not worry about forcing pills down my throat every day since I was 6 years old and still not always working. I guarantee you that you will not find a single person with TS that wouldn’t give it away in a heartbeat.” (My friend)

1) BBC News , "Tourette Syndrome." bbc.co.uk. 15 Jul 2003. BBC News. 3 Dec 2007 <http://news.bbc.co.uk/1/hi/health/medical_notes/3067443.stm>.

2) Bower, B. "Brain Images Illuminate Tourette Syndrome." Science News 150. 9. 31 Aug 1996 133. November 29 2007:

<http://links.jstor.org/sici?sici=00368423%2819960831%29150%3A9%3c133%3ABIITS%E2.0.CO%3B22-J>.

3) Francavilla, Julie. "Nicotine and Tourette's." Tourette's Syndrome. 2000. Tourette-Syndrome.com. 3 Dec 2007 <Shwartz, John. "A Cigarette Chemical Packed with Helpful Effects?." Tourette-Syndrome. 29 Nov 1998. Tourette Syndrome.com. 3 Dec 2007 . >.

4) National Institutes of Health, "Tourette Syndrome Fact Sheet." National Institute of Neurological Disorders and Stroke. 19 Nov 2007. National Institutes of Health. 3 Dec 2007 <http://www.ninds.nih.gov/disorders/tourette/detail_tourette.htm>.

5) Pernar, Luise. "Parkinson's Disease and Tourette's Syndrome." Serendip. 07 Jan 2002. Serendip. 3 Dec 2007 </bb/neuro/neuro98/202s98-paper2/Pernar2.html>.

6) Society for Neuroscience, "Tourette's Syndrom and Dopamine." Society for Neuroscience: Brain Briefings. 2007. Society of Neuroscience. 3 Dec 2007 <http://www.sfn.org/index.cfm?pagename=brainBriefings_tourettesSyndromeAndDopamine>.

7) Shwartz, John. "A Cigarette Chemical Packed with Helpful Effects?." Tourette-Syndrome. 29 Nov 1998. Tourette Syndrome.com. 3 Dec 2007 <http://www.tourette-syndrome.com/tsarticles.htm>.

8) Steven S. Wolf; Douglas W. Jones; Michael B. Knable; Julia G. Gorey; Kan Sam Lee; Thomas M. Hyde; Richard Coppola; Daniel R. Weinberger. "Tourette Syndrome: Prediction of Phenotypic Variation in Monozygotic Twins by Caudate Nucleus D2 Receptor Binding" Science News 273. 5279. 30 Aug 1996: pp. 1225-1227.

<http://links.jstor.org/sici?sici=00368075%2819960830%293%3A273%3A5279%3C1225%3ATSPOPV%3E2.0.CO%3B2-P>.

9) Yi , Sooyoun. "Tourette Syndrome." Serendip. 14 Feb 2006. Serendip. 3 Dec 2007 </bb/neuro/neuro00/web2/Yi.html>.