TOURETTE SYNDROME A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES
J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS
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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1
Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Tourette Syndrome: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-84099-7 1. Tourette Syndrome-Popular works. I. Title.
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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.
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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on Tourette syndrome. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.
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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.
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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health
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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON TOURETTE SYNDROME.............................................................................. 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Tourette Syndrome ....................................................................... 4 E-Journals: PubMed Central ....................................................................................................... 18 The National Library of Medicine: PubMed ................................................................................ 19 CHAPTER 2. NUTRITION AND TOURETTE SYNDROME .................................................................... 63 Overview...................................................................................................................................... 63 Finding Nutrition Studies on Tourette Syndrome ...................................................................... 63 Federal Resources on Nutrition ................................................................................................... 65 Additional Web Resources ........................................................................................................... 66 CHAPTER 3. ALTERNATIVE MEDICINE AND TOURETTE SYNDROME ............................................. 67 Overview...................................................................................................................................... 67 National Center for Complementary and Alternative Medicine.................................................. 67 Additional Web Resources ........................................................................................................... 73 General References ....................................................................................................................... 74 CHAPTER 4. DISSERTATIONS ON TOURETTE SYNDROME ............................................................... 75 Overview...................................................................................................................................... 75 Dissertations on Tourette Syndrome ........................................................................................... 75 Keeping Current .......................................................................................................................... 76 CHAPTER 5. CLINICAL TRIALS AND TOURETTE SYNDROME .......................................................... 77 Overview...................................................................................................................................... 77 Recent Trials on Tourette Syndrome ........................................................................................... 77 Keeping Current on Clinical Trials ............................................................................................. 84 CHAPTER 6. PATENTS ON TOURETTE SYNDROME .......................................................................... 87 Overview...................................................................................................................................... 87 Patents on Tourette Syndrome .................................................................................................... 87 Patent Applications on Tourette Syndrome................................................................................. 90 Keeping Current .......................................................................................................................... 94 CHAPTER 7. BOOKS ON TOURETTE SYNDROME .............................................................................. 97 Overview...................................................................................................................................... 97 Book Summaries: Federal Agencies.............................................................................................. 97 Book Summaries: Online Booksellers........................................................................................... 98 The National Library of Medicine Book Index ........................................................................... 100 Chapters on Tourette Syndrome ................................................................................................ 101 Directories.................................................................................................................................. 102 CHAPTER 8. MULTIMEDIA ON TOURETTE SYNDROME ................................................................. 105 Overview.................................................................................................................................... 105 Bibliography: Multimedia on Tourette Syndrome ..................................................................... 105 CHAPTER 9. PERIODICALS AND NEWS ON TOURETTE SYNDROME .............................................. 107 Overview.................................................................................................................................... 107 News Services and Press Releases.............................................................................................. 107 Newsletter Articles .................................................................................................................... 109 Academic Periodicals covering Tourette Syndrome................................................................... 110 CHAPTER 10. RESEARCHING MEDICATIONS................................................................................. 111 Overview.................................................................................................................................... 111 U.S. Pharmacopeia..................................................................................................................... 111 Commercial Databases ............................................................................................................... 112 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 115 Overview.................................................................................................................................... 115
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NIH Guidelines.......................................................................................................................... 115 NIH Databases........................................................................................................................... 117 Other Commercial Databases..................................................................................................... 119 The Genome Project and Tourette Syndrome ............................................................................ 119 APPENDIX B. PATIENT RESOURCES ............................................................................................... 123 Overview.................................................................................................................................... 123 Patient Guideline Sources.......................................................................................................... 123 Associations and Tourette Syndrome ........................................................................................ 128 Finding Associations.................................................................................................................. 129 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 131 Overview.................................................................................................................................... 131 Preparation................................................................................................................................. 131 Finding a Local Medical Library................................................................................................ 131 Medical Libraries in the U.S. and Canada ................................................................................. 131 ONLINE GLOSSARIES................................................................................................................ 137 Online Dictionary Directories ................................................................................................... 138 TOURETTE SYNDROME DICTIONARY ................................................................................ 139 INDEX .............................................................................................................................................. 189
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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with Tourette syndrome is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about Tourette syndrome, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to Tourette syndrome, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on Tourette syndrome. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to Tourette syndrome, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on Tourette syndrome. The Editors
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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.
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CHAPTER 1. STUDIES ON TOURETTE SYNDROME Overview In this chapter, we will show you how to locate peer-reviewed references and studies on Tourette syndrome.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and Tourette syndrome, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “Tourette syndrome” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •
Adoptees from Overseas: Post-Institutionalized Children Present with Host of Communication Disorders Source: ADVANCE for Speech-Language Pathologists and Audiologists. 9(6): 12-13. February 8, 1999. Contact: Available from Merion Publications, Inc. 650 Park Avenue, Box 61556, King of Prussia, PA 19406-0956. (800) 355-5627, ext. 279. E-mail:
[email protected]. Website: www.advanceweb.com. Summary: Diagnosing specific communication disorders in children adopted from institutions in Eastern Europe and the former Soviet Union is a complex process. This article addresses this issue, noting that many of these children present with a host of
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deficits, ranging from developmental delays and psychological disturbances to medical problems. Even very young children adopted from institutions tend to have some language problems and delays, as children develop receptive communication capabilities long before they express themselves by speaking. The author discusses the role of early intervention, the role of the native language, diagnostic strategies, the presence of attention deficit hyperactivity disorder, the impact of institutional life on language development, and the presence of certain disorders including Tourette syndrome, fetal alcohol syndrome, and traumatic brain injury (TBI). The article concludes with the contact information for the clinician interviewed, as well as the address and telephone number of the Parent Network for the Post Institutionalized Child.
Federally Funded Research on Tourette Syndrome The U.S. Government supports a variety of research studies relating to Tourette syndrome. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to Tourette syndrome. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore Tourette syndrome. The following is typical of the type of information found when searching the CRISP database for Tourette syndrome: •
Project Title: AFFECTIVE BIASING OF ATTENTIONAL PROCESSING AND CONTROL Principal Investigator & Institution: Maxwell, Jeffrey S.; Psychology; University of Wisconsin Madison 750 University Ave Madison, Wi 53706 Timing: Fiscal Year 2003; Project Start 19-MAR-2004 Summary: (provided by applicant): Planned actions, reflexive behaviors, and complex cognitions do not occur in isolation. Rather, each day we engage in a variety of activities (e.g. driving to and from work, chopping vegetables on a cutting board) that are placed within the broader context of our acute emotional state and corresponding level of arousal. Independent observations gathered from the lesion literature (animal and human), several clinical disorders (ADHD, OCD, Schizophrenia, Tourette Syndrome, Specific Phobias), and multiple electrophysiological and neuroimaging investigations, converge to suggest that several regions within the 3refrontal cortex (PFC) are critically involved in processes of voluntary inhibition, selective attention, and behavioral regulation. Many of these same PFC regions have been implicated in the experience, generation, and perception of emotion and emotional information. In particular,
2 Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).
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5
withdrawal-related (negative) affect, motivations, and imagery have been associated with the lateral and orbitofrontal regions of the right PFC. To date, however, few investigations have explicitly sought to examine the interactions between these systems. The research proposed in this application will directly test several hypothesized interactions between emotional processing and mechanisms of voluntary inhibition using behavioral (accuracy and response speed) and electrophysiological (e.g., LEG, EMG) techniques. Specifically, this research proposes to examine mechanisms of voluntary inhibition and selective attention under different conditions of emotional arousal, manipulated by incidental variations in threat-evoked anxiety. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: AUTOIMMUNE NEUROPSYCHIATRIC DISORDERS
MECHANISMS
IN
PEDIATRIC
Principal Investigator & Institution: Trifiletti, Rosario R.; Assistant Professor; Weill Medical College of Cornell Univ New York, Ny 10021 Timing: Fiscal Year 2001; Project Start 01-DEC-2000; Project End 30-NOV-2001 Summary: Recent evidence suggests that Sydenham chorea, obsessive/compulsive disorder and Tourette syndrome may have a similar autoimmune basis. Dr. Zabriskie and co-workers have shown that a specific B-cell D8/17 clonal marker is greatly expanded in all of these groups. The goal of the present study is to correlate brain autoantigens, B-cell clonal status and neurologic, psychaitric and cognitive outcome in all of these groups. If correlations are found, efforts will be made to isolate the respective autoantigens. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CLONIDINE IN ADHD Principal Investigator & Institution: Sallee, Floyd R.; Professor; Children's Hospital Med Ctr (Cincinnati) 3333 Burnet Ave Cincinnati, Oh 45229 Timing: Fiscal Year 2001; Project Start 18-AUG-2000; Project End 31-JUL-2004 Summary: Attention Deficit, Hyperactivity disorder (ADHD) is a common mental health disorder of significant morbidity for which approximately 100,000 children yearly are treated with clonidine (CLON) in the US, either as an alternative to psychostimulants, or as combination therapy. Adequate ADHD efficacy and safety data are lacking and CLON is not FDA approved for ADHD. Rationales for combination with methylphenidate (MPH) are that it may be synergistic, may extend the stimulant effect, and/or that CLON may address certain core symptoms not treated by stimulants alone. No data support these rationales, yet the combination is increasingly being prescribed despite reports of serious adverse events linked to combination therapy. CLON has yet to be comprehensively studied in primary ADHD, but an NINDS sponsored evaluation of the safety and efficacy of CLON alone and in combination with MPH is currently being conducted in children with Tourette Syndrome with comorbid ADHD (TACT). TACT subjects however may be predominantly "inattentive" subtype, in contrast to combined type, most commonly seen in primary ADHD. TACT data also cannot be extrapolated to primary ADHD because treatment with CLON in TACT is dually targeted to the treatment of both tics and ADHD such that dosing interval and potentially safety findings (if adverse events are dose related) may not be readily applied to primary ADHD. Efficacy and safety data from TACT therefore may be inadequate for primary ADHD treatment, for which the majority of CLON is prescribed. The clinical trial machinery and expertise of the TACT team however is uniquely
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Tourette Syndrome
positioned to study CLON in primary ADHD. Advantages would be: 1) reduced cost by using TACT existing infrastructure; 2) an opportunity to pool safety data across studies such that low frequency adverse events may be detected; 3) to compare therapeutic outcomes in primary ADHD to ADHD with comorbid Tourette Syndrome to determine if CLON has differential effects in "inattentive subtype" versus "hyperactive/impulsive" or combined subtypes; and 4) to determine if chronic treatment with MPH can contribute to the development of tic disorder. We propose a multicenter, controlled study of CLON, MPH, and CLON plus MPH for children with primary ADHD. The study will A) determine the safety and efficacy of CLON for the treatment of ADHD in children; B) evaluate the safety and efficacy of combined CLON+MPH for treatment of ADHD compared to standard MPH therapy; C) provide a lyr extension for all subjects to follow-up tic development during course of the study. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: COMMON CHROMOSOMAL INVERSIONS AND GENOMIC VARIABILITY Principal Investigator & Institution: Ophoff, Roel A.; None; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2003; Project Start 05-JUN-2003; Project End 31-MAY-2008 Summary: (provided by applicant): Recent studies of the human genome have revealed large blocks of almost identical sequences in particular chromosomal regions, comprising about 5 percent of the human genomic sequence. Non-allelic homologous recombination between these paralogous sequences results in changes of genomic structure creating inversions and other types of chromosomal rearrangements. Variation in chromosomal architecture, such as submicroscopical inversions, is more widespread in the human genome than previously thought. One example of a common inversion polymorphism is identified on chromosome 8p23. The main goal of this proposal is to characterize the 8p23 inversion region and develop tools for genome-wide investigation of similar rearrangements. The 8p23 rearrangement, an inversion polymorphism spanning about a 4Mb region flanked by paralogous sequences, was only recently recognized on different haptotypes. The region surrounding or including the inversion on chromosome 8p has been implicated by several independent mapping studies of complex phenotypes including schizophrenia, bipolar disorder, Tourette syndrome, harm avoidance, and prostate cancer susceptibility. Understanding the underlying structure and history of the 8p inversion region is needed to study its role in genome evolution and investigation of these putative loci also requires molecular characterization of the 8p inversion region. Little is known about common inversions. We will conduct detailed analysis of the flanking paralogous sequences and investigate the presence of haplotypes blocks for this region; this will reveal the phylogenetic history of these duplicated segments and enable us to reconstruct the most likely ancestral configuration. Expression profiles will be established for different inversion haplotypes to test the hypothesis that 8p inversion events may affect local or more global gene expression. We will develop a simple assay in order to screen large numbers of samples for the presence of the 8p inversion. Additionally, this and similar inversions may affect the results of statistical genetic analyses; we will investigate the possible implications of these rearrangements on mapping studies, develop statistical methods for linkage and linkage disequilibrium mapping to integrate inversion information for each chromosome, and re-analyze prior genotype data for the different traits that were previously associated with this region. Furthermore, tools will be developed and applied to predict and identify additional genome regions with similar variability,
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further expanding the possible link between chromosomal architecture and complex traits. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SYNDROME
DOPAMINE
SYNAPTIC
MECHANISMS
IN
TOURETTE'S
Principal Investigator & Institution: Albin, Roger L.; Professor; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2001; Project Start 01-DEC-1979; Project End 31-JUL-2006 Summary: Tourette syndrome (TS) is a common neuropsychiatric disorder with onset in childhood. Some data suggests that TS is part of a spectrum ranging from tics to Obsessive-Compulsive Disorder. The clinical pharmacology of TS implicates abnormalities of dopaminergic neurotransmission, possibly involving the nigrostriatal dopaminergic projection, in the pathophysiology of TS. Our prior data indicates normal density of dorsal striatal dopaminergic innervation. We hypothesize that TS is marked by abnormal regulation of striatal dopamine neurotransmission. We will use PET methods to study striatal dopaminergic function in TS and control subjects to determine the existence of functional abnormalities in TS striatal dopaminergic synapses. We will compare binding of one striatal dopamine terminal marker, [[11C]dihydrotetrabenazine, that is not regulated by alterations in synaptic dopamine flux, with another dopamine terminal marker that is regulated by synaptic dopamine flux, [11C]methylphenidate. We will search for specific alterations in striatal dopamine synaptic physiology by direct measurement of the stimulant releasable pool of striatal dopamine with amphetamine challenge- [11C]raclopride PET and estimates of synaptic striatal dopamine concentrations with [11C]raclopride PET after alpha-methyl-tyrosine depletion of dopamine. Discovery of an alteration in striatal dopamine synaptic physiology would lead to more mechanistic hypotheses regarding the nature of the abnormality in TS. The major alternative hypotheses is a subregional difference in dopaminergic innervation of the ventral striatum. We have preliminary data suggesting the presence of a focal abnormality of ventral striatal dopaminergic innervation in TS. We will collect additional imaging data evaluate the validity of this finding. Failure to uncover abnormalities in striatal dopamine synapse function or subregional difference sin innervation will direct attention away from the striatal dopaminergic synapse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: FRONTOSTRIATAL DEVELOPMENT AND COGNITIVE CONTROL Principal Investigator & Institution: Casey, Betty J.; Professor; Psychiatry; Weill Medical College of Cornell Univ New York, Ny 10021 Timing: Fiscal Year 2001; Project Start 01-MAY-2001; Project End 30-APR-2006 Summary: One key feature of cognitive and behavioral development is the gradual ability to override one behavior in favor of another or to suppress attention to irrelevant information in favor of more relevant information. The proposed studies examine the normal development of this ability and its neural basis. Behavioral paradigms will be used that parametrically manipulate the degree of interfering, irrelevant information, thereby increasing the demands for overriding an attentional or behavioral response (i.e., cognitive control). The investigators will examine the structural and functional connectivity of brain systems including the prefrontal cortex and basal ganglia, assumed to play a role in cognitive control. They propose to use the following methods to address this issue: 1) structural magnetic resonance imaging (MRI) to examine morphometric
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Tourette Syndrome
changes in relevant brain structures; 2) diffusion tensor imaging to examine the extent of myelination of frontostriatal circuitry; and 3) functional MRI in conjunction with well defined cognitive paradigms to examine the functional development of neural systems involved in cognitive control. The investigators will use a cross lag design exploiting both cross-sectional and longitudinal information across the ages of 4 to 30. Further, to understand the neuromodulatory role of dopamine in this developmental process, known polymorphisms in genes that contribute to the neuromodulatory effects of dopamine will be examined via gene association studies. A number of such polymorphisms have been identified that occur relatively frequently in the general population. The investigators will collect DNA samples from the cheek cells of subjects. This DNA will be typed for variation at a particular gene and then correlated with behavioral performance using simple population-based statistical tests. The method is simple, noninvasive, reliable, fast and inexpensive relative to the neuroimaging studies. They will determine if measures of genetic variation predict performance on tasks of cognitive control or relate to measures of structural and functional brain development. This work promises to have significant implications at the behavioral, biological, and ultimately at the genetic level for developmental disorders that have as a core deficit, a problem overriding or suppressing inappropriate thoughts and behaviors like Attention Deficit-Hyperactivity Disorder, Obsessive Compulsive Disorder and Tourette syndrome. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MECHANISMS OF DOPAMINE & SEROTONIN IN TOURETTE SYNDROME Principal Investigator & Institution: Wong, Dean F.; Vice Chair for Research; Radiology; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2001; Project Start 01-APR-2001; Project End 31-MAR-2004 Summary: (Verbatim from the Applicant's Abstract) The mechanisms and significance of the dopaminergic and serotonergic neurotransmission systems in Tourette Syndrome (TS) have not been thoroughly investigated and explained. A more complete understanding of their roles in TS would lead to better selection of pharmacological treatments for these patients and provide insight into the pathophysiology of TS. This project will examine pre-, and post- and intrasynaptic dopamine neurotransmission DA transporter (DAT), D2 density (D2Bmax) and DA release (DArel), simultaneously in patients with TS. Serotonin abnormalities will be studied in patients with TS and obsessive-compulsive disorder (OCD), a co-morbid disease. Based on our prior neuroreceptor imaging experience with positron emission tomography (PET) in TS and other neuropsychiatric disorders, we hypothesized that DArel stimulated by an amphetamine challenge will be increased in TS and will correlate with the severity of symptoms (Aim 1). In Aim 2 we will investigate how the relationship between the pre-, post- and intrasynaptic measures of dopamine differ between patients with TS and normal controls. For example, we predict dopamine release and D2 dopamine receptors will both be increased in TS compared to normal subjects. There is a need to establish appropriate serotonin and dopamine/serotonin combinations in the treatment of TS. We hypothesize that there are abnormal serotonin receptors and transporters in TS subjects prior to treatment and that the differences will be most pronounced in subjects with symptoms of OCD. We will examine pre-synaptic serotonin transporters(SERT) and post-synaptic (5HT24R) in TS subjects with and without OCD and compare the results to controls with and without OCD (Aim 3). In Aim 4 we will explicitly examine the relationship of DArel together with the serotonergic measures to explore dopamine
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serotonin interactions in the same individual. The measurement of pre-, and post- and intrasynaptic dopaminergic parameters has never been performed simultaneously in the same TS subject. Serotonin 5HT24R and SERT have not been studied in same patients with TS and symptoms of OCD. We propose to carry out experiments using PET to establish a more complete understanding of the neurotransmission in TS. This will also help establish new ationales for improved therapeutics in TS. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MOLECULAR APPROACHES TO CHILDHOOD PSYCHIATRIC DISORDERS Principal Investigator & Institution: State, Matthew W.; Assistant Professor; Child Study Center; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2002; Project Start 01-MAY-2002; Project End 30-APR-2007 Summary: This application presents a career development award proposal spanning the fields of child psychiatry, molecular cytogenetics and molecular genetics. The near-term objective of this submission is to develop an independent program in patient-oriented research that focuses on identifying genes that contribute to serious psychiatric disorders. The ultimate aim of the applicant is to contribute to the translation of advances in genetics into improvements in diagnosis, treatment and prevention of childhood developmental and neuropsychiatric illnesses. After completing clinical training in adult and child psychiatry, the applicant participated in a three-year NIMH funded patient-oriented research fellowship at the Yale Child Study Center (YCSC). During this time, he simultaneously pursued an expertise in molecular genetics by enrolling in the Ph.D. program in the Department of Genetics at Yale. Dr. State was appointed Assistant Professor in the Child Study Center (Department of Child Psychiatry) in July of 2000. He currently divides his time between attending in the Tourette syndrome (TS) and Obsessive Compulsive Disorder (OCD) clinics and conducting research in the laboratory. This career award will provide vital support for his efforts to bridge clinical and basic science research. It will facilitate his continued patient-oriented research training, allow him to develop further expertise in relevant areas of molecular genetics and molecular cytogenetics, and provide the opportunity to achieve full scientific independence. The research plan presented below centers on the identification and characterization of genes that reside within a small region around a chromosomal inversion breakpoint found in a patient with a Tourette syndrome/Obsessive Compulsive Disorder (TS/OCD) phenotype. The developmental expression pattern of these genes will be assessed and the transcripts will be prioritized for further study with respect to their role in the TS/OCD spectrum of disorders. The proposal also plans for the development of a repository of cytogenetic abnormalities in well- characterized patients with TS/OCD phenotypes. The overarching objective of the award proposal, comprising both the career development and research plans, is to identify candidate genes in childhood neuropsychiatric disorders as a prelude to further investigations within the Child Study Center and the Children's Clinical Research Center (CCRC) that will focus on the relevance of these genes for the diagnosis, treatment, and natural history of TS/OCD. To help reach his long-term career objectives, the applicant has arranged for an outstanding group of mentors and advisors to provide guidance with respect to the design and conduct of his research, assistance in mastering the organizational challenges of running a successful research program, and training in the ethical issues attending research. He has formulated a plan for additional didactics and intensive workshops that will deepen his understanding of clinical statistical methodology, population genetics, gene expression analysis, genomics, and
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Tourette Syndrome
bioinformatics. Finally, his overall career development plan is made possible by the existence at Yale of a multidisciplinary team conducting translational research into the pathogenesis and treatment of childhood neuropsychiatnc disorders including TS/OCD, as well as the availability of the Children's Clinical Research Center (CCRC) which serves as a key resource in the conduct of this ongoing research. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MONAMINE TRANSPORTERS IN PARKINSONISM Principal Investigator & Institution: Levey, Allan I.; Professor; Neurology; Emory University 1784 North Decatur Road Atlanta, Ga 30322 Timing: Fiscal Year 2001; Project Start 30-SEP-1998; Project End 31-JUL-2003 Summary: Parkinson's disease (PD) is characterized by a preferential loss of nigrostriatal dopaminergic neurons, and the resultant depletion of dopamine innervation to the striatum is believed to be responsible for the hallmark symptoms of PD. The goal of this study is to test the hypothesis that regulation of the plasma membrane dopamine transporter (DAT) and the neuronal vesicular monoamine transporter (VMAT2) proteins mediate cellular susceptibility in experimental models of PD. It has been proposed that the varying susceptibility observed among different dopaminergic cell groups in idiopathic PD and in MPTP-induced parkinsonism is governed by the relative concentrations of DAT and VMAT2 protein. Specifically, the ratio of DAT to VMAT2, rather than the absolute levels of proteins, controls the cytosolic levels of the putative toxin and thus cellular susceptibility. Here, the applicants capitalize on in vitro and in vivo models recently developed in their laboratories using stable neuronal cell lines and transgenic animals expressing different levels of these transporters to further understand how DAT and VMAT2 expression participate in normal physiological function, as well as disease susceptibility. Therefore, they will test the following hypotheses: Hypothesis I: Stable neuronal cell lines expressing high ratios of DAT to VMAT2 will display increased vulnerability to the parkinsonism-inducing neurotoxin MPP+. Hypothesis II. Transgenic mice expressing high DAT to VMAT2 ratios will exhibit increased susceptibility to MPTP-induced parkinsonism. To test these hypotheses, the applicants propose the following aims: Specific aim 1. Produce stable neuron cell lines that express different ratios of DAT/VMAT2 and determine their susceptibility to MPP+. Specific aim 2. Examine the mechanisms by which MPP+ causes cellular damage in stable cell lines expressing different ratios of DAT/VMAT2 using microphysiology, fluorometry, and confocal microscopy. Specific aim 3. Assess dopamine function and MPTP susceptibility in transgenic mice expressing different levels of DAT and VMAT2 protein. The collective expertise of the participating laboratories will allow successful completion of these aims and thorough testing of these hypotheses, providing crucial data regarding how these transporters regulate both the normal function of dopaminergic neurons and the vulnerability of isolated cells in vitro and in intact animals, furthering our understanding of their role in the pathogenesis of PD. Furthermore, the tools and methods developed in this study will be invaluable to researchers studying other disorders in which monoaminergic function is perturbed, such as cocaine and amphetamine abuse, schizophrenia and Tourette syndrome. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MONOAMINE AND RELATED REGULATORY SYSTEMS IN TOURETTE'S Principal Investigator & Institution: Ciliax, Brian J.; Neurology; Emory University 1784 North Decatur Road Atlanta, Ga 30322
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Timing: Fiscal Year 2001; Project Start 30-SEP-2000; Project End 31-AUG-2004 Summary: (Verbatim from the Applicant's Abstract) A prominent theory of the pathophysiology of Tourette Syndrome (TS) is based on abnormal function of monoaminergic (e.g. dopaminergic, serotonergic, and noradrenergic) pathways in basal ganglia. The abnormality may lie within the neurochemistry of the "primary" monoaminergic systems themselves or that of "secondary" systems (e.g.) gonadal steroid receptors or oxytoxin and vasopressin pathways that project to basal ganglia), which regulate the basal ganglia or their monoamine afferents. Monoamines have been implicated in TS by metabolic abnormalities, increased dopamine transporter binding, and effective treatment with dopamine receptor blockers. However, gonadal steroids and their peptidergic effector systems also may be involved, since male to female ratios are disproportionate, changes in steroid hormone levels alter tic severity, and androgen antagonist were efficacious in preliminary trials. Moreover, steroid hormones and oxytocin and vasopressin pathways have distinct sex differences, have distinct ontogenic events that could account for the chldhood onet of TS, and regulate monoaminergic circuits and related locomotor and limbic behaviors. The goal of this research proposal is to determine if there are neurochemical alterations in either of these primary and secondary circuits that could cause the pathophysiology of TS. The specific neurochemicals to be studied will be the plasma membrane transporters for dopamine (DAT), sertonin (SERT), and norepinephrine (NET), and the vesicular monoamine transporter (VMAT2), gonadal steroid receptors (androgen (AR) and estrogen (ER)), and receptors for oxytocin (OT-R), and vasopressin (V1a). The specific techniques to be used include immunocytoghemistry quantitative immunoautoradiography, quantitative immunoautoradiography, quantitative counting methods, and quantitative radioligand binding autoradiography in postmortem TS brain tissue. Our transporter analysis will focus on the respective monoaminergic neurons in brainstem and their terminal fields in basal ganaglia, whereas the steroid receptor and neuropeptide receptor analyses will focus on parvocellular oxytocin and vasopressin neurons in paraventricular nucleus of hypothalamus and bed nucleus of stria terminalis/medial amygdala complex, and their terminal fields in brainstem monoamine cell groups and basal ganglia. The findings of this study will help elucidate the neurochemical changes that occur in TS and might suggest novel therapeutic strategies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEUROBIOLOGY OF DISEASE IN CHILDREN CONFERENCES Principal Investigator & Institution: Maria, Bernard L.; Pediatrics; University of Florida Gainesville, Fl 32611 Timing: Fiscal Year 2001; Project Start 15-APR-2001; Project End 31-AUG-2001 Summary: This grant application describes for symposia titled "Neurobiology of Disease in Children", to be held in conjunction with the 2001 to 2005 annual Child Neurology Society (CNS) meetings. Each of the conditions selected as symposia topicsleukodystrophy, tuberous sclerosis complex, neurofibromatosis, Rett syndrome, and Tourette syndrome- are significant to the child neurology community. The symposia directors are Dr. Hugo Moser (leukodystrophy) Dr. Steven Roach (tuberous sclerosis complex), Dr. Bruce Korf (neurofibromatosis), Dr. Alan Percy (Rett syndrome), and Dr. Harvey Singer (Tourette syndrome). CNS members will constitute the largest segment of the projected 100 to 150 attendees. The symposia will bring together clinicians, scientists, caregivers, and National Institutes of Health (NIH) program officers to determine how research findings can be translated to enhance clinical understanding and affect clinical practice. Moreover, symposia attendees will identify the clinical and
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Tourette Syndrome
basic research needed to advance diagnostic accuracy and develop safe and effective therapies for these disorders. In 1998, the NIH funded a symposium on Joubert syndrome held as a satellite meeting of the annual CNS conference that will serve as a model for the proposed scientific sessions. The overall aims are (1) to review scientific advances and determine their relevance to current and future clinical practice in child neurology; (2) to coordinate efforts among various clinical and basic science disciplines lay organizations, and NIH to review current research initiatives and define future directions; and (3) to disseminate symposia proceedings to ensure that clinical and basic science disciplines are informed about scientific advances, current research initiatives, and future directions. We believe the "Neurobiology of Disease in Children" symposia will contribute to advancing the field of child neurology by facilitating the exchange of information and coordination of research efforts across disciplines and organizations. The project will help further develop a symposium model that may be applied to a broader range of conditions that affect the child's nervous system. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SYNDROME
PARENT
TRAINING
FOR
CHILDREN
WITH
TOURETTE
Principal Investigator & Institution: Scahill, Lawrence D.; Associate Professor; None; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2001; Project Start 01-MAY-2001; Project End 30-APR-2004 Summary: This proposal requests funding to conduct a two-year pilot study on the effectiveness of Parent Management Training (PMT) in 32 children with Tourette syndrome and explosive, noncompliant behavior. Although Tourette syndrome (TS) is defined by chronic motor and phonic tics, clinically-identified children with TS often have comorbid obsessive-- compulsive symptoms (OCS), Attention Deficit Hyperactivity Disorder (ADHD) and/or noncompliant behavior. Parents describe these more complex cases as stubborn, irritable, argumentative, emotionally brittle, easily frustrated and prone to tantrums. Whether these problems are part of TS, secondary to TS or an unrelated comorbid behavioral profile is unknown. For children with this behavior profile, however, the care- taking demands can be extraordinary. Because the tics of TS are involuntary, parents may question the child's capacity to control this noncompliant and explosive behavior. This uncertainty threatens parental competence and may lead to inconsistent and insufficient parental control. The purpose of this PMT program is to improve the explosive and noncompliant behavior in children with TS by enhancing parental management of the disruptive and explosive behavior. PMT has been successfully applied to children with disruptive behavior problems in ADHD, but has not been applied to children with TS. The study will be conducted at the Yale Child Study Center in collaboration with the Tic Disorder Clinic, the ongoing Program Project in Tourette syndrome (P01MH49351) and the Research Unit in Pediatric Psychopharmacology (N01MH7009). Three successive waves of children and their families (10 to 12 per wave) will be recruited and then randomly assigned to the 12session PMT program developed by Barkley and colleagues (1997) or twelve weeks of standard treatment in the clinic. The primary outcome measures will include Oppositional Defiant Scale and the Clinician's Global Improvement score assessed at midpoint (6-week mark) and endpoint (11-week mark) by a clinician who is blind to treatment assignment. The same clinician will evaluate the durability of PMT in this population at six weeks and twelve weeks posttreatment. Children who were randomly assigned to standard treatment will be invited to participate in the PMT program and will also be independently assessed at six and twelve weeks. This design will permit
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two sets of analysis: short-term efficacy (change from baseline in randomly assigned groups after the 11-session intervention); durability of PMT (evidence of sustained benefit up to 12 weeks post-treatment). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PET STUDY OF BIOCHEMISTRY AND METABOLISM OF THE CNS Principal Investigator & Institution: Frey, Kirk A.; Professor; Internal Medicine; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2001; Project Start 01-DEC-1979; Project End 31-JUL-2006 Summary: This Program Project focuses on in vivo neurochemistry of human neurological disorders, emphasizing subcortical structures and their interactions in neurodegenerative and idiopathic functional disorders of movement. Studies in the proposal combine neurochemical phenotypes with functional measures, the latter including motor performance, blood flow activation, neurotransmitter release, ans aspects of sleep physiology. The Program consists of 4 Scientific Projects and 3 Cores. Project by Kilbourn, "New Radiotracers for Neurological PET", will introduce a novel functional approach to assessment of GABAA receptors through allosteric ligands of the chloride ionophore. GABAergic projects are critical components of striatal output and other extrapyrimidal sites. Assessment of GABAA function will complement glucose metabolism studies that may preferentially reflect excitatory glutamatergic pathways. Project by Frey, "Striatal Dopamine and Motor Performance in Aging and Parkinson's Disease" will determine functional motor correlates of nigrostriatal dopaminergic losses in aging and Parkinson's disease and will assess their reversal by acute dopaminergic challenge. Project by Gilman, "Neurochemical and Sleep Disorders in Multiple System Atrophy", will assess the relationships between disrupted sleep in extrapyrimidal neurodegeneration and brain stem cholinergic projections. Project by Albin, "Dopamine Synaptic Mechanisms in Tourette Syndrome", will assess striatal dopaminergic projects and their function from a multi-faceted approach, including measures of their density, their capacity for dopamine re-uptake, their capacity for dopamine release, and an assessment of ambient synaptic dopamine occupancy of D2-type dopamine receptors. Cyclotron/Radiochemistry, Tomography and Data Analysis, and Administrative Core functions support each Project. Overall , the disorders under study in this Program are of unknown pathogenesis and have only symptomatic therapies. The proposed studies will lead to enhanced insight into extrapyrimidal neurochemistry and will address important aspects of dysfunction and disability in these disorders. Novel and improved therapies and new pathophysiological mechanisms and insight may ultimately result. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PHARMACOGENETICS IN TOURETTE SYNDROM Principal Investigator & Institution: Singer, Harvey S.; Professor; Neurology and Neurosurgery; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2003; Project Start 15-SEP-2003; Project End 31-AUG-2005 Summary: (provided by applicant): When individuals with Tourette syndrome (TS) are treated with medications to suppress tics, some improve, others have little or no response, and several may develop significant side effects. In order to explain this variability, pharmacogenetic research has focused on two major areas, drug metabolism and drug site of action. In this study, genetic variations of metabolizing enzymes (CYP2D6), dopamine & serotonin transporters (DAT, 5-HTT) dopamine receptors (D2,
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Tourette Syndrome
D3, D4) and serotonin receptors (5HT2a and 5HT2c) will be determined with the goal of predicting a TS patients response to treatment and a diagnostic category (TS or control). Fifteen established polymorphisms will be investigated in individuals with the diagnosis of TS using DNA obtained by buccal swabs. The first major objectives is to determine whether the presence of specific patterns of neurotransmitter polymorphisms predict the tic-suppressing pharmacologic effect of the atypical neuroleptic, risperidone. Patient response to pharmacotherapy will be based on a prospective evaluation of tic reduction, as measured by the Total Tic score of the Yale Global Tic Severity Scale, in 200 individuals with TS. This approach is similar to one that has been successfully used in schizophrenia to predict, with nearly 80% success, the response to the atypical neuroleptic, clozapine. Our second goal is to determine whether there are associations between genetic variations in dopamine or serotonin receptors and the etiology of TS. This question will be addressed in a cohort of 500 individuals with TS & compared with an equal number of age and sex-matched controls. This application, defines a study (to my knowledge, the first of its kind in TS), which will use DNA obtained from buccal mucosa, to establish a predictive therapeutic index in TS patients. The identification of genetic polymorphisms that are associated with clinical disease or treatment success, has obvious benefits. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PLASTICITY OF GAD GENE EXPRESSION IN THE BASAL GANGLIA Principal Investigator & Institution: Chesselet, Marie-Francoise S.; Charles H. Markham Professor of Neurolog; Brain Research Institute; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2003; Project Start 01-FEB-1990; Project End 31-JAN-2008 Summary: (provided by applicant): The striatum is involved in pervasive motor and psychiatric disorders such as Parkinsons's and Huntington's disease, schizophrenia, dystonia, Tourette syndrome, and attention deficit and obsessive compulsive disorders. It has been recently recognized that a subpopulation of fast-spiking GABAergic interneurons is a critical element of striatal circuitry. These interneurons provide the major source of inhibition within the striatum. They powerfully inhibit large numbers of striatal efferent neurons and mediate their feed forward inhibition by cortical inputs. These GABAergic interneurons have unique molecular properties among striatal neurons, in particular a high level of expression of GAD67, parvalbumin, and the shawlike potassium channel KV3.1. In addition, they are coupled electrotonically by GAP junctions made of connexin-36. They are regulated by nigrostriatal dopaminergic neurons, and depend on BDNF for their development. We will use a multidisciplinary approach combining molecular, morphological and electrophysiological techniques in genetically altered mice to elucidate the role of connexin-36, Kv3.1, dopamine and BDNF in the regulation of the molecular and functional properties of these fast-spiking GABAergic interneurons. We will measure Parvalbumin, GAD67, Kv3.1, connexin-36, and their mRNA by immunohistochemistry and single cell semi-quantitative in situ hybridization histochemistry, respectively. Changes in electrophysioiogical properties (action potential characteristics, spike trains, electrotonic coupling and cortical inputs) of the striatal fast-spiking GABAergic interneurons will be analyzed in striatal slices. These experiments will be done in mice lacking intrinsic molecules that may be critical for the functional properties of the fast-spiking GABAergic interneurons, specifically connexin36 and Kv3.1, and in mice with alteration in extrinsic factors known to alter the function of these interneurons, specifically dopamine and Brain Derived Growth Factor (BDNF).
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These studies will provide basic information on the mechanisms involved in the maturation of a crucial population of striatal GABAerglc neurons and provide new cues for striatal pathologies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: POPULATION GENETIC MAPPING OF TOURETTE SYNDROME Principal Investigator & Institution: Freimer, Nelson B.; Professor and Director; None; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2001; Project Start 30-APR-1998; Project End 31-JAN-2004 Summary: (Adapted from investigator's abstract): This is a proposal to identify the chromosomal location of genes responsible for Tourette Syndrome (TS), an inherited disorder characterized by motor and vocal tics. They plan studies of two genetically homogeneous populations that have expanded rapidly over the past few hundred years: that of the Central Valley of Costa Rica (CR) and that of Ashkenazi Jews in the United States. TS patients in these populations may have inherited a susceptibility to this disorder from one or a few common ancestors. TS genes will be mapped by searching for genomic regions that TS patients share identical by descent (IBD) from such ancestors; these regions will include the TS genes, and may differ between the two populations. They will search for IBD regions by randomly sampling only affected individuals and their parents from these isolated populations. The study sample will consist of individuals moderately to severely affected with TS, about 100 from CR and about 200 Ashkenazim. Diagnostic assessment will include interviews of patients and family members and review of medical records; final diagnoses will be assigned through a 'best estimate' consensus process conducted by experts in diagnosing TS. Genealogies will be obtained for all subjects, who will be included in the study only if most of their ancestors were from the target populations. The samples will be genotyped using markers distributed throughout the genome. Evaluation of IBD in each genome region will be accomplished using association tests. Their computer simulation power studies show a high probability of detecting TS loci in each study population, even if TS is etiologically heterogeneous within each population. Once TS genes are localized, finemapping studies will begin, leading to positional cloning efforts. Also, clinical questions relevant to understanding the cause and course of TS will be addressed using the patients sampled for the PGM studies. They have completed preliminary studies to show the feasibility of the sampling, diagnostic, and genotyping approaches described in this proposal. The sampling will be facilitated by ongoing collaborations in CR and new collaborations with several TS centers in the U.S. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: SOLID-PHASE APPROACH TO THE SYNTHESIS OF CII PET TRACERS Principal Investigator & Institution: Lepore, Salvatore D.; Chemistry and Biochemistry; Florida Atlantic University Boca Raton, Fl 33431 Timing: Fiscal Year 2003; Project Start 01-MAY-2003; Project End 30-APR-2005 Summary: (provided by applicant): Positron emission tomography (PET) is a powerful tool that utilizes radioisotope-labeled molecules (PET tracers) to study the biochemistry and distribution of these molecules in the human brain. A considerable fraction of PET studies involve the use of 11C-labeled PET tracers. Due to the short half-life of the 11Cisotope (20 minutes), the synthesis of 11C-PET tracers must be preformed in an
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Tourette Syndrome
extremely short timeframe if the tracer is to retain sufficient radio-emitting properties to be useful as an imaging agent. Thus the growth of the 11C-PET technique has been closely tied to the development of new rapid synthesis and purification methods. In this proposal, we outline the development of a novel solid-phase technique that should significantly expedite the synthesis of 11C-PET tracers that should find application in a wide variety of therapeutic areas (including brain imaging). In our proposed approach, a PET tracer precursor is covalently attached to a designed polymer resin followed by the addition of cyclotron-derived hydrogen cyanide. This reaction sequence should result in the formation of the desired 11C-PET tracer as the only product. Thus, this resin-based strategy has been designed to avoid the traditional reaction purification step, leaving more time for the synthesis of PET tracers with potentially higher specific radioactivities and greater molecular complexity than previously possible. Based on various hypotheses on the mechanism of the cyanide addition reaction, a series of resins have been designed to maximize the rate of 11C-PET-tracer production. We also propose to employ this new methodology in the first 11C-synthesis of two gammabutyric acid (GABA) receptor agonists 11C-GABOB and 11C-baclofen. CABOB has been prescribed for the treatment of epilepsy and baclofen is widely-used for the management of spasticity exhibited in multiple sclorosis, Tourette Syndrome, and dystonia. The creation of radioisotope-labeled analogs of CABOB and baclofen for PET studies should significantly further our understanding of these drugs and potentially lead to the development of new therapies for treating central nervous system diseases. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: STREP THROAT, SYDENHAM CHOREA, AND TOURETTE SYNDROME Principal Investigator & Institution: Mcmahon, William M.; Associate Professor; Psychiatry; University of Utah Salt Lake City, Ut 84102 Timing: Fiscal Year 2001; Project Start 01-MAR-2000; Project End 28-FEB-2005 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: TESTING DOPAMINERGIC FUNCTION USING PHARMACOLOGIC FMRI Principal Investigator & Institution: Black, Kevin J.; Psychiatry; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2002; Project Start 15-DEC-2001; Project End 30-NOV-2003 Summary: Many important neurological and psychiatric illnesses involve abnormalities of dopamine function. Positron emission tomography (PET) has been used to quantify the regional sensitivity of the brain to activation of dopaminergic pathways. However, for repeated serial studies or in children, PET may be less appropriate. This R21 application proposes to implement a novel method using functional MRI to measure cerebral blood oxygen-level dependent (COLD) responses to the mixed dopamine agonist apomorphine in normal humans. Furthermore, we will validate this pharmacological challenge functional MRI (phMRI) method in the following ways: (1) Test with a single-blind protocol whether such responses are specifically related to drug; (2) test whether the phMRI method is sensitive to important functional differences, by comparing BOLD responses are neurologically relevant, by determining the magnitude and time course of clinical improvement in PD patients at similar apomorphine blood levels to those achieved in controls, and by measuring in all subjects the growth
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hormone response to apomorphine. At present there are no published data with dopamine agonist phMRI in humans to guide this pilot study. However, successful apomorphine challenge phMRI experiments in non-human species and apomorphine challenge PET studies in humans, together with our own recent successful development of levodopa challenge phMRI in humans, suggest that the proposed approach is feasible. If this translational research is successful, it will bring a method previously tested only in other species to a finished state in which it could be immediately applied to the study of human diseases. In this laboratory, exp3ected applications of this method would include longitudinal studies of treatment-induced side effects in Parkinson's disease, and pathophysiological studies in Tourette syndrome or dopa-related dystonia. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: THE ROLE OF NOREPINEPHRINE IN HYPERACTIVITY DISORDERS Principal Investigator & Institution: Bruno, Kristy J.; Neuroscience and Anatomy; Pennsylvania State Univ Hershey Med Ctr 500 University Dr Hershey, Pa 17033 Timing: Fiscal Year 2001; Project Start 15-AUG-2001 Summary: (provided by applicant): Hyperactivity is associated with several human neurological disorders, such as attention deficit hyperactivity disorder (ADHD) and Tourette syndrome (TS). The coloboma mouse represents a model of spontaneous hyperactivity. Coloboma mice have a heterozygous, semidominant deletion mutation on mouse chromosome 2 that spans the Snap gene and causes a 50% reduction in SNAP-25 (synaptosomal-associated protein). SNAP-25 is a presynaptic docking protein that regulates exocytotic neurotransmitter release. Therefore, it is likely that presynaptic mechanisms are responsible for the hyperactivity of coloboma mice. In fact, presynaptic dopamine (DA) regulation is thought to play a major role in hyperactivity disorders. Dopaminergic abnormalities in patients who have such disorders have been studied intensively for several decades. However, it is becoming increasingly clear that norepinephrine (NE) also plays a role. The majority of drugs efficacious in the treatment of ADHD modify both DA and NE neurotransmission. Indeed, administration of clonidine, an a2-adrenergic receptor agonist that inhibits NE release, ameliorates symptoms in some ADHD and TS patients. Studies of coloboma mice also implicate NE in hyperactive behavior. Coloboma mice have high levels of NE in the striatum and nucleus accumbens, brain regions implicated in movement and attention, respectively. Destruction of noradrenergic terminals with neurotoxin DSP-4 decreases locomotor activity of coloboma mice. Thus, coloboma mice may be extremely useful for determining the role of NE in the regulation of hyperactivity. We hypothesize that aberrant neurotransmission of NE contributes to the hyperactivity of these mice. The specific aims of this proposal are 1) to determine if noradrenergic challenge will ameliorate the coloboma phenotype, and 2) to determine the effect of drug challenge on neurotransmitter release. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: TIC: TOURETTE INTERVENTION FOR CHILDREN Principal Investigator & Institution: Holtz, Kristen D.; Vice President of Child and Family Healt; Danya International, Inc. 8737 Colesville Rd, Ste 1200 Silver Spring, Md 20910 Timing: Fiscal Year 2001; Project Start 26-SEP-2001; Project End 31-AUG-2003 Summary: In Phase I of this SBIR project, Danya International, Inc., in collaboration with a team of experts, developed a video-based intervention package to educate school-aged
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children about Tourette Syndrome (TS). This intervention package, entitled "You've Got A Friend," provides information, prosocial messages, and interactional strategies to foster acceptance and social integration for children with TS. Building on the success of Phase I, Phase II will include three tasks that will expand the intervention package. First, we will develop a video for older children with Tourette Syndrome. The video will be developed in collaboration with a team of teens with TS who will provide extensive input on the content, design and presentation of the video. Second, a supporting website for the intervention package will be programmed, which will contain information for teachers, parents and children with and without TS. Finally, a full-scale, nationwide empirical evaluation of the effectiveness of the intervention package will be conducted. This evaluation will explore whether or not presentation of the video intervention in the classroom of a child with TS has an impact on the social adjustment of that child, as reported through three informants: the teacher, the parent and the child himself. All of the intervention materials will also be translated, filmed, and printed in Spanish. PROPOSED COMMERCIAL APPLICATION: The TIC intervention package will be marketed as an educational tool to newly diagnosed children, their teachers, peers, and parents. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “Tourette syndrome” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for Tourette syndrome in the PubMed Central database: •
Epigenetic abnormalities associated with a chromosome 18(q21-q22) inversion and a Gilles de la Tourette syndrome phenotype. by State MW, Greally JM, Cuker A, Bowers PN, Henegariu O, Morgan TM, Gunel M, DiLuna M, King RA, Nelson C, Donovan A, Anderson GM, Leckman JF, Hawkins T, Pauls DL, Lifton RP, Ward DC.; 2003 Apr 15; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=153616
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Prevalence of tics and Tourette syndrome in an inpatient adult psychiatry setting. by Eapen V, Laker M, Anfield A, Dobbs J, Robertson MM.; 2001 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=167200
3 4
Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.
With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.
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The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with Tourette syndrome, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “Tourette syndrome” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for Tourette syndrome (hyperlinks lead to article summaries): •
A clinical study of Gilles de la Tourette syndrome in the United Kingdom. Author(s): Lees AJ, Robertson M, Trimble MR, Murray NM. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 1984 January; 47(1): 1-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6582230&dopt=Abstract
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A controlled study of psychopathology and associated symptoms in Tourette syndrome. Author(s): Rickards H, Robertson M. Source: World J Biol Psychiatry. 2003 April; 4(2): 64-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12692776&dopt=Abstract
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A family study of Tourette syndrome in Japan. Author(s): Kano Y, Ohta M, Nagai Y, Pauls DL, Leckman JF. Source: American Journal of Medical Genetics. 2001 July 8; 105(5): 414-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11449392&dopt=Abstract
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A functional neuroanatomy of tics in Tourette syndrome. Author(s): Stern E, Silbersweig DA, Chee KY, Holmes A, Robertson MM, Trimble M, Frith CD, Frackowiak RS, Dolan RJ. Source: Archives of General Psychiatry. 2000 August; 57(8): 741-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10920461&dopt=Abstract
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A neurobiological model for Tourette syndrome centered on the nucleus accumbens. Author(s): Brito GN. Source: Medical Hypotheses. 1997 August; 49(2): 133-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9278925&dopt=Abstract
6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.
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Tourette Syndrome
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A perplexing document in the early history of Gilles de la Tourette Syndrome: Melotti's rendition of a “Lecture of Charcot” (including a complete translation from the Italian with commentary). Author(s): Kushner HI, Luzzatti C, Finger S. Source: Journal of the History of the Neurosciences. 1999 April; 8(1): 5-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11624136&dopt=Abstract
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A placebo-controlled trial of risperidone in Tourette syndrome. Author(s): Scahill L, Leckman JF, Schultz RT, Katsovich L, Peterson BS. Source: Neurology. 2003 April 8; 60(7): 1130-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12682319&dopt=Abstract
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Abnormalities of the acoustic startle reflex and reaction time in gilles de la tourette syndrome. Author(s): Gironell A, Rodriguez-Fornells A, Kulisevsky J, Pascual B, Riba J, Barbanoj M, Berthier M. Source: Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology. 2000 August; 111(8): 1366-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10904216&dopt=Abstract
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Altered inhibition of motor responses in Tourette Syndrome and ObsessiveCompulsive Disorder. Author(s): Johannes S, Wieringa BM, Mantey M, Nager W, Rada D, Muller-Vahl KR, Emrich HM, Dengler R, Munte TF, Dietrich D. Source: Acta Neurologica Scandinavica. 2001 July; 104(1): 36-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11442441&dopt=Abstract
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Amantadine in Tourette syndrome. Author(s): Borison RL, Davis JM. Source: Curr Psychiatr Ther. 1983; 22: 127-30. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6587960&dopt=Abstract
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An atypical case of Gilles de la Tourette syndrome. Author(s): Sirota P, Mark M, Meshulam B, Wijsenbeek H. Source: The Israel Journal of Psychiatry and Related Sciences. 1984; 21(1): 69-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6595249&dopt=Abstract
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An international perspective on Tourette syndrome: selected findings from 3,500 individuals in 22 countries. Author(s): Freeman RD, Fast DK, Burd L, Kerbeshian J, Robertson MM, Sandor P. Source: Developmental Medicine and Child Neurology. 2000 July; 42(7): 436-47. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10972415&dopt=Abstract
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An update on the genetics of Gilles de la Tourette syndrome. Author(s): Pauls DL. Source: Journal of Psychosomatic Research. 2003 July; 55(1): 7-12. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12842226&dopt=Abstract
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Antiphospholipid antibodies: an epiphenomenon in Tourette syndrome. Author(s): Singer HS, Krumholz A, Giuliano J, Kiessling LS. Source: Movement Disorders : Official Journal of the Movement Disorder Society. 1997 September; 12(5): 738-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9380057&dopt=Abstract
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Antistreptococcal, neuronal, and nuclear antibodies in Tourette syndrome. Author(s): Loiselle CR, Wendlandt JT, Rohde CA, Singer HS. Source: Pediatric Neurology. 2003 February; 28(2): 119-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12699862&dopt=Abstract
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Anti-striatal antibodies in Tourette syndrome cause neuronal dysfunction. Author(s): Hallett JJ, Harling-Berg CJ, Knopf PM, Stopa EG, Kiessling LS. Source: Journal of Neuroimmunology. 2000 November 1; 111(1-2): 195-202. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11063838&dopt=Abstract
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Association between the low molecular weight cytosolic acid phosphatase gene ACP1*A and comorbid features of Tourette syndrome. Author(s): Bottini N, MacMurray J, Rostamkani M, McGue M, Iacono WG, Comings DE. Source: Neuroscience Letters. 2002 September 20; 330(2): 198-200. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12231445&dopt=Abstract
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Attention deficit hyperactivity disorder and Tourette syndrome: what's the best treatment? Author(s): Nass R, Bressman S. Source: Neurology. 2002 February 26; 58(4): 513-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11865123&dopt=Abstract
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Attention deficit hyperactivity disorder in the presence of Tourette syndrome. Author(s): Freeman RD. Source: Neurologic Clinics. 1997 May; 15(2): 411-20. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9115471&dopt=Abstract
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Autism spectrum disorders: relevance to Tourette syndrome. Author(s): Rapin I. Source: Adv Neurol. 2001; 85: 89-101. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11530449&dopt=Abstract
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Baclofen treatment in Tourette syndrome: a double-blind, placebo-controlled, crossover trial. Author(s): Singer HS, Wendlandt J, Krieger M, Giuliano J. Source: Neurology. 2001 March 13; 56(5): 599-604. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11245709&dopt=Abstract
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Basal ganglia peptidergic staining in Tourette syndrome. A follow-up study. Author(s): Haber SN, Wolfer D. Source: Adv Neurol. 1992; 58: 145-50. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1414617&dopt=Abstract
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Basal Ganglia volumes in patients with Gilles de la Tourette syndrome. Author(s): Peterson BS, Thomas P, Kane MJ, Scahill L, Zhang H, Bronen R, King RA, Leckman JF, Staib L. Source: Archives of General Psychiatry. 2003 April; 60(4): 415-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12695320&dopt=Abstract
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Behavior disorder and attention deficits in boys with Tourette syndrome. Author(s): Sverd J, Curley AD, Jandorf L, Volkersz L. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 1988 July; 27(4): 413-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3182596&dopt=Abstract
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Behavior disturbance in children with Tourette syndrome. Author(s): Wilson RS, Garron DC, Tanner CM, Klawans HL. Source: Adv Neurol. 1982; 35: 329-33. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6959509&dopt=Abstract
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Behavior therapy for obsessive-compulsive disorder and trichotillomania. Implications for Tourette syndrome. Author(s): Baer L. Source: Adv Neurol. 1992; 58: 333-40. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1414641&dopt=Abstract
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Behavioral and emotional aspects of Tourette syndrome. Author(s): Coffey BJ, Park KS. Source: Neurologic Clinics. 1997 May; 15(2): 277-89. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9115461&dopt=Abstract
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Behavioral effects of haloperidol in young Tourette syndrome patients. Author(s): Bogomolny A, Erenberg G, Rothner AD. Source: Adv Neurol. 1982; 35: 427-32. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6959520&dopt=Abstract
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Behavioral treatments for Tourette syndrome and tic disorders: state of the art. Author(s): Piacentini J, Chang S. Source: Adv Neurol. 2001; 85: 319-31. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11530440&dopt=Abstract
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Bilateral globus pallidus lesions in a patient with Tourette syndrome and related disorders. Author(s): Demirkol A, Erdem H, Inan L, Yigit A, Guney M. Source: Biological Psychiatry. 1999 September 15; 46(6): 863-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10494458&dopt=Abstract
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Bilineal transmission in Tourette syndrome. Author(s): Hanna PA, Janjua FN, Contant CF, Jankovic J. Source: Neurology. 1999 September 11; 53(4): 813-8. Erratum In: Neurology 1999 October 22; 53(7): 1612. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10489047&dopt=Abstract
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Biogenic amine metabolism in Tourette syndrome. Author(s): Butler IJ, Koslow SH, Seifert WE Jr, Caprioli RM, Singer HS. Source: Annals of Neurology. 1979 July; 6(1): 37-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=292354&dopt=Abstract
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Blood serotonin and tryptophan in Tourette syndrome. Author(s): Comings DE. Source: American Journal of Medical Genetics. 1990 August; 36(4): 418-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2389798&dopt=Abstract
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Blunted growth hormone response to clonidine in Gilles de la Tourette syndrome. Author(s): Muller N, Putz A, Klages U, Hofschuster E, Straube A, Ackenheil M. Source: Psychoneuroendocrinology. 1994; 19(4): 335-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8047638&dopt=Abstract
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Breakpoint sequences of an 1;8 translocation in a family with Gilles de la Tourette syndrome. Author(s): Matsumoto N, David DE, Johnson EW, Konecki D, Burmester JK, Ledbetter DH, Weber JL. Source: European Journal of Human Genetics : Ejhg. 2000 November; 8(11): 875-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11093278&dopt=Abstract
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Brief report: cases for an association between Tourette syndrome, autistic disorder, and schizophrenia-like disorder. Author(s): Sverd J, Montero G, Gurevich N. Source: Journal of Autism and Developmental Disorders. 1993 June; 23(2): 407-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8331056&dopt=Abstract
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Brief report: effects of propranolol in Tourette syndrome. Author(s): Sverd J, Cohen S, Camp JA. Source: Journal of Autism and Developmental Disorders. 1983 June; 13(2): 207-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6345501&dopt=Abstract
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Candidate region for Gilles de la Tourette syndrome at 7q31. Author(s): Kroisel PM, Petek E, Emberger W, Windpassinger C, Wladika W, Wagner K. Source: American Journal of Medical Genetics. 2001 July 1; 101(3): 259-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11424142&dopt=Abstract
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Card sorting performance and ADHD symptomatology in children and adolescents with tourette syndrome. Author(s): Cirino PT, Chapieski LM, Massman PJ. Source: J Clin Exp Neuropsychol. 2000 April; 22(2): 245-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10779838&dopt=Abstract
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Catechol-O-methyltransferase and Gilles de la Tourette syndrome. Author(s): Barr CL, Wigg KG, Sandor P. Source: Molecular Psychiatry. 1999 September; 4(5): 492-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10523824&dopt=Abstract
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Cavum septi pellucidi in Tourette syndrome. Author(s): Kim KJ, Peterson BS. Source: Biological Psychiatry. 2003 July 1; 54(1): 76-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12842311&dopt=Abstract
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Children with Tourette syndrome: results of psychological tests given prior to drug treatment. Author(s): Ferrari M, Matthews WS, Barabas G. Source: Journal of Developmental and Behavioral Pediatrics : Jdbp. 1984 June; 5(3): 1169. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6588056&dopt=Abstract
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Clinical and molecular genetics of ADHD and Tourette syndrome. Two related polygenic disorders. Author(s): Comings DE. Source: Annals of the New York Academy of Sciences. 2001 June; 931: 50-83. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11462757&dopt=Abstract
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Clinical characteristics of Tourette syndrome probands and relatives' risks. Author(s): Kano Y, Leckman JF, Pauls DL. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 2002 October; 41(10): 1148-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12364837&dopt=Abstract
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Clinical phenomenology of episodic rage in children with Tourette syndrome. Author(s): Budman CL, Rockmore L, Stokes J, Sossin M. Source: Journal of Psychosomatic Research. 2003 July; 55(1): 59-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12842232&dopt=Abstract
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Clinical psychopharmacology for Tourette syndrome and associated disorders. Author(s): Riddle MA, Carlson J. Source: Adv Neurol. 2001; 85: 343-54. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11530442&dopt=Abstract
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Clonidine treatment increases tics in patients with Tourette syndrome: case report. Author(s): Kessler AR. Source: Journal of Child Neurology. 2001 May; 16(5): 380-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11392527&dopt=Abstract
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Cognitive function paradigms: implications of neurophysiological studies of dopamine stimulants for Tourette syndrome and comorbid attention-deficit hyperactivity disorder. Author(s): Walters JR, Ruskin DN, Baek D, Allers KA, Bergstrom DA. Source: Adv Neurol. 2001; 85: 133-49. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11530423&dopt=Abstract
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Coincident infantile autism and Tourette syndrome: a case report. Author(s): Barabas G, Matthews WS. Source: Journal of Developmental and Behavioral Pediatrics : Jdbp. 1983 December; 4(4): 280-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6582069&dopt=Abstract
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Color vision deficiencies in Gilles de la Tourette syndrome. Author(s): Melun JP, Morin LM, Muise JG, DesRosiers M. Source: Journal of the Neurological Sciences. 2001 May 1; 186(1-2): 107-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11412879&dopt=Abstract
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Comorbid Down's syndrome, Tourette syndrome and intellectual disability: registry prevalence and developmental course. Author(s): Kerbeshian J, Burd L. Source: Journal of Intellectual Disability Research : Jidr. 2000 February; 44 ( Pt 1): 60-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10711651&dopt=Abstract
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Complex phonic tic and disinhibition in Tourette syndrome: case report. Author(s): Maia DP, Cardoso F. Source: Arquivos De Neuro-Psiquiatria. 2001 September; 59(3-A): 587-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11588640&dopt=Abstract
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Complex segregation analysis of families ascertained through Gilles de la Tourette syndrome. Author(s): Seuchter SA, Hebebrand J, Klug B, Knapp M, Lehmkuhl G, Poustka F, Schmidt M, Remschmidt H, Baur MP. Source: Genetic Epidemiology. 2000 January; 18(1): 33-47. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10603457&dopt=Abstract
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Complex segregation analysis of Gilles de la Tourette syndrome: further evidence for a major locus mode of transmission. Author(s): Devor EJ. Source: American Journal of Human Genetics. 1984 May; 36(3): 704-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6587775&dopt=Abstract
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Could Tourette syndrome be a neurologic manifestation of rheumatic fever? Author(s): Kurlan R. Source: Adv Neurol. 2001; 85: 307-10. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11530437&dopt=Abstract
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Cultural influences on diagnosis and perception of Tourette syndrome in Costa Rica. Author(s): Mathews CA, Herrera Amighetti LD, Lowe TL, van de Wetering BJ, Freimer NB, Reus VI. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 2001 April; 40(4): 456-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11314572&dopt=Abstract
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Current issues in Tourette syndrome. Author(s): Singer HS. Source: Movement Disorders : Official Journal of the Movement Disorder Society. 2000 November; 15(6): 1051-63. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11104186&dopt=Abstract
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D2-like dopamine receptor density in Tourette syndrome measured by PET. Author(s): Wong DF, Singer HS, Brandt J, Shaya E, Chen C, Brown J, Kimball AW, Gjedde A, Dannals RF, Ravert HT, Wilson PD, Wagner HN Jr. Source: Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine. 1997 August; 38(8): 1243-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9255158&dopt=Abstract
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Deanol in Gilles de la Tourette Syndrome: a preliminary investigation. Author(s): Pinta ER. Source: Dis Nerv Syst. 1977 March; 38(3): 214-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=264808&dopt=Abstract
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Delayed and severe but transient Tourette syndrome after head injury. Author(s): Majumdar A, Appleton RE. Source: Pediatric Neurology. 2002 October; 27(4): 314-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12435574&dopt=Abstract
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Delta 9-tetrahydrocannabinol (THC) is effective in the treatment of tics in Tourette syndrome: a 6-week randomized trial. Author(s): Muller-Vahl KR, Schneider U, Prevedel H, Theloe K, Kolbe H, Daldrup T, Emrich HM. Source: The Journal of Clinical Psychiatry. 2003 April; 64(4): 459-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12716250&dopt=Abstract
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Dermatological manifestations of Tourette syndrome and obsessive-compulsive disorder. Author(s): Jankovic J, Sekula S. Source: Archives of Dermatology. 1998 January; 134(1): 113-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9449929&dopt=Abstract
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Detection of major gene for Gilles de la Tourette syndrome. Author(s): Comings DE, Comings BG, Devor EJ, Cloninger CR. Source: American Journal of Human Genetics. 1984 May; 36(3): 586-600. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6587774&dopt=Abstract
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Developmental perspective of the Gilles de la Tourette syndrome. Author(s): Incagnoli T, Kane R. Source: Percept Mot Skills. 1983 December; 57(3 Pt 2): 1271-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6582444&dopt=Abstract
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Developmental processes and brain imaging studies in Tourette syndrome. Author(s): Gerard E, Peterson BS. Source: Journal of Psychosomatic Research. 2003 July; 55(1): 13-22. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12842227&dopt=Abstract
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Diagnosing Tourette syndrome: is it a common disorder? Author(s): Robertson MM. Source: Journal of Psychosomatic Research. 2003 July; 55(1): 3-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12842225&dopt=Abstract
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Diagnostic criteria for genetic studies of Tourette syndrome. Author(s): Kurlan R. Source: Archives of Neurology. 1997 May; 54(5): 517-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9152107&dopt=Abstract
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Differences in clinical characteristics between Tourette syndrome patients with and without 'generalized tics' or coprolalia. Author(s): Kano Y, Ohta M, Nagai Y. Source: Psychiatry and Clinical Neurosciences. 1997 December; 51(6): 357-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9472118&dopt=Abstract
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Disruption of a novel gene (IMMP2L) by a breakpoint in 7q31 associated with Tourette syndrome. Author(s): Petek E, Windpassinger C, Vincent JB, Cheung J, Boright AP, Scherer SW, Kroisel PM, Wagner K. Source: American Journal of Human Genetics. 2001 April; 68(4): 848-58. Epub 2001 March 09. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11254443&dopt=Abstract
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Disturbed monitoring and response inhibition in patients with Gilles de la Tourette syndrome and co-morbid obsessive compulsive disorder. Author(s): Muller SV, Johannes S, Wieringa B, Weber A, Muller-Vahl K, Matzke M, Kolbe H, Dengler R, Munte TF. Source: Behavioural Neurology. 2003; 14(1-2): 29-37. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12719636&dopt=Abstract
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Disturbed sleep in children with Tourette syndrome: a polysomnographic study. Author(s): Kostanecka-Endress T, Banaschewski T, Kinkelbur J, Wullner I, Lichtblau S, Cohrs S, Ruther E, Woerner W, Hajak G, Rothenberger A. Source: Journal of Psychosomatic Research. 2003 July; 55(1): 23-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12842228&dopt=Abstract
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Do the same genes predispose to Gilles de la Tourette syndrome and dystonia? Report of a new family and review of the literature. Author(s): Nemeth AH, Mills KR, Elston JS, Williams A, Dunne E, Hyman NM. Source: Movement Disorders : Official Journal of the Movement Disorder Society. 1999 September; 14(5): 826-31. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10495045&dopt=Abstract
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Dopamine D2 receptor gene (DRD2) haplotypes and the defense style questionnaire in substance abuse, Tourette syndrome, and controls. Author(s): Comings DE, MacMurray J, Johnson P, Dietz G, Muhleman D. Source: Biological Psychiatry. 1995 June 1; 37(11): 798-805. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7647164&dopt=Abstract
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Dopamine D2 receptor imaging in Gilles de la Tourette syndrome. Author(s): Muller-Vahl KR, Berding G, Kolbe H, Meyer GJ, Hundeshagen H, Dengler R, Knapp WH, Emrich HM. Source: Acta Neurologica Scandinavica. 2000 March; 101(3): 165-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10705938&dopt=Abstract
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Dopamine transporter binding in Gilles de la Tourette syndrome. Author(s): Muller-Vahl KR, Berding G, Brucke T, Kolbe H, Meyer GJ, Hundeshagen H, Dengler R, Knapp WH, Emrich HM. Source: Journal of Neurology. 2000 July; 247(7): 514-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10993492&dopt=Abstract
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Dopa-responsive dystonia and Tourette syndrome in a large Danish family. Author(s): Romstad A, Dupont E, Krag-Olsen B, Ostergaard K, Guldberg P, Guttler F. Source: Archives of Neurology. 2003 April; 60(4): 618-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12707079&dopt=Abstract
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Dysfluency and phonic tics in Tourette syndrome: a case report. Author(s): Van Borsel J, Vanryckeghem M. Source: Journal of Communication Disorders. 2000 May-June; 33(3): 227-39; Quiz 239-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10907717&dopt=Abstract
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Early-onset Tourette syndrome with reversible autistic behaviour: a dysmaturational disorder. Author(s): Zappella M. Source: European Child & Adolescent Psychiatry. 2002 February; 11(1): 18-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11942423&dopt=Abstract
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Effects of high dose propranolol in Tourette syndrome. Author(s): Sverd J, Kupietz S. Source: Journal of Clinical Psychopharmacology. 1984 December; 4(6): 359-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6595274&dopt=Abstract
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Effects of pimozide on cognition in children with Tourette syndrome: interaction with comorbid attention deficit hyperactivity disorder. Author(s): Sallee FR, Sethuraman G, Rock CM. Source: Acta Psychiatrica Scandinavica. 1994 July; 90(1): 4-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7976448&dopt=Abstract
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Electrophysiological measures and dual-task performance in Tourette syndrome indicate deficient divided attention mechanisms. Author(s): Johannes S, Wieringa BM, Nager W, Muller-Vahl KR, Dengler R, Munte TF. Source: European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies. 2001 May; 8(3): 253-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11328334&dopt=Abstract
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Elevated frontal cerebral blood flow in Gilles de la Tourette syndrome: a 99TcmHMPAO SPECT study. Author(s): George MS, Trimble MR, Costa DC, Robertson MM, Ring HA, Ell PJ. Source: Psychiatry Research. 1992 November; 45(3): 143-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1484907&dopt=Abstract
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Elevated plasma kynurenine in Tourette syndrome. Author(s): Dursun SM, Farrar G, Handley SL, Rickards H, Betts T, Corbett JA. Source: Mol Chem Neuropathol. 1994 January; 21(1): 55-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8179771&dopt=Abstract
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Elevated striatal dopamine transporter in a drug naive patient with Tourette syndrome and attention deficit/ hyperactivity disorder: positive effect of methylphenidate. Author(s): Krause KH, Dresel S, Krause J, Kung HF, Tatsch K, Lochmuller H. Source: Journal of Neurology. 2002 August; 249(8): 1116-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12420715&dopt=Abstract
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Emotional and behavioral difficulties associated with Tourette syndrome. Author(s): King RA, Scahill L. Source: Adv Neurol. 2001; 85: 79-88. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11530448&dopt=Abstract
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Enhanced stress responsivity of Tourette syndrome patients undergoing lumbar puncture. Author(s): Chappell P, Riddle M, Anderson G, Scahill L, Hardin M, Walker D, Cohen D, Leckman J. Source: Biological Psychiatry. 1994 July 1; 36(1): 35-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8080901&dopt=Abstract
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Epidemiology of Tourette syndrome. Author(s): Tanner CM, Goldman SM. Source: Neurologic Clinics. 1997 May; 15(2): 395-402. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9115469&dopt=Abstract
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Epigenetic abnormalities associated with a chromosome 18(q21-q22) inversion and a Gilles de la Tourette syndrome phenotype. Author(s): State MW, Greally JM, Cuker A, Bowers PN, Henegariu O, Morgan TM, Gunel M, DiLuna M, King RA, Nelson C, Donovan A, Anderson GM, Leckman JF, Hawkins T, Pauls DL, Lifton RP, Ward DC. Source: Proceedings of the National Academy of Sciences of the United States of America. 2003 April 15; 100(8): 4684-9. Epub 2003 Apr 07. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12682296&dopt=Abstract
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Epigenetic and environmental risk factors in Tourette syndrome. Author(s): Walkup JT. Source: Adv Neurol. 2001; 85: 273-9. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11530434&dopt=Abstract
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Estrogen, progesterone, and tic severity in women with Gilles de la Tourette syndrome. Author(s): Kompoliti K, Goetz CG, Leurgans S, Raman R, Comella CL. Source: Neurology. 2001 October 23; 57(8): 1519. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11673608&dopt=Abstract
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Exacerbation of tics following antidepressant therapy in a case of Gilles-de-laTourette syndrome. Author(s): Muller N. Source: Pharmacopsychiatry. 1992 September; 25(5): 243-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1409868&dopt=Abstract
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Excessive action monitoring in Tourette syndrome. Author(s): Johannes S, Wieringa BM, Nager W, Muller-Vahl KR, Dengler R, Munte TF. Source: Journal of Neurology. 2002 August; 249(8): 961-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12195438&dopt=Abstract
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Executive function abilities in autism and Tourette syndrome: an information processing approach. Author(s): Ozonoff S, Strayer DL, McMahon WM, Filloux F. Source: Journal of Child Psychology and Psychiatry, and Allied Disciplines. 1994 September; 35(6): 1015-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7995842&dopt=Abstract
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Executive function in children with Tourette syndrome and/or attention deficit hyperactivity disorder. Author(s): Harris EL, Schuerholz LJ, Singer HS, Reader MJ, Brown JE, Cox C, Mohr J, Chase GA, Denckla MB. Source: Journal of the International Neuropsychological Society : Jins. 1995 November; 1(6): 511-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9375237&dopt=Abstract
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Executive function in fluency and recall measures among children with Tourette syndrome or ADHD. Author(s): Mahone EM, Koth CW, Cutting L, Singer HS, Denckla MB. Source: Journal of the International Neuropsychological Society : Jins. 2001 January; 7(1): 102-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11253836&dopt=Abstract
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Exon and intron variants in the human tryptophan 2,3-dioxygenase gene: potential association with Tourette syndrome, substance abuse and other disorders. Author(s): Comings DE, Gade R, Muhleman D, Chiu C, Wu S, To M, Spence M, Dietz G, Winn-Deen E, Rosenthal RJ, Lesieur HR, Rugle L, Sverd J, Ferry L, Johnson JP, MacMurray JP. Source: Pharmacogenetics. 1996 August; 6(4): 307-18. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8873217&dopt=Abstract
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Eye movement abnormalities in a case of Tourette syndrome. Author(s): Narita AS, Shawkat FS, Lask B, Taylor DS, Harris CM. Source: Developmental Medicine and Child Neurology. 1997 April; 39(4): 270-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9183269&dopt=Abstract
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Failure to establish control over tics in the Gilles de la Tourette syndrome with behaviour therapy techniques. Author(s): Sand PL, Carlson C. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1973 June; 122(571): 665-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4515130&dopt=Abstract
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Familial aspects of Gilles de la Tourette syndrome. Author(s): Hajal F, Leach AM. Source: The American Journal of Psychiatry. 1981 January; 138(1): 90-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6934700&dopt=Abstract
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Familial communicational patterns of a patient with Gilles-De-La-Tourette syndrome. Author(s): Bradnan WA, Talmage JB, Van Sickle GR. Source: The Journal of Nervous and Mental Disease. 1972 January; 154(1): 60-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4500325&dopt=Abstract
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Familial occurrence of Gilles de la Tourette syndrome. Report of the syndrome occurring in a father and son. Author(s): Sanders DG. Source: Archives of General Psychiatry. 1973 March; 28(3): 326-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4510886&dopt=Abstract
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Familial pattern and transmission of Gilles de la Tourette syndrome and multiple tics. Author(s): Pauls DL, Cohen DJ, Heimbuch R, Detlor J, Kidd KK. Source: Archives of General Psychiatry. 1981 October; 38(10): 1091-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6945827&dopt=Abstract
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Familial pattern of Gilles de la Tourette syndrome. Author(s): Kidd KK, Prusoff BA, Cohen DJ. Source: Archives of General Psychiatry. 1980 December; 37(12): 1336-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6934712&dopt=Abstract
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Familial Tourette syndrome. Author(s): Guggenheim MA. Source: Annals of Neurology. 1979 January; 5(1): 104. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=284759&dopt=Abstract
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Family data support a dominant major gene for Tourette syndrome. Author(s): Price RA, Pauls DL, Kruger SD, Caine ED. Source: Psychiatry Research. 1988 June; 24(3): 251-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3165533&dopt=Abstract
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Family study and segregation analysis of Tourette syndrome: evidence for a mixed model of inheritance. Author(s): Walkup JT, LaBuda MC, Singer HS, Brown J, Riddle MA, Hurko O. Source: American Journal of Human Genetics. 1996 September; 59(3): 684-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8751870&dopt=Abstract
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Functional neuroanatomy of Tourette syndrome. Limbic-motor interactions studied with FDG PET. Author(s): Stoetter B, Braun AR, Randolph C, Gernert J, Carson RE, Herscovitch P, Chase TN. Source: Adv Neurol. 1992; 58: 213-26. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1414626&dopt=Abstract
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Further evidence for linkage of Gilles de la Tourette syndrome (GTS) susceptibility loci on chromosomes 2p11, 8q22 and 11q23-24 in South African Afrikaners. Author(s): Simonic I, Nyholt DR, Gericke GS, Gordon D, Matsumoto N, Ledbetter DH, Ott J, Weber JL. Source: American Journal of Medical Genetics. 2001 March 8; 105(2): 163-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11304830&dopt=Abstract
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Future direction of research in Tourette syndrome. Author(s): Kurlan R. Source: Neurologic Clinics. 1997 May; 15(2): 451-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9115474&dopt=Abstract
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Future therapies of Tourette syndrome. Author(s): Chappell PB, Scahill LD, Leckman JF. Source: Neurologic Clinics. 1997 May; 15(2): 429-50. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9115473&dopt=Abstract
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Gender study of neuropsychological and neuromotor function in children with Tourette syndrome with and without attention-deficit hyperactivity disorder. Author(s): Schuerholz LJ, Singer HS, Denckla MB. Source: Journal of Child Neurology. 1998 June; 13(6): 277-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9660511&dopt=Abstract
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Genome scan for linkage to Gilles de la Tourette syndrome. Author(s): Barr CL, Wigg KG, Pakstis AJ, Kurlan R, Pauls D, Kidd KK, Tsui LC, Sandor P. Source: American Journal of Medical Genetics. 1999 August 20; 88(4): 437-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10402514&dopt=Abstract
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Genomewide scan of hoarding in sib pairs in which both sibs have Gilles de la Tourette syndrome. Author(s): Zhang H, Leckman JF, Pauls DL, Tsai CP, Kidd KK, Campos MR; Tourette Syndrome Association International Consortium for Genetics. Source: American Journal of Human Genetics. 2002 April; 70(4): 896-904. Epub 2002 February 11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11840360&dopt=Abstract
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Gilles de la Tourette and the discovery of Tourette syndrome. Includes a translation of his 1884 article. Author(s): Lajonchere C, Nortz M, Finger S. Source: Archives of Neurology. 1996 June; 53(6): 567-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8660160&dopt=Abstract
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Gilles de la Tourette on Tourette syndrome. Author(s): Sandor P. Source: Journal of Psychosomatic Research. 1998 June; 44(6): 633-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9678742&dopt=Abstract
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Gilles de la Tourette syndrome and mania in an adolescent. Author(s): Bleich A, Bernout E, Apter A, Tyano S. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1985 June; 146: 664-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3860272&dopt=Abstract
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Gilles de la Tourette syndrome in a child with congenital deafness. Author(s): Dalsgaard S, Damm D, Thomsen PH. Source: European Child & Adolescent Psychiatry. 2001 December; 10(4): 256-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11794551&dopt=Abstract
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Gilles de la Tourette syndrome in mental handicap. Author(s): Reid AH. Source: J Ment Defic Res. 1984 March; 28 (Pt 1): 81-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6425505&dopt=Abstract
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Gilles de la Tourette syndrome in Papua New Guinea. Author(s): Johnson FY. Source: P N G Med J. 1995 June; 38(2): 127-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9599974&dopt=Abstract
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Gilles de la Tourette syndrome with schizophrenia and obsessive-compulsive disorder: a case report. Author(s): Wagle AC, Staley CJ. Source: The Journal of Neuropsychiatry and Clinical Neurosciences. 1999 Fall; 11(4): 517. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10570769&dopt=Abstract
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Gilles de la Tourette syndrome. Author(s): Shenken L. Source: N Z Med J. 1984 January 25; 97(748): 51. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6582409&dopt=Abstract
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Gilles de la Tourette Syndrome. Author(s): Horn S. Source: Clinical Neuropharmacology. 2001 May-June; 24(3): 125-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11391121&dopt=Abstract
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Gilles de la Tourette syndrome. Author(s): Arzimanoglou AA. Source: Journal of Neurology. 1998 December; 245(12): 761-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9840347&dopt=Abstract
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Gilles de la Tourette syndrome. Author(s): Gelbart M. Source: Nurs Times. 1998 July 22-28; 94(29): 32. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9749024&dopt=Abstract
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Gilles de la Tourette syndrome. Author(s): Robertson MM, Stern JS. Source: Br J Hosp Med. 1997 September 17-30; 58(6): 253-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9488798&dopt=Abstract
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Gilles de la Tourette syndrome. Interactions with other neuropsychiatric disorders. Author(s): Yaryura-Tobias JA. Source: Acta Psychiatrica Scandinavica. 1979 January; 59(1): 9-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=283685&dopt=Abstract
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Gilles de la Tourette syndrome: a 20-month study of the effects of stressful life events and haloperidol on symptom frequency. Author(s): Surwillo WW, Shafii M, Barrett CL. Source: The Journal of Nervous and Mental Disease. 1978 November; 166(11): 812-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=281456&dopt=Abstract
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Gilles de la Tourette syndrome: an underdiagnosed disorder. Author(s): Joy-Sobrino JL, Rivera-Reyes L, Aviles-Michel R. Source: Bol Asoc Med P R. 1985 May; 77(5): 202-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3860208&dopt=Abstract
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Gilles de la tourette syndrome: studies with the fluorine-18-labeled fluorodeoxyglucose positron emission tomographic method. Author(s): Chase TN, Foster NL, Fedio P, Brooks R, Mansi L, Kessler R, Di Chiro G. Source: Annals of Neurology. 1984; 15 Suppl: S175. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6611119&dopt=Abstract
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Gilles de la Tourette syndrome: symptomatic treatment based on evidence. Author(s): Robertson MM, Stern JS. Source: European Child & Adolescent Psychiatry. 2000; 9 Suppl 1: I60-75. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11140781&dopt=Abstract
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Habit reversal for the treatment of Tourette syndrome. Author(s): Azrin NH, Peterson AL. Source: Behaviour Research and Therapy. 1988; 26(4): 347-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3214400&dopt=Abstract
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Hallervorden-Spatz syndrome resembling a typical Tourette syndrome. Author(s): Scarano V, Pellecchia MT, Filla A, Barone P. Source: Movement Disorders : Official Journal of the Movement Disorder Society. 2002 May; 17(3): 618-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12112223&dopt=Abstract
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Haloperidol, fluphenazine and clonidine in Tourette syndrome: controversies in treatment. Author(s): Singer HS, Gammon K, Quaskey S. Source: Pediatr Neurosci. 1985-86; 12(2): 71-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3870139&dopt=Abstract
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Height distribution in children with Tourette syndrome. Author(s): Zelnik N, Newfield RS, Silman-Stolar Z, Goikhman I. Source: Journal of Child Neurology. 2002 March; 17(3): 200-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12026236&dopt=Abstract
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Helping school-age children cope with Tourette syndrome. Author(s): Parker K. Source: The Journal of School Health. 1985 January; 55(1): 30-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3856077&dopt=Abstract
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Helping your patient cope with Tourette syndrome. Author(s): Adkins AS. Source: Pediatric Nursing. 1989 March-April; 15(2): 135-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2649862&dopt=Abstract
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Heterogeneity and variability in Tourette syndrome. Author(s): Caine ED, Polinsky RJ, Ludlow CL, Ebert MH, Nee LE. Source: Adv Neurol. 1982; 35: 437-42. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6959522&dopt=Abstract
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HGPRT in the Gilles de la Tourette syndrome. Author(s): Johnson GG, Pepple JM, Singer HS, Littlefield JW. Source: The New England Journal of Medicine. 1977 August 11; 297(6): 339. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=267247&dopt=Abstract
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History of tic disorders and Gilles de la Tourette syndrome: part 5 of the MDSsponsored history of movement disorders exhibit, Barcelona, June 2000. Author(s): Goetz CG, Chmura TA, Lanska DJ. Source: Movement Disorders : Official Journal of the Movement Disorder Society. 2001 March; 16(2): 346-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11295792&dopt=Abstract
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HLA typing in Tourette syndrome. Author(s): Comings DE, Gursey BT, Hecht T, Blume K. Source: Adv Neurol. 1982; 35: 251-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6959494&dopt=Abstract
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Home alone: methods to maximize tic expression for objective videotape assessments in Gilles de la Tourette syndrome. Author(s): Goetz CG, Leurgans S, Chmura TA. Source: Movement Disorders : Official Journal of the Movement Disorder Society. 2001 July; 16(4): 693-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11481693&dopt=Abstract
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Homogeneous clinical subgroups in children with Tourette syndrome. Author(s): Barabas G, Matthews WS. Source: Pediatrics. 1985 January; 75(1): 73-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3855330&dopt=Abstract
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How to treat OCD in patients with Tourette syndrome. Author(s): Miguel EC, Shavitt RG, Ferrao YA, Brotto SA, Diniz JB. Source: Journal of Psychosomatic Research. 2003 July; 55(1): 49-57. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12842231&dopt=Abstract
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Huntington disease and childhood-onset Tourette syndrome. Author(s): Kerbeshian J, Burd L, Leech C, Rorabaugh A. Source: American Journal of Medical Genetics. 1991 April 1; 39(1): 1-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1831007&dopt=Abstract
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Huntington disease and Tourette syndrome. I. Electron spin resonance of bed ghosts. Author(s): Comings DE, Pekkala A, Schuh JR, Kuo PC, Chan SI. Source: American Journal of Human Genetics. 1981 March; 33(2): 166-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6259936&dopt=Abstract
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Huntington disease and Tourette syndrome. II. Uptake of glutamic acid and other amino acids by fibroblasts. Author(s): Comings DE, Goetz IE, Holden J, Holtz J. Source: American Journal of Human Genetics. 1981 March; 33(2): 175-86. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6452058&dopt=Abstract
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Hyperkinetic movement disorders misdiagnosed as tics in Gilles de la Tourette syndrome. Author(s): Kompoliti K, Goetz CG. Source: Movement Disorders : Official Journal of the Movement Disorder Society. 1998 May; 13(3): 477-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9613740&dopt=Abstract
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Hyperkinetic syndrome and Tourette syndrome. Author(s): Rapoport JL, Nee L, Mitchell S, Polinsky R, Ebert M. Source: Adv Neurol. 1982; 35: 423-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6959519&dopt=Abstract
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Hypothesis III. Tourette syndrome is only one of several causes of a developmental basal ganglia syndrome. Author(s): Palumbo D, Maughan A, Kurlan R. Source: Archives of Neurology. 1997 April; 54(4): 475-83. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9109750&dopt=Abstract
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Hypothesis: homozygosity in Tourette syndrome. Author(s): Comings DE, Comings BG, Knell E. Source: American Journal of Medical Genetics. 1989 November; 34(3): 413-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2596529&dopt=Abstract
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Identification of genetic markers associated with Gilles de la Tourette syndrome in an Afrikaner population. Author(s): Simonic I, Gericke GS, Ott J, Weber JL. Source: American Journal of Human Genetics. 1998 September; 63(3): 839-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9718333&dopt=Abstract
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Improvement in Gilles de la Tourette syndrome after corticosteroid therapy. Author(s): Kondo K, Kabasawa T. Source: Annals of Neurology. 1978 October; 4(4): 387. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=281893&dopt=Abstract
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Improvement of symptoms in Tourette syndrome by piquindone, a novel dopamine-2 receptor antagonist. Author(s): Uhr SB, Pruitt B, Berger PA, Stahl SM. Source: International Clinical Psychopharmacology. 1986 July; 1(3): 216-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3549873&dopt=Abstract
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Increased body movements during sleep in Gilles de la Tourette syndrome. Author(s): Hashimoto T, Endo S, Fukuda K, Hiura K, Kawano N, Suzue J, Kokawa T, Miyao M. Source: Brain & Development. 1981; 3(1): 31-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6942662&dopt=Abstract
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Increased chromosomal breakage in Tourette syndrome predicts the possibility of variable multiple gene involvement in spectrum phenotypes: preliminary findings and hypothesis. Author(s): Gericke GS, Simonic I, Cloete E, Buckle C, Becker PJ. Source: American Journal of Medical Genetics. 1995 October 9; 60(5): 444-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8546159&dopt=Abstract
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Increased expression of aphidicolin-induced common fragile sites in Tourette syndrome: the key to understand the genetics of comorbid phenotypes? Author(s): Gericke GS, Simonic I, Cloete E, Becker PJ. Source: American Journal of Medical Genetics. 1996 February 16; 67(1): 25-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8678110&dopt=Abstract
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Influence of treatment of Tourette syndrome with delta9-tetrahydrocannabinol (delta9-THC) on neuropsychological performance. Author(s): Muller-Vahl KR, Koblenz A, Jobges M, Kolbe H, Emrich HM, Schneider U. Source: Pharmacopsychiatry. 2001 January; 34(1): 19-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11229617&dopt=Abstract
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Inhibitory deficits in Tourette syndrome: a function of comorbidity and symptom severity. Author(s): Ozonoff S, Strayer DL, McMahon WM, Filloux F. Source: Journal of Child Psychology and Psychiatry, and Allied Disciplines. 1998 November; 39(8): 1109-18. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9844981&dopt=Abstract
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Insight and hindsight into Tourette syndrome. Author(s): Hollenbeck PJ. Source: Adv Neurol. 2001; 85: 363-7. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11530444&dopt=Abstract
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Insights into the pathophysiology and pathogenesis of Gilles de la Tourette syndrome. Author(s): Friedhoff AJ. Source: Revue Neurologique. 1986; 142(11): 860-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2950584&dopt=Abstract
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Intellectual, academic, and adaptive functioning of Tourette syndrome children with and without attention deficit disorder. Author(s): Dykens E, Leckman J, Riddle M, Hardin M, Schwartz S, Cohen D. Source: Journal of Abnormal Child Psychology. 1990 December; 18(6): 607-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2074343&dopt=Abstract
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Interaction of biological and psychological factors in the natural history of Tourette syndrome: a paradigm for childhood neuropsychiatric disorders. Author(s): Cohen DJ, Detlor J, Shaywitz BA, Leckman JF. Source: Adv Neurol. 1982; 35: 31-40. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6959506&dopt=Abstract
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Intermediate inheritance of Tourette syndrome, assuming assortative mating. Author(s): Hasstedt SJ, Leppert M, Filloux F, van de Wetering BJ, McMahon WM. Source: American Journal of Human Genetics. 1995 September; 57(3): 682-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7668298&dopt=Abstract
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Intermittent medication cessation in the treatment of Tourette syndrome. Author(s): Fulton WA. Source: Neuroscience and Biobehavioral Reviews. 1988 Fall-Winter; 12(3-4): 235-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2906422&dopt=Abstract
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Investigation of the potential role of genetic imprinting in Gilles de la Tourette syndrome. Author(s): Furtado S, Suchowersky O. Source: American Journal of Medical Genetics. 1994 May 15; 51(1): 51-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8030670&dopt=Abstract
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Is Tourette syndrome a cause of sudden infant death syndrome and childhood obstructive sleep apnea? Author(s): Sverd J, Montero G. Source: American Journal of Medical Genetics. 1993 June 15; 46(5): 494-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8322807&dopt=Abstract
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ISBH launches public awareness campaign about Tourette syndrome. Author(s): Myers WA Jr. Source: Indiana Med. 1985 April; 78(4): 263. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3858381&dopt=Abstract
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Issues in genetic linkage studies of Tourette syndrome. Phenotypic spectrum and genetic model parameters. Author(s): Pauls DL. Source: Adv Neurol. 1992; 58: 151-7. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1414619&dopt=Abstract
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Language and speech abnormalities in Tourette syndrome. Author(s): Ludlow CL, Polinsky RJ, Caine ED, Bassich CJ, Ebert MH. Source: Adv Neurol. 1982; 35: 351-61. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6959512&dopt=Abstract
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Language-based cognitive functioning in parents of offspring with ADHD comorbid for Tourette syndrome or learning disabilities. Author(s): Casey MB, Cohen M, Schuerholz LJ, Singer HS, Denckla MB. Source: Developmental Neuropsychology. 2000; 17(1): 85-110. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10916577&dopt=Abstract
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Late components of the auditory evoked potentials in Gilles de la Tourette syndrome. Author(s): van de Wetering BJ, Martens CM, Fortgens C, Slaets JP, van Woerkom TC. Source: Clinical Neurology and Neurosurgery. 1985; 87(3): 181-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3863732&dopt=Abstract
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Learning difficulties in children with Tourette syndrome. Author(s): Singer HS, Schuerholz LJ, Denckla MB. Source: Journal of Child Neurology. 1995 January; 10 Suppl 1: S58-61. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7751556&dopt=Abstract
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Linkage analysis and exclusion of regions of chromosomes 3 and 8 in Gilles de la Tourette syndrome following the identification of a balanced reciprocal translocation 46 XY, t(3:8)(p21.3 q24.1) in a case of Tourette syndrome. Author(s): Brett PM, Curtis D, Robertson MM, Dahlitz M, Gurling HM. Source: Psychiatric Genetics. 1996 Fall; 6(3): 99-105. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8902885&dopt=Abstract
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Linkage and Tourette syndrome. Author(s): Heutink P, Sandkuyl LA, van de Wetering BJ, Oostra BA, Weber J, Wilkie P, Devor EJ, Pakstis AJ, Pauls D, Kidd KK. Source: Lancet. 1991 January 12; 337(8733): 122-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1670715&dopt=Abstract
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Linkage disequilibrium between an allele at the dopamine D4 receptor locus and Tourette syndrome, by the transmission-disequilibrium test. Author(s): Grice DE, Leckman JF, Pauls DL, Kurlan R, Kidd KK, Pakstis AJ, Chang FM, Buxbaum JD, Cohen DJ, Gelernter J. Source: American Journal of Human Genetics. 1996 September; 59(3): 644-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8751866&dopt=Abstract
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Linkage studies on Gilles de la Tourette syndrome: what is the strategy of choice? Author(s): Heutink P, van de Wetering BJ, Pakstis AJ, Kurlan R, Sandor P, Oostra BA, Sandkuijl LA. Source: American Journal of Human Genetics. 1995 August; 57(2): 465-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7668273&dopt=Abstract
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Linkage study of the dopamine D5 receptor gene and Gilles de la Tourette syndrome. Author(s): Barr CL, Wigg KG, Zovko E, Sandor P, Tsui LC. Source: American Journal of Medical Genetics. 1997 February 21; 74(1): 58-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9034008&dopt=Abstract
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Linkage to Tourette syndrome is excluded for red-cell acid phosphatase (ACP1) and flanking markers on chromosome 2pter-2p23. Author(s): Devor EJ, Henderson V, Sparkes RS. Source: Human Biology; an International Record of Research. 1991 April; 63(2): 221-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2019415&dopt=Abstract
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Long-term follow-up of an epidemiologically defined cohort of patients with Tourette syndrome. Author(s): Burd L, Kerbeshian PJ, Barth A, Klug MG, Avery PK, Benz B. Source: Journal of Child Neurology. 2001 June; 16(6): 431-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11417610&dopt=Abstract
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Management of clonidine overdose in a child with Tourette syndrome. Author(s): Whelan R, Dearlove OR. Source: Developmental Medicine and Child Neurology. 1995 May; 37(5): 469. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7768347&dopt=Abstract
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Management of Gilles de la Tourette syndrome using sulpiride. Author(s): Robertson MM, Schnieden V, Lees AJ. Source: Clinical Neuropharmacology. 1990 June; 13(3): 229-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2357704&dopt=Abstract
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Menstrual cycle-related fluctuations of tics in Tourette syndrome. Author(s): Schwabe MJ, Konkol RJ. Source: Pediatric Neurology. 1992 January-February; 8(1): 43-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1558574&dopt=Abstract
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Mental health needs associated with Tourette syndrome. Author(s): Stefl ME. Source: American Journal of Public Health. 1984 December; 74(12): 1310-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6594941&dopt=Abstract
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Methylphenidate role in Tourette syndrome prevalence. Author(s): Millichap JG. Source: Journal of the Royal Society of Medicine. 1999 March; 92(3): 156. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10396274&dopt=Abstract
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Methylphenidate-induced Tourette syndrome: case report. Author(s): Bremness AB, Sverd J. Source: The American Journal of Psychiatry. 1979 October; 136(10): 1334-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=290280&dopt=Abstract
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Misdiagnosis of Gilles de la Tourette syndrome. Author(s): Temlett JA, Cartwright J, Rodda J, Lilienfeld S. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1995 March; 85(3): 187-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7777984&dopt=Abstract
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Modulation of prefrontal cortical-striatal circuits: relevance to therapeutic treatments for Tourette syndrome and attention-deficit hyperactivity disorder. Author(s): Arnsten AF. Source: Adv Neurol. 2001; 85: 333-41. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11530441&dopt=Abstract
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Monoamine oxidase and catechol-O-methyltransferase activities in cultured fibroblasts and blood cells from children with autism and the Gilles de la Tourette syndrome. Author(s): Giller EL Jr, Young JG, Breakefield XO, Carbonari C, Braverman M, Cohen DJ. Source: Psychiatry Research. 1980 May; 2(2): 187-97. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6932062&dopt=Abstract
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Motor tics, Tourette syndrome, and learning disabilities. Author(s): Lerer RJ. Source: Journal of Learning Disabilities. 1987 May; 20(5): 266-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3474329&dopt=Abstract
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Movement control of manipulative tasks in patients with Gilles de la Tourette syndrome. Author(s): Serrien DJ, Nirkko AC, Loher TJ, Lovblad KO, Burgunder JM, Wiesendanger M. Source: Brain; a Journal of Neurology. 2002 February; 125(Pt 2): 290-300. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11844729&dopt=Abstract
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Movement disorders in children: Tourette syndrome. Author(s): Golden GS. Source: Journal of Developmental and Behavioral Pediatrics : Jdbp. 1982 December; 3(4): 209-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6961138&dopt=Abstract
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MRI parcellation of the frontal lobe in boys with attention deficit hyperactivity disorder or Tourette syndrome. Author(s): Kates WR, Frederikse M, Mostofsky SH, Folley BS, Cooper K, MazurHopkins P, Kofman O, Singer HS, Denckla MB, Pearlson GD, Kaufmann WE. Source: Psychiatry Research. 2002 November 30; 116(1-2): 63-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12426035&dopt=Abstract
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Multiple childhood behavioral disorders (Tourette syndrome, multiple tics, ADD and OCD) presenting in a family with a balanced chromosome translocation (t1;8)(q21.1;q22.1). Author(s): Devor EJ, Magee HJ. Source: Psychiatric Genetics. 1999 September; 9(3): 149-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10551546&dopt=Abstract
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Neurobiological issues in Tourette syndrome. Author(s): Singer HS. Source: Brain & Development. 1994 September-October; 16(5): 353-64. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7892954&dopt=Abstract
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Neurobiology of basal ganglia circuits in Tourette syndrome: faulty inhibition of unwanted motor patterns? Author(s): Mink JW. Source: Adv Neurol. 2001; 85: 113-22. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11530421&dopt=Abstract
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Neurobiology of Tourette syndrome. Author(s): Singer HS. Source: Neurologic Clinics. 1997 May; 15(2): 357-79. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9115467&dopt=Abstract
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Neurochemical analysis of postmortem cortical and striatal brain tissue in patients with Tourette syndrome. Author(s): Singer HS. Source: Adv Neurol. 1992; 58: 135-44. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1414616&dopt=Abstract
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Neurochemistry and synaptic neurotransmission in Tourette syndrome. Author(s): Singer HS, Wendlandt JT. Source: Adv Neurol. 2001; 85: 163-78. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11530426&dopt=Abstract
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Neuroendocrine and behavioral effects of naloxone in Tourette syndrome. Author(s): Chappell PB, Leckman JF, Riddle MA, Anderson GM, Listwack SJ, Ort SI, Hardin MT, Scahill LD, Cohen DJ. Source: Adv Neurol. 1992; 58: 253-62. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1414631&dopt=Abstract
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Neuroimaging studies of Tourette syndrome: a decade of progress. Author(s): Peterson BS. Source: Adv Neurol. 2001; 85: 179-96. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11530427&dopt=Abstract
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Neurological soft signs and EEG findings in children and adolescents with Gilles de la Tourette syndrome. Author(s): Semerci ZB. Source: Turk J Pediatr. 2000 January-March; 42(1): 53-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10731871&dopt=Abstract
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Neuromotor functioning in children with Tourette syndrome with and without attention deficit hyperactivity disorder. Author(s): Schuerholz LJ, Cutting L, Mazzocco MM, Singer HS, Denckla MB. Source: Journal of Child Neurology. 1997 October; 12(7): 438-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9373800&dopt=Abstract
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Neuropathology in Tourette syndrome: an update. Author(s): Swerdlow NR, Young AB. Source: Adv Neurol. 2001; 85: 151-61. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11530425&dopt=Abstract
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Neuropsychological characteristics of children with Tourette syndrome: evidence for a nonverbal learning disability? Author(s): Brookshire BL, Butler IJ, Ewing-Cobbs L, Fletcher JM. Source: J Clin Exp Neuropsychol. 1994 April; 16(2): 289-302. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8021315&dopt=Abstract
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Neuropsychological correlates of obsessive characteristics in Tourette syndrome. Author(s): Bornstein RA. Source: The Journal of Neuropsychiatry and Clinical Neurosciences. 1991 Spring; 3(2): 157-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1821229&dopt=Abstract
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Neuropsychological function in Tourette syndrome. Author(s): Como PG. Source: Adv Neurol. 2001; 85: 103-11. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11530420&dopt=Abstract
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Neuroreceptor subunit genes and the genetic susceptibility to Gilles de la Tourette syndrome. Author(s): Brett PM, Curtis D, Robertson MM, Gurling HM. Source: Biological Psychiatry. 1997 November 15; 42(10): 941-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9359981&dopt=Abstract
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No association of a tyrosine hydroxylase gene tetranucleotide repeat polymorphism in autism, Tourette syndrome, or ADHD. Author(s): Comings DE, Gade R, Muhleman D, Sverd J. Source: Biological Psychiatry. 1995 April 1; 37(7): 484-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7786965&dopt=Abstract
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No evidence for a major gene effect of the dopamine D4 receptor gene in the susceptibility to Gilles de la Tourette syndrome in five Canadian families. Author(s): Barr CL, Wigg KG, Zovko E, Sandor P, Tsui LC. Source: American Journal of Medical Genetics. 1996 May 31; 67(3): 301-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8725747&dopt=Abstract
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No evidence of partial trisomy 16p in an autistic calendar savant with Tourette syndrome. Author(s): Nelson EC. Source: American Journal of Medical Genetics. 1997 July 25; 74(4): 450. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9259384&dopt=Abstract
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Non-invasive assessment of autonomic nervous function in Gilles de la Tourette syndrome. Author(s): van Dijk JG, Koenderink M, Kramer CG, den Heijer JC, Roos RA. Source: Clinical Neurology and Neurosurgery. 1992; 94(2): 157-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1324814&dopt=Abstract
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Nonreplication of linkage disequilibrium between the dopamine D4 receptor locus and Tourette syndrome. Author(s): Hebebrand J, Nothen MM, Ziegler A, Klug B, Neidt H, Eggermann K, Lehmkuhl G, Poustka F, Schmidt MH, Propping P, Remschmidt H. Source: American Journal of Human Genetics. 1997 July; 61(1): 238-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9246007&dopt=Abstract
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Noradrenergic and dopaminergic mechanisms in Gilles de la Tourette syndrome. Author(s): Sweeney D, Pickar D, Redmond DE Jr, Maas J. Source: Lancet. 1978 April 22; 1(8069): 872. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=76814&dopt=Abstract
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Obsessionality in Tourette syndrome. Author(s): Jadresic D. Source: Lancet. 1993 April 24; 341(8852): 1063. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8096967&dopt=Abstract
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Obsessive compulsive behaviour and depressive symptoms in young people with Tourette syndrome. A controlled study. Author(s): Robertson MM, Banerjee S, Eapen V, Fox-Hiley P. Source: European Child & Adolescent Psychiatry. 2002 December; 11(6): 261-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12541004&dopt=Abstract
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Obsessive compulsive symptoms in Gilles de la Tourette syndrome and obsessive compulsive disorder: differences by diagnosis and family history. Author(s): Eapen V, Robertson MM, Alsobrook JP 2nd, Pauls DL. Source: American Journal of Medical Genetics. 1997 July 25; 74(4): 432-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9259380&dopt=Abstract
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Obsessive-compulsive disorder and Tourette syndrome: is there a relationship? Author(s): do Rosario MC, Miguel Filho EC. Source: Rev Paul Med. 1997 March-April; 115(2): 1410-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9460303&dopt=Abstract
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Obsessive-compulsive symptom clusters and urinary amine correlates in Tourette syndrome. Author(s): de Groot CM, Bornstein RA, Baker GB. Source: The Journal of Nervous and Mental Disease. 1995 April; 183(4): 224-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7536233&dopt=Abstract
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Obsessive-compulsive symptom dimensions in affected sibling pairs diagnosed with Gilles de la Tourette syndrome. Author(s): Leckman JF, Pauls DL, Zhang H, Rosario-Campos MC, Katsovich L, Kidd KK, Pakstis AJ, Alsobrook JP, Robertson MM, McMahon WM, Walkup JT, van de Wetering BJ, King RA, Cohen DJ; Tourette Syndrome Assocation International Consortium for Genetics. Source: American Journal of Medical Genetics. 2003 January 1; 116B(1): 60-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12497616&dopt=Abstract
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Oculomotor abnormalities in boys with tourette syndrome with and without ADHD. Author(s): Mostofsky SH, Lasker AG, Singer HS, Denckla MB, Zee DS. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 2001 December; 40(12): 1464-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11765293&dopt=Abstract
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Oculomotor control in Gilles de la Tourette syndrome. Author(s): Bollen EL, Roos RA, Cohen AP, Minderaa RB, Reulen JP, Van de Wetering BJ, Van Woerkom TC, Buruma OJ. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 1988 August; 51(8): 1081-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3216209&dopt=Abstract
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Olanzapine in severe Gilles de la Tourette syndrome: a 52-week double-blind crossover study vs. low-dose pimozide. Author(s): Onofrj M, Paci C, D'Andreamatteo G, Toma L. Source: Journal of Neurology. 2000 June; 247(6): 443-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10929273&dopt=Abstract
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Olanzapine in Tourette syndrome. Author(s): Bhadrinath BR. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1998 April; 172: 366. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9715346&dopt=Abstract
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On the role of CNS serotonin in the motor abnormalities of Tourette syndrome: behavioral and single-unit studies. Author(s): Jacobs BL, Trulson ME, Heym J, Steinfels GF. Source: Adv Neurol. 1982; 35: 93-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6959527&dopt=Abstract
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Ophthalmic manifestations of gilles de la Tourette syndrome. Author(s): Tatlipinar S, Iener EC, Ilhan B, Semerci B. Source: Eur J Ophthalmol. 2001 July-September; 11(3): 223-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11681499&dopt=Abstract
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Opioid neuronal denervation in Gilles de la Tourette syndrome. Author(s): Sandyk R. Source: The International Journal of Neuroscience. 1987 July; 35(1-2): 95-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3040612&dopt=Abstract
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Opioid receptor differentiation and Gilles de la Tourette syndrome. Author(s): Sandyk R. Source: The International Journal of Neuroscience. 1987 February; 32(3-4): 995-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3036730&dopt=Abstract
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Overview of pharmacological approaches to therapy for Tourette syndrome. Author(s): van Woert MH, Rosenbaum D, Enna SJ. Source: Adv Neurol. 1982; 35: 369-75. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6183950&dopt=Abstract
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Pathogenesis of Tourette syndrome. Clues from the clinical phenotype and natural history. Author(s): Leckman JF, Pauls DL, Peterson BS, Riddle MA, Anderson GM, Cohen DJ. Source: Adv Neurol. 1992; 58: 15-24. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1414618&dopt=Abstract
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Pathophysiology of tics and Tourette syndrome. Author(s): Berardelli A, Curra A, Fabbrini G, Gilio F, Manfredi M. Source: Journal of Neurology. 2003 July; 250(7): 781-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12883917&dopt=Abstract
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Peek-a-boo fragile site at 16d associated with Tourette syndrome, bipolar disorder, autistic disorder, and mental retardation. Author(s): Kerbeshian J, Severud R, Burd L, Larson L. Source: American Journal of Medical Genetics. 2000 February 7; 96(1): 69-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10686555&dopt=Abstract
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Pergolide in the management of Tourette syndrome. Author(s): Griesemer DA. Source: Journal of Child Neurology. 1997 September; 12(6): 402-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9309526&dopt=Abstract
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PET studies on the integrity of the pre and postsynaptic dopaminergic system in Tourette syndrome. Author(s): Brooks DJ, Turjanski N, Sawle GV, Playford ED, Lees AJ. Source: Adv Neurol. 1992; 58: 227-31. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1414627&dopt=Abstract
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Polygenic inheritance of Tourette syndrome, stuttering, attention deficit hyperactivity, conduct, and oppositional defiant disorder: the additive and subtractive effect of the three dopaminergic genes--DRD2, D beta H, and DAT1. Author(s): Comings DE, Wu S, Chiu C, Ring RH, Gade R, Ahn C, MacMurray JP, Dietz G, Muhleman D. Source: American Journal of Medical Genetics. 1996 May 31; 67(3): 264-88. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8725745&dopt=Abstract
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Positron emission tomography evaluation of dopamine D-2 receptors in adults with Tourette syndrome. Author(s): Singer HS, Wong DF, Brown JE, Brandt J, Krafft L, Shaya E, Dannals RF, Wagner HN Jr. Source: Adv Neurol. 1992; 58: 233-9. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1414628&dopt=Abstract
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Postmortem analysis of subcortical monoamines and amino acids in Tourette syndrome. Author(s): Anderson GM, Pollak ES, Chatterjee D, Leckman JF, Riddle MA, Cohen DJ. Source: Adv Neurol. 1992; 58: 123-33. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1414615&dopt=Abstract
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Postprandial changes in superoxide dismutase activity in subjects with Gilles de la Tourette syndrome and controls. Author(s): Saghir AN, Rickards H, Pall HS. Source: Experimental Neurology. 1997 April; 144(2): 420-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9168842&dopt=Abstract
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Predictors of clonidine response in Tourette syndrome: implications and inferences. Author(s): Lichter DG, Jackson LA. Source: Journal of Child Neurology. 1996 March; 11(2): 93-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8881983&dopt=Abstract
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Premonitory sensory phenomena and suppressibility of tics in Tourette syndrome: developmental aspects in children and adolescents. Author(s): Banaschewski T, Woerner W, Rothenberger A. Source: Developmental Medicine and Child Neurology. 2003 October; 45(10): 700-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14515942&dopt=Abstract
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Prevalence of tic disorders and Tourette syndrome in a Swedish school population. Author(s): Khalifa N, von Knorring AL. Source: Developmental Medicine and Child Neurology. 2003 May; 45(5): 315-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12729145&dopt=Abstract
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Prevalence of tics and Tourette syndrome in an inpatient adult psychiatry setting. Author(s): Eapen V, Laker M, Anfield A, Dobbs J, Robertson MM. Source: Journal of Psychiatry & Neuroscience : Jpn. 2001 November; 26(5): 417-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11762209&dopt=Abstract
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Prevalence of Tourette syndrome. Author(s): Millichap JG. Source: Developmental Medicine and Child Neurology. 1999 May; 41(5): 356. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10378765&dopt=Abstract
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Probabilistic classification learning in Tourette syndrome. Author(s): Keri S, Szlobodnyik C, Benedek G, Janka Z, Gadoros J. Source: Neuropsychologia. 2002; 40(8): 1356-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11931939&dopt=Abstract
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Probing striato-thalamic function in obsessive-compulsive disorder and Tourette syndrome using neuroimaging methods. Author(s): Rauch SL, Whalen PJ, Curran T, Shin LM, Coffey BJ, Savage CR, McInerney SC, Baer L, Jenike MA. Source: Adv Neurol. 2001; 85: 207-24. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11530429&dopt=Abstract
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Pseudo-tics in Tourette syndrome. Author(s): Dooley JM, Stokes A, Gordon KE. Source: Journal of Child Neurology. 1994 January; 9(1): 50-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8151083&dopt=Abstract
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Psycholinguistic findings in gilles de la Tourette syndrome. Author(s): Frank SM. Source: Journal of Communication Disorders. 1978 July; 11(4): 349-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=276531&dopt=Abstract
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Psychopharmacology of obsessive-compulsive disorder in Tourette syndrome. Author(s): King RA, Riddle MA, Goodman WK. Source: Adv Neurol. 1992; 58: 283-91. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1414634&dopt=Abstract
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Psychosocial factors in Tourette syndrome. Author(s): Earls F. Source: Adv Neurol. 1992; 58: 55-9. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1414644&dopt=Abstract
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Quest for the elusive genetic basis of Tourette syndrome. Author(s): Patel PI. Source: American Journal of Human Genetics. 1996 November; 59(5): 980-2. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8900223&dopt=Abstract
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Quetiapine treatment in patients with Tourette syndrome. Author(s): Parraga HC, Parraga MI. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 2001 March; 46(2): 184-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11280092&dopt=Abstract
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Rates for tic disorders and obsessive compulsive symptomatology in families of children and adolescents with Gilles de la Tourette syndrome. Author(s): Hebebrand J, Klug B, Fimmers R, Seuchter SA, Wettke-Schafer R, Deget F, Camps A, Lisch S, Hebebrand K, von Gontard A, Lehmkuhl G, Poustka F, Schmidt M, Baur MP, Remschmidt H. Source: Journal of Psychiatric Research. 1997 September-October; 31(5): 519-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9368194&dopt=Abstract
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Recent advances in Gilles de la Tourette syndrome: implications for clinical practice and future research. Author(s): Leckman JF, Cohen DJ. Source: Psychiatr Dev. 1983 Autumn; 1(3): 301-16. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6324164&dopt=Abstract
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Receptor maturation in pathogenesis and treatment of Tourette syndrome. Author(s): Friedhoff AJ. Source: Adv Neurol. 1982; 35: 133-40. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6959485&dopt=Abstract
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Recurrence of Gilles de la Tourette syndrome. Author(s): Carney PA. Source: British Medical Journal. 1977 April 2; 1(6065): 884. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=265742&dopt=Abstract
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Red blood cell choline in Tourette syndrome. Author(s): Comings DE, Gursey BT, Avelino E, Kopp U, Hanin I. Source: Adv Neurol. 1982; 35: 255-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6959495&dopt=Abstract
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Red-cell choline and Gilles de la Tourette syndrome. Author(s): Hanin I, Merikangas JR, Merikangas KR, Kopp U. Source: The New England Journal of Medicine. 1979 September 20; 301(12): 661-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=288985&dopt=Abstract
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Reduced excretion of MHPG in Tourette syndrome. Author(s): Ang L, Borison R, Dysken M, Davis JM. Source: Adv Neurol. 1982; 35: 171-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6959487&dopt=Abstract
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Reflex tics in two patients with Gilles de la Tourette syndrome. Author(s): Commander M, Corbett J, Prendergast M, Ridley C. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1991 December; 159: 877-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1790463&dopt=Abstract
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Regional brain and ventricular volumes in Tourette syndrome. Author(s): Peterson BS, Staib L, Scahill L, Zhang H, Anderson C, Leckman JF, Cohen DJ, Gore JC, Albert J, Webster R. Source: Archives of General Psychiatry. 2001 May; 58(5): 427-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11343521&dopt=Abstract
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Relaxation therapy in Tourette syndrome: a pilot study. Author(s): Bergin A, Waranch HR, Brown J, Carson K, Singer HS. Source: Pediatric Neurology. 1998 February; 18(2): 136-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9535299&dopt=Abstract
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Relaxation-imagery (self-hypnosis) in Tourette syndrome: experience with four children. Author(s): Kohen DP, Botts P. Source: Am J Clin Hypn. 1987 April; 29(4): 227-37. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3296729&dopt=Abstract
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Repetitive transcranial magnetic stimulation for Tourette syndrome. Author(s): Munchau A, Bloem BR, Thilo KV, Trimble MR, Rothwell JC, Robertson MM. Source: Neurology. 2002 December 10; 59(11): 1789-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12473773&dopt=Abstract
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Response to levodopa challenge in Tourette syndrome. Author(s): Black KJ, Mink JW. Source: Movement Disorders : Official Journal of the Movement Disorder Society. 2000 November; 15(6): 1194-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11104204&dopt=Abstract
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Risperidone in Gilles de la Tourette syndrome. Author(s): Shulman LM, Singer C, Weiner WJ. Source: Neurology. 1995 July; 45(7): 1419. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7542376&dopt=Abstract
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Risperidone in the treatment of tourette syndrome: a double-blind, placebocontrolled trial. Author(s): Dion Y, Annable L, Sandor P, Chouinard G. Source: Journal of Clinical Psychopharmacology. 2002 February; 22(1): 31-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11799340&dopt=Abstract
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Risperidone treatment of aggressive behavior in children with Tourette syndrome. Author(s): Sandor P, Stephens RJ. Source: Journal of Clinical Psychopharmacology. 2000 December; 20(6): 710-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11106151&dopt=Abstract
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Role of genetic factors in depression based on studies of Tourette syndrome and ADHD probands and their relatives. Author(s): Comings DE. Source: American Journal of Medical Genetics. 1995 April 24; 60(2): 111-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7485244&dopt=Abstract
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Role of genetic factors in human sexual behavior based on studies of Tourette syndrome and ADHD probands and their relatives. Author(s): Comings DE. Source: American Journal of Medical Genetics. 1994 September 15; 54(3): 227-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7810580&dopt=Abstract
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S100B protein, glia and Gilles de la Tourette syndrome. Author(s): van Passel R, Schlooz WA, Lamers KJ, Lemmens WA, Rotteveel JJ. Source: European Journal of Paediatric Neurology : Ejpn : Official Journal of the European Paediatric Neurology Society. 2001; 5(1): 15-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11277359&dopt=Abstract
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Screening for mutations in the MECP2 (Rett syndrome) gene in Gilles de la Tourette syndrome. Author(s): Rosa AL, Jankovic J, Ashizawa T. Source: Archives of Neurology. 2003 April; 60(4): 502-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12707062&dopt=Abstract
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Significant linkage for Tourette syndrome in a large French Canadian family. Author(s): Merette C, Brassard A, Potvin A, Bouvier H, Rousseau F, Emond C, Bissonnette L, Roy MA, Maziade M, Ott J, Caron C. Source: American Journal of Human Genetics. 2000 October; 67(4): 1008-13. Epub 2000 September 11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10986045&dopt=Abstract
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Sleep and Tourette syndrome. Author(s): Rothenberger A, Kostanecka T, Kinkelbur J, Cohrs S, Woerner W, Hajak G. Source: Adv Neurol. 2001; 85: 245-59. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11530432&dopt=Abstract
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Social and educational resources for patients with Tourette syndrome. Author(s): Packer LE. Source: Neurologic Clinics. 1997 May; 15(2): 457-73. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9115475&dopt=Abstract
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Somnambulism in children with Tourette syndrome. Author(s): Barabas G, Matthews WS, Ferrari M. Source: Developmental Medicine and Child Neurology. 1984 August; 26(4): 457-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6148287&dopt=Abstract
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Stereotactic treatment of Gilles de la Tourette syndrome by high frequency stimulation of thalamus. Author(s): Vandewalle V, van der Linden C, Groenewegen HJ, Caemaert J. Source: Lancet. 1999 February 27; 353(9154): 724. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10073521&dopt=Abstract
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Studies of the 48 bp repeat polymorphism of the DRD4 gene in impulsive, compulsive, addictive behaviors: Tourette syndrome, ADHD, pathological gambling, and substance abuse. Author(s): Comings DE, Gonzalez N, Wu S, Gade R, Muhleman D, Saucier G, Johnson P, Verde R, Rosenthal RJ, Lesieur HR, Rugle LJ, Miller WB, MacMurray JP. Source: American Journal of Medical Genetics. 1999 August 20; 88(4): 358-68. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10402503&dopt=Abstract
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Studies on the mechanism of a fatal clarithromycin-pimozide interaction in a patient with Tourette syndrome. Author(s): Flockhart DA, Drici MD, Kerbusch T, Soukhova N, Richard E, Pearle PL, Mahal SK, Babb VJ. Source: Journal of Clinical Psychopharmacology. 2000 June; 20(3): 317-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10831018&dopt=Abstract
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Subcortical volumes in girls with tourette syndrome: support for a gender effect. Author(s): Zimmerman AM, Abrams MT, Giuliano JD, Denckla MB, Singer HS. Source: Neurology. 2000 June 27; 54(12): 2224-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10881244&dopt=Abstract
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Sustained attention and impulsivity in children with Tourette syndrome: comorbidity and confounds. Author(s): Sherman EM, Shepard L, Joschko M, Freeman RD. Source: J Clin Exp Neuropsychol. 1998 October; 20(5): 644-57. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10079041&dopt=Abstract
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Tourette syndrome in the classroom: special problems, special needs. Author(s): Stefl ME, Rubin M. Source: The Journal of School Health. 1985 February; 55(2): 72-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3856078&dopt=Abstract
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Tourette syndrome, atypical pervasive developmental disorder and Ganser syndrome in a 15-year-old, visually impaired, mentally retarded boy. Author(s): Burd L, Kerbeshian J. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 1985 February; 30(1): 74-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3855681&dopt=Abstract
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Tourette syndrome, pimozide, and school phobia: the neuroleptic separation anxiety syndrome. Author(s): Linet LS. Source: The American Journal of Psychiatry. 1985 May; 142(5): 613-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3857012&dopt=Abstract
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Tourette syndrome. Author(s): Castiglia PT. Source: Journal of Pediatric Health Care : Official Publication of National Association of Pediatric Nurse Associates & Practitioners. 1997 July-August; 11(4): 189-91. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9281968&dopt=Abstract
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Tourette syndrome: a review and educational implications. Author(s): Bauer AM, Shea TM. Source: Journal of Autism and Developmental Disorders. 1984 March; 14(1): 69-80. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6368522&dopt=Abstract
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Tourette syndrome: clinical and psychological aspects of 250 cases. Author(s): Comings DE, Comings BG. Source: American Journal of Human Genetics. 1985 May; 37(3): 435-50. Erratum In: 1985 July; 37(4): 718. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3859204&dopt=Abstract
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Treatment approaches in Gilles de la Tourette syndrome. Author(s): Borison RL, Ang L, Hamilton WJ, Diamond BI, Davis JM. Source: Brain Research Bulletin. 1983 August; 11(2): 205-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6578865&dopt=Abstract
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Treatment of Gilles de la Tourette syndrome with depot neuroleptics. Author(s): Paolucci S, Buttinelli C, Fiume S, Ciani S, Lenzi GL. Source: Acta Neurol (Napoli). 1984 June; 6(3): 222-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6591768&dopt=Abstract
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Treatment of Gilles de la Tourette syndrome with pimozide. Author(s): Shapiro AK, Shapiro E, Eisenkraft GJ. Source: The American Journal of Psychiatry. 1983 September; 140(9): 1183-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6351642&dopt=Abstract
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Treatment of multiple tics and the Tourette syndrome. Author(s): Gillies DR, Forsythe WI. Source: Developmental Medicine and Child Neurology. 1984 December; 26(6): 830-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6151532&dopt=Abstract
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Uncomplicated Gilles de la Tourette syndrome and probable Ganser syndrome. A case report and review of the literature. Author(s): Refaat R, Firth DA, Robertson MM. Source: European Child & Adolescent Psychiatry. 2002 October; 11(5): 234-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12469241&dopt=Abstract
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Unrecognized Tourette syndrome in adult patients referred for psychogenic tremor. Author(s): Kulisevsky J, Berthier ML, Avila A, Gironell A, Escartin AE. Source: Archives of Neurology. 1998 March; 55(3): 409-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9520016&dopt=Abstract
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Untying the gordian knot: the genetics of Tourette syndrome. Author(s): Devor EJ. Source: The Journal of Nervous and Mental Disease. 1990 November; 178(11): 669-79. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2230753&dopt=Abstract
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Update on the genetics of Tourette syndrome. Author(s): Pauls DL; Tourette Syndrome Association International Consortium on Genetics. Source: Adv Neurol. 2001; 85: 281-93. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11530435&dopt=Abstract
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Urinary indoleamines in Tourette syndrome patients with obsessive-compulsive characteristics. Author(s): Bornstein RA, Baker GB. Source: Psychiatry Research. 1992 March; 41(3): 267-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1375759&dopt=Abstract
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Visual field defects detected in patients with Gilles de la Tourette syndrome: preliminary report. Author(s): Enoch JM, Itzhaki A, Lakshminarayanan V, Comerford JP, Lieberman M. Source: International Ophthalmology. 1989 September; 13(5): 331-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2625381&dopt=Abstract
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Visual fields in Gilles de la Tourette Syndrome. Author(s): Whitefield L, Middleton EM, Brazier DJ, Robertson MM. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1995 December; 167(6): 825-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8829763&dopt=Abstract
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Visually evoked responses in Tourette syndrome. Author(s): Domino EF, Piggott L, Demetriou S, Culbert J. Source: Adv Neurol. 1982; 35: 115-20. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6959484&dopt=Abstract
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Visual-motor integration functioning in children with Tourette syndrome. Author(s): Schultz RT, Carter AS, Gladstone M, Scahill L, Leckman JF, Peterson BS, Zhang H, Cohen DJ, Pauls D. Source: Neuropsychology. 1998 January; 12(1): 134-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9460741&dopt=Abstract
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Vocal tics in Gilles de la Tourette syndrome treated with botulinum toxin injections. Author(s): Trimble MR, Whurr R, Brookes G, Robertson MM. Source: Movement Disorders : Official Journal of the Movement Disorder Society. 1998 May; 13(3): 617-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9613771&dopt=Abstract
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Vomiting and retching in Gilles de la Tourette syndrome: a report of ten cases and a review of the literature. Author(s): Rickards H, Robertson MM. Source: Movement Disorders : Official Journal of the Movement Disorder Society. 1997 July; 12(4): 531-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9251071&dopt=Abstract
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CHAPTER 2. NUTRITION AND TOURETTE SYNDROME Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and Tourette syndrome.
Finding Nutrition Studies on Tourette Syndrome The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail:
[email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “Tourette syndrome” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.
7 Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.
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The following information is typical of that found when using the “Full IBIDS Database” to search for “Tourette syndrome” (or a synonym): •
Catechol-O-methyltransferase and Gilles de la Tourette syndrome. Author(s): The Department of Psychiatry, Toronto Hospital Western Division, Toronto, Ontario, Canada.
[email protected] Source: Barr, C L Wigg, K G Sandor, P Mol-Psychiatry. 1999 September; 4(5): 492-5 13594184
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Effects of foods on the brain. Possible implications for understanding and treating Tourette syndrome. Author(s): Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge 02139. Source: Wurtman, R J Adv-Neurol. 1992; 58293-301 0091-3952
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Estrogen as adjuvant treatment of Tourette syndrome. Author(s): Department of Neurology, University of Arizona Health Sciences Center, Tucson 85724. Source: Sandyk, R Bamford, C R Pediatr-Neurol. 1987 Mar-April; 3(2): 122 0887-8994
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Gilles de la Tourette syndrome: symptomatic treatment based on evidence. Author(s): Department of Psychiatry and Behavioural Sciences, Royal Free and University College Medical School, University College, London, UK. Source: Robertson, M M Stern, J S Eur-Child-Adolesc-Psychiatry. 2000; 9 Suppl 1I60-75 1018-8827
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Increased expression of aphidicolin-induced common fragile sites in Tourette syndrome: the key to understand the genetics of comorbid phenotypes? Author(s): Department of Human Genetics, University of Pretoria, South Africa. Source: Gericke, G S Simonic, I Cloete, E Becker, P J Am-J-Med-Genet. 1996 February 16; 67(1): 25-30 0148-7299
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Influence of treatment of Tourette syndrome with delta9-tetrahydrocannabinol (delta9-THC) on neuropsychological performance. Author(s): Department of Clinical Psychiatry and Psychotherapy, Medical School Hannover, Germany.
[email protected] Source: Muller Vahl, K R Koblenz, A Jobges, M Kolbe, H Emrich, H M Schneider, U Pharmacopsychiatry. 2001 January; 34(1): 19-24 0176-3679
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Multicenter, double-blind, placebo-controlled study of mecamylamine monotherapy for Tourette's disorder. Author(s): University of South Florida College of Medicine, Tampa 33613, USA. Source: Silver, A A Shytle, R D Sheehan, K H Sheehan, D V Ramos, A Sanberg, P R JAm-Acad-Child-Adolesc-Psychiatry. 2001 September; 40(9): 1103-10 0890-8567
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Neuroendocrine and behavioral effects of naloxone in Tourette syndrome. Author(s): Child Study Center, Yale University School of Medicine, New Haven, Connecticut 06515. Source: Chappell, P B Leckman, J F Riddle, M A Anderson, G M Listwack, S J Ort, S I Hardin, M T Scahill, L D Cohen, D J Adv-Neurol. 1992; 58253-62 0091-3952
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Nicotine and cannabinoids as adjuncts to neuroleptics in the treatment of Tourette syndrome and other motor disorders. Author(s): Laboratory of Psychobiochemistry, University of Texas El Paso 79968. Source: Moss, D E Manderscheid, P Z Montgomery, S P Norman, A B Sanberg, P R LifeSci. 1989; 44(21): 1521-5 0024-3205
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Nicotine attenuates DOI-induced head-twitch response in mice: implications for Tourette syndrome. Author(s): Department of Pharmacology, College of Medicine, Howard University, Washington, DC 20059, USA.
[email protected] Source: Tizabi, Y Russell, L T Johnson, M Darmani, N A Prog-NeuropsychopharmacolBiol-Psychiatry. 2001 October; 25(7): 1445-57 0278-5846
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Nicotine potentiates the effects of haloperidol in animals and in patients with Tourette syndrome. Author(s): Department of Psychiatry, University of Cincinnati College of Medicine, OH 45267-0559. Source: Sanberg, P R McConville, B J Fogelson, H M Manderscheid, P Z Parker, K W Blythe, M M Klykylo, W M Norman, A B Biomed-Pharmacother. 1989; 43(1): 19-23 07533322
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Nicotine potentiation of haloperidol in reducing tic frequency in Tourette's disorder. Author(s): Division of Child and Adolescent Psychiatry, University of Cincinnati College of Medicine, OH 45267-0559. Source: McConville, B J Fogelson, M H Norman, A B Klykylo, W M Manderscheid, P Z Parker, K W Sanberg, P R Am-J-Psychiatry. 1991 June; 148(6): 793-4 0002-953X
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No change in striatal dopamine re-uptake site density in psychotropic drug naive and in currently treated Tourette's disorder patients: a [(123)I]-beta-CIT SPECt-study. Author(s): Department of General Psychiatry, University Hospital for Psychiatry, Wahringer Gurtel 18-20, A-1090 Vienna, Austria.
[email protected] Source: Stamenkovic, M Schindler, S D Asenbaum, S Neumeister, A Willeit, M Willinger, U de Zwaan, M Riederer, F Aschauer, H N Kasper, S EurNeuropsychopharmacol. 2001 February; 11(1): 69-74 0924-977X
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Pergolide in the management of Tourette syndrome. Author(s): Department of Neurology, Medical University of South Carolina, Charleston, USA. Source: Griesemer, D A J-Child-Neurol. 1997 September; 12(6): 402-3 0883-0738
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Response to levodopa challenge in Tourette syndrome. Author(s): Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA. Source: Black, K J Mink, J W Mov-Disord. 2000 November; 15(6): 1194-8 0885-3185
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The effects of nicotine plus haloperidol compared to nicotine only and placebo nicotine only in reducing tic severity and frequency in Tourette's disorder. Author(s): Department of Psychiatry, University of Cincinnati College of Medicine, Ohio 45267-0559. Source: McConville, B J Sanberg, P R Fogelson, M H King, J Cirino, P Parker, K W Norman, A B Biol-Psychiatry. 1992 April 15; 31(8): 832-40 0006-3223
Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •
healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0
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The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov
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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov
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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/
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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/
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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/
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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/
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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/
Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats
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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html
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Google: http://directory.google.com/Top/Health/Nutrition/
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Healthnotes: http://www.healthnotes.com/
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Open Directory Project: http://dmoz.org/Health/Nutrition/
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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/
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WebMDHealth: http://my.webmd.com/nutrition
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
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CHAPTER 3. ALTERNATIVE MEDICINE AND TOURETTE SYNDROME Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to Tourette syndrome. At the conclusion of this chapter, we will provide additional sources.
National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to Tourette syndrome and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “Tourette syndrome” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to Tourette syndrome: •
“Dude, you don't have Tourette's:” Tourette's syndrome, beyond the tics. Author(s): Schapiro NA. Source: Pediatric Nursing. 2002 May-June; 28(3): 243-6, 249-53. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12087644&dopt=Abstract
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156 cases of Gilles de la Tourette's syndrome treated by acupuncture. Author(s): Wu L, Li H, Kang L. Source: J Tradit Chin Med. 1996 September; 16(3): 211-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9389122&dopt=Abstract
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A behavioural intervention for Gilles de la Tourette syndrome in a severely mentally handicapped girl. Author(s): Zarkowska E, Crawley B, Locke J.
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Source: J Ment Defic Res. 1989 June; 33 ( Pt 3): 245-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2666670&dopt=Abstract •
A brief behavior therapy protocol for Tourette syndrome. Author(s): Carr JE, Bailey JS. Source: Journal of Behavior Therapy and Experimental Psychiatry. 1996 March; 27(1): 33-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8814519&dopt=Abstract
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A four-step hypnotherapy model for Gilles de la Tourette's syndrome. Author(s): Culbertson FM. Source: Am J Clin Hypn. 1989 April; 31(4): 252-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2653022&dopt=Abstract
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A new hypnobehavioral method for the treatment of children with Tourette's disorder. Author(s): Young MH, Montano RJ. Source: Am J Clin Hypn. 1988 October; 31(2): 97-106. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3228065&dopt=Abstract
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A simple and a complex tic (Gilles de la Tourette's syndrome): their response to EEG sensorimotor rhythm biofeedback training. Author(s): Tansey MA. Source: International Journal of Psychophysiology : Official Journal of the International Organization of Psychophysiology. 1986 July; 4(2): 91-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3460976&dopt=Abstract
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A treatment model for motor tics based on a specific tension-reduction technique. Author(s): Evers RA, van de Wetering BJ. Source: Journal of Behavior Therapy and Experimental Psychiatry. 1994 September; 25(3): 255-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7852608&dopt=Abstract
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An evaluation of behavioral treatments for Tourette syndrome. Author(s): Peterson AL, Azrin NH. Source: Behaviour Research and Therapy. 1992 March; 30(2): 167-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1567346&dopt=Abstract
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Cannabinoids: possible role in patho-physiology and therapy of Gilles de la Tourette syndrome. Author(s): Muller-Vahl KR, Kolbe H, Schneider U, Emrich HM.
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Source: Acta Psychiatrica Scandinavica. 1998 December; 98(6): 502-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9879795&dopt=Abstract •
Cannabis in movement disorders. Author(s): Muller-Vahl KR, Kolbe H, Schneider U, Emrich HM. Source: Forschende Komplementarmedizin. 1999 October; 6 Suppl 3: 23-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10627163&dopt=Abstract
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Case study of circadian rhythm sleep disorder following haloperidol treatment: reversal by risperidone and melatonin. Author(s): Ayalon L, Hermesh H, Dagan Y. Source: Chronobiology International. 2002 September; 19(5): 947-59. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12405556&dopt=Abstract
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Child psychiatry comes of age: growing sophistication, evolving strategies. Author(s): Rapoport JL. Source: The American Journal of Psychiatry. 1997 August; 154(8): 1043-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9247385&dopt=Abstract
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Cortical evoked potentials in Gilles de la Tourette's syndrome--a single case study. Author(s): Surwillo WW. Source: Psychiatry Research. 1981 February; 4(1): 31-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6938999&dopt=Abstract
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Delta 9-tetrahydrocannabinol (THC) is effective in the treatment of tics in Tourette syndrome: a 6-week randomized trial. Author(s): Muller-Vahl KR, Schneider U, Prevedel H, Theloe K, Kolbe H, Daldrup T, Emrich HM. Source: The Journal of Clinical Psychiatry. 2003 April; 64(4): 459-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12716250&dopt=Abstract
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Dopamine autoreceptor stimulation: clinical significance. Author(s): Meltzer HY. Source: Pharmacology, Biochemistry, and Behavior. 1982; 17 Suppl 1: 1-10. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6223322&dopt=Abstract
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Dopamine D2 receptor imaging in Gilles de la Tourette syndrome. Author(s): Muller-Vahl KR, Berding G, Kolbe H, Meyer GJ, Hundeshagen H, Dengler R, Knapp WH, Emrich HM. Source: Acta Neurologica Scandinavica. 2000 March; 101(3): 165-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10705938&dopt=Abstract
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Effects of massed practice and cue-controlled relaxation on tic frequency in Gilles de la Tourette's syndrome. Author(s): Turpin G, Powell GE. Source: Behaviour Research and Therapy. 1984; 22(2): 165-78. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6370223&dopt=Abstract
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Elevated striatal dopamine transporter in a drug naive patient with Tourette syndrome and attention deficit/ hyperactivity disorder: positive effect of methylphenidate. Author(s): Krause KH, Dresel S, Krause J, Kung HF, Tatsch K, Lochmuller H. Source: Journal of Neurology. 2002 August; 249(8): 1116-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12420715&dopt=Abstract
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Gilles de la Tourette's syndrome--an overview of development and treatment of a case, using hypnotherapy, haloperidol, and psychotherapy. Author(s): Clements RO. Source: Am J Clin Hypn. 1972 January; 14(3): 167-72. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4526606&dopt=Abstract
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Hypnosis as an “entree” for consultation-liaison psychiatry. Author(s): Sandor RS. Source: General Hospital Psychiatry. 1980 March; 2(1): 65-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6929771&dopt=Abstract
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Influence of treatment of Tourette syndrome with delta9-tetrahydrocannabinol (delta9-THC) on neuropsychological performance. Author(s): Muller-Vahl KR, Koblenz A, Jobges M, Kolbe H, Emrich HM, Schneider U. Source: Pharmacopsychiatry. 2001 January; 34(1): 19-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11229617&dopt=Abstract
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Inherited diseases in North American Mennonites: focus on Old Colony (Chortitza) Mennonites. Author(s): Jaworski MA, Severini A, Mansour G, Hennig K, Slater JD, Jeske R, Schlaut J, Yoon JW, Maclaren NK, Nepom GT. Source: American Journal of Medical Genetics. 1989 February; 32(2): 158-68. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2784628&dopt=Abstract
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Man's tripartite brain and psychosomatic medicine. Author(s): Knopp W. Source: Psychotherapy and Psychosomatics. 1970; 18(1): 130-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5286242&dopt=Abstract
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Nicotine for the treatment of Tourette's syndrome. Author(s): Sanberg PR, Silver AA, Shytle RD, Philipp MK, Cahill DW, Fogelson HM, McConville BJ. Source: Pharmacology & Therapeutics. 1997; 74(1): 21-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9336013&dopt=Abstract
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No change in striatal dopamine re-uptake site density in psychotropic drug naive and in currently treated Tourette's disorder patients: a [(123)I]-beta-CIT SPECt-study. Author(s): Stamenkovic M, Schindler SD, Asenbaum S, Neumeister A, Willeit M, Willinger U, de Zwaan M, Riederer F, Aschauer HN, Kasper S. Source: European Neuropsychopharmacology : the Journal of the European College of Neuropsychopharmacology. 2001 February; 11(1): 69-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11226814&dopt=Abstract
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'Obsessions' in children with autism or Asperger syndrome. Content analysis in terms of core domains of cognition. Author(s): Baron-Cohen S, Wheelwright S. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1999 November; 175: 484-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10789283&dopt=Abstract
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Obsessive compulsive disorder: is there an association with childhood streptococcal infections and altered immune function? Author(s): Murphy TK, Petitto JM, Voeller KK, Goodman WK. Source: Semin Clin Neuropsychiatry. 2001 October; 6(4): 266-76. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11607922&dopt=Abstract
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Occurrence of tics in Asperger's syndrome and autistic disorder. Author(s): Ringman JM, Jankovic J. Source: Journal of Child Neurology. 2000 June; 15(6): 394-400. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10868783&dopt=Abstract
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Opiatergic and dopaminergic function and Lesch-Nyhan syndrome. Author(s): Gillman MA, Sandyk R. Source: The American Journal of Psychiatry. 1985 October; 142(10): 1226. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2994499&dopt=Abstract
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Pathophysiology of tics and Tourette syndrome. Author(s): Berardelli A, Curra A, Fabbrini G, Gilio F, Manfredi M. Source: Journal of Neurology. 2003 July; 250(7): 781-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12883917&dopt=Abstract
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PET studies of the presynaptic and postsynaptic dopaminergic system in Tourette's syndrome. Author(s): Turjanski N, Sawle GV, Playford ED, Weeks R, Lammerstma AA, Lees AJ, Brooks DJ. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 1994 June; 57(6): 688-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7911827&dopt=Abstract
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Pharmacological options for the treatment of Tourette's disorder. Author(s): Jimenez-Jimenez FJ, Garcia-Ruiz PJ. Source: Drugs. 2001; 61(15): 2207-20. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11772131&dopt=Abstract
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Receptor and transporter imaging studies in schizophrenia, depression, bulimia and Tourette's disorder--implications for psychopharmacology. Author(s): Kasper S, Tauscher J, Willeit M, Stamenkovic M, Neumeister A, Kufferle B, Barnas C, Stastny J, Praschak-Rieder N, Pezawas L, de Zwaan M, Quiner S, Pirker W, Asenbaum S, Podreka I, Brucke T. Source: World J Biol Psychiatry. 2002 July; 3(3): 133-46. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12478878&dopt=Abstract
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Relaxation therapy in Tourette syndrome: a pilot study. Author(s): Bergin A, Waranch HR, Brown J, Carson K, Singer HS. Source: Pediatric Neurology. 1998 February; 18(2): 136-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9535299&dopt=Abstract
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Relaxation-imagery (self-hypnosis) in Tourette syndrome: experience with four children. Author(s): Kohen DP, Botts P. Source: Am J Clin Hypn. 1987 April; 29(4): 227-37. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3296729&dopt=Abstract
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Repetitive transcranial magnetic stimulation for Tourette syndrome. Author(s): Munchau A, Bloem BR, Thilo KV, Trimble MR, Rothwell JC, Robertson MM. Source: Neurology. 2002 December 10; 59(11): 1789-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12473773&dopt=Abstract
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The Gilles de la Tourette syndrome. Author(s): Robertson MM, Stern JS. Source: Crit Rev Neurobiol. 1997; 11(1): 1-19. Review. Erratum In: Crit Rev Neurobiol 1997; 11(4): Preceding 241. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9093811&dopt=Abstract
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The metabolic effects of limbic leucotomy in Gilles de la Tourette syndrome. Author(s): Sawle GV, Lees AJ, Hymas NF, Brooks DJ, Frackowiak RS. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 1993 September; 56(9): 1016-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8410025&dopt=Abstract
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Tourette syndrome. Author(s): Carey M, Carbonari C. Source: Nurs News (Meriden). 1979 May; 52(9): 2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=286980&dopt=Abstract
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Tourette syndrome: pieces of the puzzle. Author(s): Leckman JF, Cohen DJ, Goetz CG, Jankovic J. Source: Adv Neurol. 2001; 85: 369-90. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11530445&dopt=Abstract
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Treatment of Tourette syndrome with delta-9-tetrahydrocannabinol (delta 9-THC): no influence on neuropsychological performance. Author(s): Muller-Vahl KR, Prevedel H, Theloe K, Kolbe H, Emrich HM, Schneider U. Source: Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology. 2003 February; 28(2): 384-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12589392&dopt=Abstract
Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •
Alternative Medicine Foundation, Inc.: http://www.herbmed.org/
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AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats
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Chinese Medicine: http://www.newcenturynutrition.com/
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drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html
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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm
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Google: http://directory.google.com/Top/Health/Alternative/
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Healthnotes: http://www.healthnotes.com/
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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine
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Open Directory Project: http://dmoz.org/Health/Alternative/
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HealthGate: http://www.tnp.com/
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WebMDHealth: http://my.webmd.com/drugs_and_herbs
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
•
Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/
The following is a specific Web list relating to Tourette syndrome; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
Herbs and Supplements Lecithin Source: Prima Communications, Inc.www.personalhealthzone.com
General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.
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CHAPTER 4. DISSERTATIONS ON TOURETTE SYNDROME Overview In this chapter, we will give you a bibliography on recent dissertations relating to Tourette syndrome. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “Tourette syndrome” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on Tourette syndrome, we have not necessarily excluded non-medical dissertations in this bibliography.
Dissertations on Tourette Syndrome ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to Tourette syndrome. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •
A Path Analysis of the Role of Symptom Severity and Health Care and Educational Resources in the Psychosocial Functioning of Adults with Tourette Syndrome by Keefer, Amy Jane; PhD from Drexel University, 2003, 116 pages http://wwwlib.umi.com/dissertations/fullcit/3093985
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Adlerian Personality Priorities of Siblings of Individuals with Tourette Syndrome by Sims, Deanna, PhD from University of North Texas, 1998, 78 pages http://wwwlib.umi.com/dissertations/fullcit/9841451
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An Exploratory Study of the Educational Services Provided for Students with Tourette Syndrome (behaviors, Perceptions, Parents, Naturalistic Design; Florida) by Anderson, Donna, PhD from University of South Florida, 1984, 304 pages http://wwwlib.umi.com/dissertations/fullcit/8508829
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Neuropsychological Functioning of School-age Children with Tourette Syndrome by Dornbush, Marilyn Pierce, PhD from Georgia State University, 1984, 260 pages http://wwwlib.umi.com/dissertations/fullcit/8425845
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The Organic Characteristics of Children with Tourette Syndrome: Counseling Implications by Swallow, Ward Kent, PhD from The University of Akron, 1986, 139 pages http://wwwlib.umi.com/dissertations/fullcit/8616445
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Tourette Syndrome by Dunn, Molly Elizabeth; Ms from Sarah Lawrence College, 2003, 41 pages http://wwwlib.umi.com/dissertations/fullcit/1413581
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Tourette's Syndrome Children: Significant Achievement and Social Behavior Variables (Tourette Syndrome, Attention Deficit Hyperactivity Disorder) by Gallina, Nancy Burleigh, PhD from City University of New York, 1989, 104 pages http://wwwlib.umi.com/dissertations/fullcit/9000024
Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.
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CHAPTER 5. CLINICAL TRIALS AND TOURETTE SYNDROME Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning Tourette syndrome.
Recent Trials on Tourette Syndrome The following is a list of recent trials dedicated to Tourette syndrome.8 Further information on a trial is available at the Web site indicated. •
Brain Activation in Vocal and Motor Tics Condition(s): Tourette's Syndrome; Chronic Motor Tic Disorder; Chronic Motor Vocal Disorder Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Neurological Disorders and Stroke (NINDS) Purpose - Excerpt: This study will investigate the brain areas that are activated by vocal and motor tics in patients with Tourette's syndrome and other tic disorders. Tics are involuntary repetitive movements similar to voluntary movements. They may be simple, involving only a few muscles or simple sounds, or complex, involving several groups of muscles in orchestrated bouts. This study will involve only simple motor tics, such as eye blinking, nose wrinkling, facial grimacing and abdominal tensing, and simple vocal tics, such as throat clearing, sniffing and snorting. Healthy normal volunteers and patients between 14 and 65 years of age with simple motor or vocal tics may be eligible for this study. Participants will have a brief medical history and physical examination and magnetic resonance imaging (MRI) of the brain. MRI uses a magnetic field and radio waves to produce images. For the procedure, the subject lies on a table that is moved into a cylindrical chamber containing a strong magnet. Earplugs are worn to muffle the loud thumping sounds made by electrical switching of the radio frequency circuits and protect against temporary hearing impairment. During the scan, normal volunteers will be asked to make simple movements or sounds designed to imitate tics, such as raising eyebrows, blinking or coughing. Patients with tic disorders will have two
8
These are listed at www.ClinicalTrials.gov.
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parts to the scanning session. First they will relax and allow tics to occur spontaneously, then they will be asked to imitate a specific tic when there is no urge to tic. Patients and healthy subjects will have electromyography (EMG) to record the timing of the voluntary movements and tics. For this procedure, several pairs of small, saucer-like electrodes are attached to the skin with a gel or paste. Electric signals from the electrodes are amplified and recorded on a computer. A microphone may be placed near patients to record any vocal tics. A video camera may also be used to record the tics. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00026000 •
Brain Dynamics Involved in Generating Tics and Controlling Voluntary Movement Condition(s): Tourette Syndrome; Tic Disorders Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Neurological Disorders and Stroke (NINDS) Purpose - Excerpt: This study will use electroencephalography (EEG) and electromyography (EMG) to examine how the brain generates tics and controls voluntary movement in patients with Tourette's syndrome and chronic motor tic disorder. EEG records the electrical activity of the brain. For this test, a cap with built-in electrodes is placed on the subject's head, and the electrodes are connected to a monitor that records the brain activity. EMG records muscle activity using electrodes placed on the skin over muscles on the fingers or above the outer corner of the eyes. Healthy normal volunteers and patients with Tourette's syndrome and chronic motor tic disorder between 21 and 65 years of age may be eligible for this 2- to 3-hour study. Each candidate will be screened with a medical history, physical and neurological examinations, and a questionnaire that screens for psychiatric disorders. During EEG and EMG recordings, participants undergo the following tasks while seated comfortably in a sound-shielded room: Patients - Finger task: Patients raise their index finger once every 10 seconds for about 25 minutes. - Tic evaluation and mimicking: Patients allow their tics to occur as they do naturally. After each tic, they report whether the tic was voluntary and whether it was preceded by a sensation of urge. They then mimic tics that they normally have, at a rate of about once every 10 seconds. - Tic suppression task: Patients suppress tics they normally have for several minutes. They then allow the tics to occur naturally, without attempting to suppress them. Normal Volunteers - Finger task: Volunteers raise their index finger once every 10 seconds for about 25 minutes. Open eye task: Volunteers keep their eyes open for a minute or so, and then resume blinking as often as feels comfortable. The process is repeated several times. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00056420
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Brain Tissue Collection for Neuropathological Studies Condition(s): Bipolar Disorder; Huntington Disease; Schizophrenia; Tourette Syndrome; Dementia Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH)
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Purpose - Excerpt: The purpose of this study is to collect and study the brain tissue of deceased individuals to learn more about the nervous system and mental disorders. Information gained from donated tissue may lead to better treatments and potential cures for nervous system and mental disorders. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001260 •
Central Mechanisms in Speech Motor Control Studied with H215O PET Condition(s): Communication Disorder; Healthy; Stuttering; Tourette Syndrome; Voice Disorder Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Deafness and Other Communication Disorders (NIDCD) Purpose - Excerpt: Positron Emission Tomography (PET) is a technique used to investigate the functional activity of the brain. The PET technique allows doctors to study the normal biochemical and metabolic processes of the central nervous system of normal individuals and patients with neurologic illnesses without physical / structural damage to the brain. Radioactive water H215O in PET scans permits good visualization of areas of the brain related to speech. Most of the PET scan studies conducted have concentrated on learning about how language is formed and decoded. Few studies have been conducted on speech production. This study aims to use radioactive water (H215O) and Positron Emission Tomography (PET scan) to measure blood flow to different areas of the brain in order to better understand the mechanisms involved in speech motor control. When a region of the brain is active, it uses more fuel in the form of oxygen and sugar (glucose). As the brain uses more fuel it produces more waste products, carbon dioxide and water. Blood carries fuel to the brain and waste products away from the brain. As brain activity increases blood flow to and from the area of activity increases also. Knowing these facts, researchers can use radioactive chemicals (H215O) and PET scans to observe what areas of the brain are receiving more blood flow. Researchers will ask patients to perform tasks that will affect speech, voice, and language. At the same time patients will undergo a PET scan. The tasks are designed to help researchers observe the blood flow to brain areas associated with voicebox (laryngeal) functions, movement of muscles in the jaw, tongue, and mouth, and other aspects of motor speech. Special studies will be conducted to evaluate how certain therapies and tasks can draw out symptoms in illnesses in which speech and language are affected. Results of these tests will be used in other studies to evaluate the neurologic mechanisms of diseases like Tourette's syndrome and parkinson's disease. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001308
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Developmental Phenomenology of Obsessive Compulsive Disorder and Tourette Syndrome in Children and Adolescents Condition(s): Tourette Syndrome; Obsessive Compulsive Disorder Study Status: This study is currently recruiting patients.
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Sponsor(s): National Center for Research Resources (NCRR); Yale University Purpose - Excerpt: Objectives: I. Characterize the natural history, associated features, and severity of symptoms of obsessive compulsive disorder and Tourette syndrome in children and adolescents. II. Identify factors that influence the clinical course and prognosis of these patients. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00004324 •
Evaluation and Follow-up of Individuals with Obsessive-Compulsive Disorder and Related Conditions Condition(s): Anorexia Nervosa; Obsessive Compulsive Disorder; Tourette Syndrome; Trichotillomania Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: The purpose of this study is to better understand the long-term progress of people with obsessive-compulsive disorder (OCD) and related conditions such as anorexia nervosa, Tourette syndrome, and trichotillomania. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00004550
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Magnetic Resonance Spectroscopy to Evaluate Tourette's Syndrome Condition(s): Tourette Syndrome Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Neurological Disorders and Stroke (NINDS) Purpose - Excerpt: This study will use magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) of the brain to try to gain a better understanding of the disease process in Tourette's syndrome, a neuropsychiatric disorder characterized by motor and vocal tics. Tourette's syndrome is also associated with behavioral and emotional disturbances, including symptoms of attention deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD). MRI and MRS show chemical substances in the brain. Findings in normal volunteers will be compared with those of patients. Healthy volunteers and patients with Tourette's syndrome 14 years of age and older may be eligible for this study. Volunteers will be screened with a medical history and physical and neurological examinations. Patients will be screened through NINDS protocol 93-N-0202. Participants will undergo MRI and MRS. MRI uses a strong magnetic field and radio waves to visualize brain anatomy and chemistry. For this study, the subject lies on a stretcher, which is moved into a strong magnetic field (the MRI scanner). Earplugs are worn to muffle loud thumping noises caused by the electrical switching of the radio frequency circuits. During the study, the subject lies still during each scan, for 1 to 8 minutes at a time. Total scanning time varies from 20 minutes to 2 hours, with most examinations lasting between 45 and 90 minutes. The subject can speak through an intercom with the staff member performing the study at all times during the procedure. Up to 5 studies may be performed.
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Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00030953 •
Study of GABA-A receptors in the Generation of Tics in Patients with Tourette's Syndrome Condition(s): Tourette Syndrome Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Neurological Disorders and Stroke (NINDS) Purpose - Excerpt: This study will investigate how the brain generates tics in patients with Tourette's syndrome and which areas of the brain are primarily affected. Tourette's syndrome is a neuropsychiatric disorder characterized by motor and vocal tics, and is associated with behavioral and emotional disturbances, including symptoms of attention deficit hyperactivity disorder and obsessive-compulsive disorder. This study will examine whether tic generation is related to changes in brain cell receptors for a chemical messenger called gamma-aminobutyric acid (GABA). Healthy normal volunteers and patients with Tourette's syndrome between 21 and 65 years of age may be eligible for this study. Candidates will be screened with a medical history and physical and neurological examinations. Participants will undergo positron emission tomography (PET) scanning to measure brain blood flow. For this procedure, the subject receives an injection of H215O, a radioactive substance similar to water. A special camera detects the radiation emitted by the H215O, allowing measurement of the blood flow. Subjects will receive up to five injections of H215O during the scanning. They will also be injected with another radioactive chemical, (11C) flumazenil, which binds to GABA receptors, to measure the density and distribution of these receptors. This will reveal which areas of the brain in patients with Tourette's syndrome have abnormal binding of flumazenil compared with the brains of healthy control subjects. During the PET procedure, the subject lies on a table in the PET scanner. A small catheter (plastic tube) is placed in an arm vein for injecting the radioactive tracers, and a mask is placed on the face to help keep the head still during scanning. The mask has large openings for eyes, nose and mouth, so that it does not interfere with talking or breathing. The entire test takes about 3 hours. On a separate day, participants will also undergo magnetic resonance imaging (MRI), a diagnostic test that uses a magnetic field and radio waves to produce images of the brain. For this procedure, the subject lies still on a stretcher that is moved into the scanner (a narrow cylinder containing the magnet). Earplugs are worn to muffle loud noises caused by electrical switching of radio frequency circuits used in the scanning process. The scan lasts about 45 to 60 minutes. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00034398
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Study of the Neurobiology of Tourette Syndrome and Related Disorders Condition(s): Tourette Syndrome; Obsessive Compulsive Disorder Study Status: This study is currently recruiting patients. Sponsor(s): National Center for Research Resources (NCRR); Yale University
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Purpose - Excerpt: Objectives: I. Investigate the pathobiology of Tourette syndrome and related disorders by measuring various compounds of interest in cerebrospinal fluid, plasma, and urine of patients with Tourette syndrome, obsessive compulsive disorder, and/or chronic tics. II. Determine the pattern of familial aggregation of Tourette syndrome and obsessive compulsive disorder by systematic assessment of all firstdegree family members of patients selected for cerebrospinal fluid studies. III. Establish the neurochemical and neuropeptide profile associated with the range of expression of the putative Tourette gene expression in adult and adolescent patients. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00004325 •
Study of Tics in Patients with Tourette's Syndrome and Chronic Motor Tic Disorder Condition(s): Tourette Syndrome; Tic Disorders Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Neurological Disorders and Stroke (NINDS) Purpose - Excerpt: This study will investigate which areas of the brain are primarily involved in and responsible for tics in patients with Tourette's syndrome and chronic motor disorder. Tourette's syndrome is a neuropsychiatric disorder characterized by motor and vocal tics and is associated with behavioral and emotional disturbances, including symptoms of attention deficit hyperactivity disorder and obsessivecompulsive disorder. Chronic motor disorder has the same characteristics as Tourette's syndrome, except that patients do not have vocal tics. Healthy normal volunteers and patients with Tourette's syndrome or chronic motor tic disorder between 18 and 65 years of age may be eligible for this study. Candidates will be screened with a medical history and physical and neurological examinations. Participants will undergo positron emission tomography (PET) scanning to study tics under three conditions- spontaneous tics, suppression of tics, and sleep-to determine which areas of the brain are responsible for generation of tics. For this procedure, the subject is injected with H215O, a radioactive substance similar to water. A special camera detects the radiation emitted by the H215O, allowing measurement of brain blood flow. Subjects will receive up to 20 injections of H215O during the scanning. Participants will be asked not to sleep the entire night before the test. Before the scan, both patients and volunteers will have EEG electrodes placed on their heads to record the electrical activity of their brains. Patients will also have EMG electrodes placed in areas of the body where tics occur. A small catheter (plastic tube) will be placed in an arm vein for injecting the radioactive tracers, and a mask will be placed on the face to help keep the head still during scanning. The mask has large openings for eyes, nose and mouth, so that it does not interfere with talking or breathing. The entire test takes about 4 hours. During this time, the subject will sleep for 1.5 hours either at the beginning or end of the scan. For the other 2.5 hours, scans will be done every 10 minutes for 1 minute under the different conditions of tic suppression or release of tics. On a separate day, participants will also undergo magnetic resonance imaging (MRI), a diagnostic test that uses a magnetic field and radio waves to produce images of the brain. For this procedure, the subject lies still on a stretcher that is moved into the scanner (a narrow cylinder containing the magnet). Earplugs are worn to muffle loud noises caused by electrical switching of radio frequency circuits used in the scanning process. The scan lasts about 45 to 60 minutes. Study Type: Observational
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Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00033995 •
Randomized Study of Pergolide in Children with Tourette Syndrome Condition(s): Tourette Syndrome Study Status: This study is no longer recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH); FDA Office of Orphan Products Development; Medical University of South Carolina Purpose - Excerpt: Objectives: I. Evaluate the presumed mechanism of action of low dose pergolide to act acutely through the dopaminergic autoreceptor or postsynaptically at D2 sites in children 7 to 17 with tourette syndrome (GTS). II. Compare tolerability and safety of pergolide in these patients to standard neuroleptic therapy via naturalist assessment after 3-6 months of treatment using matched historical controls on neuroleptics. III. Determine efficacy of pergolide for tic control in these patients. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00004433
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I-123 Brain Studies of Serotonin Metabolism in Psychiatric Patients and Normal Volunteers Condition(s): Healthy; Mental Schizophrenia; Tourette Syndrome
Disorder;
Obsessive
Compulsive
Disorder;
Study Status: This study is completed. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: Abnormalities in the re-uptake of dopamine and serotonin have been described in various neuropsychiatric disorders and substance abuse. [I-123] Beta-CIT is a recently developed radioligand for SPECT imaging of dopamine and serotonin transporters. [I-123]Beta-CIT SPECT has been used at the SPECT-lab of the Clinical Brain Disorders Branch in over fifty subjects without adverse events. Due to the trace concentrations used, a pharmacological effect of Beta-CIT is unlikely and has not been observed. The purpose of this study is to use Beta-CIT and SPECT to study the expression of dopamine and serotonin transporters in vivo in normal controls and various patient populations to address hypothesized abnormalities of the transporters in different disorders and to understand the effects of genetic variations in the genes of these transporters on their in vivo expression. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001771 •
Phase II Double Blind Placebo Controlled Trial of Risperidone in Tourette Syndrome Condition(s): Tourette Syndrome Study Status: This study is completed. Sponsor(s): National Center for Research Resources (NCRR); Yale University
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Purpose - Excerpt: Objectives: I. Conduct a randomized, double blind, placebo controlled, parallel study of the atypical neuroleptic risperidone (RIS) in the treatment of children and adults with moderate to severe Tourette Syndrome. II. Evaluate further the safety of RIS in this population. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00004393 •
Phase II Pilot Controlled Study of Short vs Longer Term Pimozide (Orap) Therapy in Tourette Syndrome Condition(s): Tourette Syndrome Study Status: This study is completed. Sponsor(s): National Center for Research Resources (NCRR); University of Rochester Purpose - Excerpt: Objectives: I. Determine whether the time period between randomization and endpoint is longer in the short term pimozide therapy or longer term therapy in patients with Tourette syndrome. II. Determine whether tic severity, medication side effects, academic performance and psychosocial functioning are better in the short term pimozide therapy or longer term pimozide therapy. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00004652
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Phase III Randomized, Double-Blind, Placebo-Controlled Study of Guanfacine for Tourette Syndrome and Attention Deficit Hyperactivity Disorder Condition(s): Tourette Syndrome Study Status: This study is completed. Sponsor(s): National Center for Research Resources (NCRR); Yale University Purpose - Excerpt: Objectives: I. Evaluate the safety and efficacy of the alpha-2 adrenergic agonist guanfacine in children and adolescents with Tourette syndrome or other chronic tic disorder, and attention deficit hyperactivity disorder. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00004376
Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions.
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The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “Tourette syndrome” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: •
For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/
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For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html
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For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/
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For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm
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For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm
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For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm
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For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp
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For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm
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For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/
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For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm
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For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm
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For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm
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For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm
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For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm
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For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials
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CHAPTER 6. PATENTS ON TOURETTE SYNDROME Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.9 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “Tourette syndrome” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on Tourette syndrome, we have not necessarily excluded nonmedical patents in this bibliography.
Patents on Tourette Syndrome By performing a patent search focusing on Tourette syndrome, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. 9Adapted from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.
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Tourette Syndrome
The following is an example of the type of information that you can expect to obtain from a patent search on Tourette syndrome: •
Nicotine antagonists for nicotine-responsive neuropsychiatric disorders Inventor(s): Sanberg; Paul R. (Spring Hill, FL), Shytle; Roland D. (Lutz, FL), Silver; Archie A. (Tampa, FL) Assignee(s): University of South Florida (Tampa, FL) Patent Number: 6,034,079 Date filed: November 23, 1998 Abstract: Nicotine-responsive neuropsychiatric disorders can be treated by administering a nicotine antagonist, particularly mecamylamine. Combination therapy of mecamylamine with a neuroleptic drug also is disclosed. The neuropsychiatric disorders include Tourette's syndrome, schizophrenia, depression, bipolar disorder, tremors, attention deficit hyperactivity disorder, obsessive-compulsive disorder, hemidystonia, rage outbursts and tardive dyskinesia. Excerpt(s): The present invention is in the field of pharmacotherapy of nicotineresponsive neuropsychiatric disorders by administering a nicotine antagonist alone, particularly mecamylamine, or in combination with a neuroleptic agent. Examples of such disorders are schizophrenia, bipolar disorder, obsessive compulsive disorder, attention deficit hyperactivity disorder, Tourette's syndrome, and other movement disorders. Tourette's syndrome (TS) is an autosomal dominant neuropsychiatric disorder characterized by a range of symptoms, including multiple motor and phonic tics. It is a hyperkinetic movement disorder expressed largely by sudden, rapid, brief, recurrent, nonrhythmic, stereotyped motor movements (motor tics) or sounds (phonic tics), experienced as irresistible impulses but which can be suppressed for varying lengths of time (Tourette Syndrome Classification Study Group, Arch Neurol 50: 101316). Motor tics generally include eye blinking, head jerking, shoulder shrugging and facial grimacing, while phonic or vocal tics include throat clearing, sniffling, yelping, tongue clicking and coprolalia. The symptoms typically begin in childhood and range from relatively mild to very severe over the course of a patient's lifetime (Robertson M M, Br J Psychiatry, 154:147-169, 1989). Many TS patients also exhibit other neuropsychiatric abnormalities including obsessive compulsive symptoms (Pauls D L et al. Psychopharm Bull, 22:730-733, 1986), hyperactivity and attention deficits (Comings D E, Himes J A, Comings B G, J Clin Psychiatry, 51:463-469, 1990). Problems with extreme temper or aggressive behavior also are frequent (Riddle M A et al. Wiley Series in Child and Adolescent Mental Health, Eds. Cohen D J, Bruun, R D, Leckman J F, New York City, John Wiley and Sons, pp. 151-162, 1988; Stelf M E, Bornstein R A, Hammond L, A survey of Tourette syndrome patients and their families: the 1987 Ohio Tourette Survey, Cincinnati, Ohio Tourette Syndrome Association, 1988), as are school refusal and learning disabilities (Harris D, Silver A A, Learning Disabilities, 6(1):1-7, 1995; Silver A A, Hagin R A, Disorders of Learning Childhood, Noshpitz J D, ed. New York City: Wiley, pp. 469-508, 1990). While the pathogenesis of TS is still unknown, excessive striatal dopamine and/or dopamine receptor hypersensitivity has been proposed (Singer H S et al. Ann Neurol, 12:361-366, 1982), based largely on the therapeutic effectiveness of dopamine receptor antagonists. T S is frequently treated with the dopamine antagonist haloperidol (Haldol.RTM., McNeil Pharmaceutical, Raritan, N.J.), which is effective in about 70% of cases (Erenberg G, Cruse R P, Rothner, A D, Ann Neurol, 22:383-385, 1987; Shapiro A K, Shapiro E, Wiley series in child and adolescent
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mental health, Eds. Cohen D J, Bruun R D, Leckman J F, New York City, John Wiley and Sons, pp. 267-280, 1988). Other neuroleptics include pimozide (Shapiro E S et al. Arch Gen Psychiatry, 46:722-730, 1989), fluphenazine (Singer H S, Gammon K, Quaskey S. Pediat Neuroscience, 12:71-74, 1985-1986), and risperidone (Stamenkovic et al., Lancet 344:1577-78, 1994). An alternative medication frequently employed is the.alpha.adrenergic agonist clonidine, which also is effective for associated attention deficit hyperactivity disorder (ADHD) but has only a 40% success rate for motor and vocal tics (Bruun R D, J Am Acad Child Psychiatry, 23: 126-133, 1984; Cohen D J et al. Arch Gen Psychiatry 37: 1350-1357, 1980). Other medications that have been used with varying degrees of effectiveness include clonazepam (Gonce M, Barbeau A. Can J Neurol Sci 4:279-283, 1977), naloxone (Davidson P W et al. Appl Res Ment Retardation 4: 1-4, 1983) and fluoxetine (Riddle M A et al. J Am Acad Child Adol Psychiatry 29: 45-48, 1990). One of the most commonly used medications is haloperidol (Erenberg G, Cruse R P, Rothner A D, Ann Neurol, 22:383-385, 1987). However, therapeutic doses of haloperidol have frequent side effects that affect compliance, including difficulty in concentration, drowsiness, depression, weight gain, parkinsonian-like symptoms--and with long-term use--tardive dyskinesia (Shapiro A K, Shapiro E, Tourette's syndrome and Tic Disorders: Clinical Understanding and Treatment. Wiley series in child and adolescent mental health. Eds. Cohen, D J, Bruun, R D, Leckman J F, New York City, John Wiley and Sons, pp. 267-298, 1988). The side effect of tardive dyskinesia is particularly bothersome because it may add additional abnormal, involuntary movements of the tongue, jaw, trunk and/or extremities. Web site: http://www.delphion.com/details?pn=US06034079__ •
Substituted pyridines useful as modulators of acetylcholine receptors Inventor(s): Cosford; Nicholas D. (San Diego, CA), Vernier; Jean-Michel (San Diego, CA) Assignee(s): Merck & Co., Inc. (Rahway, NJ) Patent Number: 6,194,581 Date filed: December 22, 1998 Abstract: In accordance with the present invention, there is provided a class of pyridine compounds which are modulators of acetylcholine receptors. The compounds of the invention displace acetylcholine receptor ligands from their binding sites. Invention compounds may act as agonists, partial agonists, antagonists or allosteric modulators of acetylcholine receptors, and are useful for a variety of therapeutic applications, such as the treatment of Alzheimer's disease and other disorders involving memory loss and/or dementia (including AIDS dementia); disorders of attention and focus (such as attention deficit disorder); disorders of extrapyramidal motor function such as Parkinson's disease, Huntington's disease, Gilles de la Tourette syndrome and tardive dyskinesia; mood and emotional disorders such as depression, panic, anxiety and psychosis; substance abuse including withdrawal syndromes and substitution therapy; neuroendocrine disorders and dysregulation of food intake, including bulimia and anorexia; disorders of nociception and control of pain; autonomic disorders including dysfunction of gastrointestinal motility and function such as inflammatory bowel disease, irritable bowel syndrome, diarrhea, constipation, gastric acid secretion and ulcers; pheochromocytoma; cardiovascular dysfunction including hypertension and cardia arrhythmias, comedication in surgical procedures, and the like. Excerpt(s): The present invention relates to novel compounds which are capable of modulating acetylcholine receptors. Invention compounds are useful, for example, for
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treatment of dysfunction of the central or autonomic nervous systems including dementia, cognitive disorders, neurodegenerative disorders, extrapyramidal disorders, convulsive disorders, cardiovascular disorders, endocrine disorders, pain, gastrointestinal disorders, eating disorders, affective disorders, and drug abuse. In addition, the present invention relates to pharmaceutical compositions containing these compounds, as well as various uses therefor. By modulation of neurotransmitter release (including dopamine, norepinephrine, acetylcholine and serotonin) from different brain regions, acetylcholine receptors are involved in the modulation of neuroendocrine function, respiration, mood, motor control and function, focus and attention, concentration, memory and cognition, and the mechanisms of substance abuse. Ligands for acetylcholine receptors have been demonstrated to have effects on attention, cognition, appetite, substance abuse, memory, extrapyramidal function, cardiovascular function, pain and gastrointestinal motility and function. The distribution of acetylcholine receptors that bind nicotine, i.e., nicotinic acetylcholine receptors, is widespread in the brain, including the basal ganglia, limbic system, cerebral cortex and mid- and hind-brain nuclei. In the periphery, the distribution includes muscle, autonomic ganglia, the gastrointestinal tract and the cardiovascular system. Acetylcholine receptors have been shown to be decreased, inter alia, in the brains of patients suffering from Alzheimer's disease or Parkinson's disease, diseases associated with dementia, motor dysfunction and cognitive impairment. Such correlations between acetylcholine receptors and nervous system disorders suggest that compounds that modulate acetylcholine receptors will have beneficial therapeutic effects for many human nervous system disorders. Thus, there is a continuing need for compounds which can selectively modulate the activity of acetylcholine receptors. In response to such need, the present invention provides a new family of compounds which modulate acetylcholine receptors. Web site: http://www.delphion.com/details?pn=US06194581__
Patent Applications on Tourette Syndrome As of December 2000, U.S. patent applications are open to public viewing.10 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to Tourette syndrome: •
Combinations of SSRI and estrogenic agents Inventor(s): Jenkins, Simon N.; (Audubon, PA) Correspondence: Arnold S. Milowsky; American Home Products Corporation; Patent Law Department - 2B; Five Giralda Farms; Madison; NJ; 07940; US Patent Application Number: 20020042432 Date filed: June 29, 2001 Abstract: This invention comprises methods of depression, anxiety, generalized anxiety disorder (GAD), hot flush, post partum depression, premenstrual syndrome, obesity, obsessive compulsive disorder, post-traumatic stress disorder, social phobia, disruptive behavior disorders, impulse control disorders, borderline personality disorder, chronic fatigue disorder, premature ejaculation, pain, attention deficit disorders, with and
10
This has been a common practice outside the United States prior to December 2000.
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without hyperactivity, Gilles de la Tourette syndrome, bulimia nervosa, or Shy Drager Syndrome comprising administration of a selective serotonin reuptake inhibitor and compound of the formulae I or II: 1wherein Z is a moiety selected from the group of: 2wherein: R.sub.1 is selected from H, OH or the C.sub.1-C.sub.12 esters or C.sub.1C.sub.12 alkyl ethers thereof, benzyloxy, or halogen; or C.sub.1-C.sub.4 halogenated ethers including trifluoromethyl ether and trichloromethyl ether; R.sub.2, R.sub.3, R.sub.4, R.sub.5, and R.sub.6 are H, OH or C.sub.1-C.sub.12 esters or C.sub.1-C.sub.12 alkyl ethers thereof, halogens, or C.sub.1-C.sub.4 halogenated ethers, cyano, C.sub.1C.sub.6 alkyl, or trifluoromethyl, with the proviso that, when R.sub.1 is H, R.sub.2 is not OH; Y is the moiety: 3R.sub.7 and R.sub.8 are alkyl or concatenated together to form an optionally substituted, nitrogen-containing ring; or a pharmaceutically acceptable salt thereof. Excerpt(s): This application claims the benefit of U.S. Provisional Application No. 60/216,408, filed Jul. 6, 2000. This invention relates to methods of using substituted indole compounds in the combination with a selective serotonin reuptake inhibitor (SSRI) for the treatment, prevention, inhibition or alleviation of depression, anxiety, generalized anxiety disorder (GAD), hot flush, post partum depression, premenstrual syndrome, obesity, obsessive compulsive disorder, social phobia, disruptive behavior disorders, impulse control disorders, borderline personality disorder, chronic fatigue disorder, premature ejaculation, pain, post-traumatic stress disorder, attention deficit disorders, with and without hyperactivity, Gilles de la Tourette syndrome, bulimia nervosa, or Shy Drager Syndrome and related pharmaceutical compositions and kits. as well as their use as estrogenic agents, including the treatment of bone loss, cardiovascular disease, maladies associated with or resulting from the proliferation or abnormal development of endometrial or endometrial-like tissues, and disease states or syndromes associated with estrogen deficiency. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
METHODS FOR THE TREATMENT OF CENTRAL DISORDERS IN CERTAIN PATIENT GROUPS
NERVOUS
SYSTEM
Inventor(s): Cutler, Neal R.; (Los Angeles, CA), Sramek, John; (Irvine, CA) Correspondence: Medlen & Carroll, Llp; 101 Howard Street; Suite 350; San Francisco; CA; 94105; US Patent Application Number: 20020147215 Date filed: January 26, 2001 Abstract: Methods and compositions for treating specific patient groups for Central Nervous System disorders, including but not limited to Tourette Syndrome, are provided. The methods of the present invention comprise the utilization of pharmaceutical compositions comprising quinolinones (and derivatives thereof) in patients with symptoms of a Central Nervous System Disorder who are otherwise free of cardiac disease and/or who have not been given organic nitrates. Excerpt(s): The present invention relates to methods and compositions for the treatment of Central Nervous System (CNS) disorders, including but not limited to Tourette Syndrome, in adults and children. The methods of the present invention comprise the utilization of pharmaceutical compositions to patients who are free of symptoms of cardiac disease and who have not been treated with drugs which cause hypotensive effects, such as nitrites and nitrates. Tourette Syndrome (TS) is an autosomal dominant
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neuropsychiatric disorder affecting up to one person in 2,500 and is characterized by a range of neurological and behavioral symptoms. Such symptoms include: (A) the presence of both motor and vocal tics at some time during the illness, although not necessarily concurrently; (B) the occurrence of quasi-daily tics throughout a period of time exceeding one year; (C) variance in the clinical phenomenology of the tics; and (D) marked distress or significant impairment in social, occupational, or other important areas of functioning. Patients with TS also often suffer from co-morbid disorders such as Obsessive-Compulsive Disorder (OCD), Attention-Deficit Hyperactivity Disorder (ADHD), anxiety disorders, mood disorders, and panic disorders. Tics experienced by a sufferer of TS can be transient or acute, and simple or complex. Motor tics generally include eye blinking, nose twitching, grimacing, muscle tensing, hopping, touching objects or others, and rapid jerking of any part of the body. Vocal or phonic tics typically include coughing, spitting, grunting, barking, hissing, sucking sounds, gurgling, screeching, whistling, palilalia, echolalia, and coprolalia. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Methods of treating tardive dyskinesia and other movement disorders Inventor(s): Fogel, Barry S.; (Waban, MA) Correspondence: Choate, Hall & Stewart; Exchange Place; 53 State Street; Boston; MA; 02109; US Patent Application Number: 20020013366 Date filed: June 27, 2001 Abstract: The present invention describes a novel treatment for movement disorders, including tardive dyskinesia, tic disorders, Tourette's syndrome, and blepharospasm, and other focal dystonias. The treatment of the present invention utilizes agents that simultaneously act as NMDA-type glutamate receptor antagonists and GABA-A receptor agonists. Preferably these two activities are characteristic of a single agent, for example acamprosate. Alternatively, separate agents having these activities can be combined and administered together. The invention also provides a third agent that acts as a non-competitive NMDA-receptor blocking agent or ion channel blocker that augments the effect of the primary treatment. A particularly preferred ion channel blocking agent is magnesium. Alternatively, magnesium can be administered alone for prevention and treatment of movement disorders. Excerpt(s): The present application is a divisional of co-pending application Ser. No. 09/193,892, filed Nov. 18, 1998, which is a continuation-in-part of co-pending application Ser. No. 09/006,641, filed Jan. 13, 1998, the entire contents of which are incorporated herein by reference. Movement disorders affect a significant portion of the population, causing disability as well as distress. This invention concerns the treatment of several movement disorders: 1) tics, including multiple tics and Gilles de la Tourette syndrome (TS); 2) tardive dyskinesia (TD) and related movement disorders induced by exposure to neuroleptic (antipsychotic) drugs; and 3) focal dystonias, including blepharospasm Meige syndrome, torticollis, spasmodic dysphonia, and writer's cramp. Tics are estimated to affect 1% to 13% of boys and 1% to 11% of girls, the male-female ratio being less than 2 to 1. Approximately 5% of children between the ages of 7 and 11 years are affected with tic behavior (Leckman et al., Neuropsychiatry of the Bas. Gang, December, 20(4): 839-861, 1997). The estimated prevalence of multiple tics with vocalization, i.e. Tourette's syndrome, varies among different reports, ranging from 5 per 10,000 to 5 per 1,000. Tourette's syndrome is 3-4 times more common in boys than
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girls and 10 times more common in children and adolescents than in adults (Leckman et al., supra; Esper et al, Tenn. Med., January, 90:18-20, 1997). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
New treatment using venlafaxine Inventor(s): Derivan, Albert T.; (Villanova, PA), Muth, Eric A.; (New Hope, PA), Rudolph, Richard L.; (Berwyn, PA), Upton, G. Virginia; (Radnor, PA) Correspondence: Egon E. Berg; Americans Home Products Corporation; Patent Law Department - 2B; One Campus Drive; Parisppany; NJ; 07054; US Patent Application Number: 20010012855 Date filed: January 25, 2001 Abstract: This invention provides a method of treating obesity, generalized anxiety disorder, post-traumatic stress disorder, late luteal phase disphoric disorder (premenstrual syndrome), attention deficit disorder, with and without hyperactivity, Gilles de la Tourette syndrome, bulimia nervosa or Shy Drager Syndrome in a mammal by administering to the mammal an effective amount of a hydroxycycloalkanephenethyl amine of the following structural formula: 1in which A is a moiety of the formula 2where the dotted line represents optional unsaturation;R.sub.1 is hydrogen or alkyl;R.sub.2 is alkyl;R.sub.4 is hydrogen, alkyl, formyl, or alkanol;R.sub.5 and R.sub.6 are, independently, hydrogen, hydroxyl, alkyl, alkoxy, alkanoyloxy, cyano, nitro, alkylmercapto, amino, alkylamino, dialkylamino, alkanamido, halo, trifluoromethyl, or taken together, methylene dioxy;R.sub.7 is hydrogen or alkyl; andn is 0, 1, 2, 3, or 4;or a pharmaceutically acceptable salt thereof. Excerpt(s): The active ingredients of this invention include (1-[2-(dimethylamino)-1-(4methoxyphenyl) ethyl]cyclohexanol), or therapeutically acceptable salts thereof, which are known generally as venlafaxine and its analogues. Venlafaxine is disclosed in U.S. Pat. No. 4,535,186 (Husbands et al.) and has been previously reported to be useful as an antidepressant. U.S. Pat. No. 4,535,186 teaches the production of venlafaxine and its analogues and is incorporated herein as reference. For the purposes of this disclosure, and the claims that follow, the use of venlafaxine is understood to include the free base and pharmaceutically acceptable salt forms of venlafaxine, the racemate and its individual enantiomers, and venlafaxine analogs, both as racemates and as their individual enantiomers. Venlafaxine has been shown to be a potent inhibitor of monoamine neurotransmitter uptake, a mechanism associated with clinical antidepressant activity. Due to its novel structure, venlafaxine has a mechanism of action unrelated to other available antidepressants, such as the tricyclic antidepressants desipramine, nostriptyline, protriptyline, imipramine, amitryptyline, trimipramine and doxepin. It is believed that venlafaxine's mechanism of action is related to potent inhibition of the uptake of the monoamine neurotransmitters serotonin and norepinephrine. To a lesser degree, venlafaxine also inhibits dopamine reuptake, but it has no inhibitory activity on monoamine oxidase. O-desmethylvenlafaxine, venlafaxine's major metabolite in humans, exhibits a similar pharmacologic profile. Venlafaxine's ability to inhibit norepinephrine and serotonin (5-HT) uptake has been predicted to have an efficacy which rivals or surpases that of tricyclic antidepressants (Stuart A. Montgomery, M. D., J. Clin. Psychiatry, 54:3, March 1993). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Novel heterocyclic urea derivatives and their use as dopamine D3 receptor ligands Inventor(s): Bordeau, Kenneth J.; (Kintnersville, PA), Brooks, Sarah; (Belmont, CA), Hemmerle, Horst; (Indianapolis, IN), Hendrix, James A.; (Hillsborough, NJ), Mueller, Paul J.; (Hoboken, NJ), Strupczewski, Joseph T.; (Flemington, NJ), Urmann, Matthias; (Eschborn, DE), Zhao, Xu-Yang; (Bridgewater, NJ) Correspondence: Ross J. Oehler; Aventis Pharmaceuticals INC.; Route 202-206, Mail Code: D-303a; Bridgewater; PA; 08807; US Patent Application Number: 20030229066 Date filed: February 19, 2002 Abstract: The invention relates to heterocyclic substituted urea derivatives that display selective binding to dopamine D.sub.3 receptors. In another aspect, the invention relates to a method for treating central nervous system disorders associated with the dopamine D.sub.3 receptor activity in a patient in need of such treatment comprising administering to the subject a therapeutically effective amount of said compounds for alleviation of such disorder. The central nervous system disorders that may be treated with these compounds include Psychotic Disorders, Substance Dependence, Substance Abuse, Dyskinetic Disorders (e.g. Parkinson's Disease, Parkinsonism, NeurolepticInduced Tardive Dyskinesia, Gilles de la Tourette Syndrome and Huntington's Disease), Dementia, Anxiety Disorders, Sleep Disorders, Circadian Rhythm Disorders and Mood Disorders. The subject invention is also directed towards processes for the preparation of the compounds described herein as well as methods for making and using the compounds as imaging agents for dopamine D.sub.3 receptors. Excerpt(s): 1) Psychoses (including schizophrenia)--See, for example, Biochem Pharmacol, 1992, 3(4), 659-66; Clin Neuropharmacol, 1993,16(4), 295-314; Neuropsychopharmacology, 1997, 16(6), 375-84; Am J Psychiatry, 1999,156(4), 610-616; Psychopharmacology (Berl), 1995, 120(1), 67-74. 2) Substance dependence and substance abuse--See, for example, Neuroreport, 1997, 8(9-10), 2373-2377; J Pharmacol Exp Ther, 1996, 278(3),1128-37; Brain Res Mol Brain Res, 1997, 45(2), 335-9. 3) Mood Disorders (including mania, depressive disorders and bipolar disorders)--See, for example, Clin Neuropharmacol, 1998, 21 (3),176-80; Am J Med Genet, 1998, 81 (2),192-4; J Clin Psychiatry, 1995, 56(11), 514-518; J Clin Psychiatry, 1995, 56(9), 423-429; Am J Med Genet,1995, 60(3), 234-237; Pharmacopsychiatry, 1999, 32(4), 127-135; J Affect Disord, 1999, 52(1-3), 275-290; Am J Psychiatry, 1999,156(4), 610-616. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
Keeping Current In order to stay informed about patents and patent applications dealing with Tourette syndrome, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “Tourette syndrome” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on Tourette syndrome.
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You can also use this procedure to view pending patent applications concerning Tourette syndrome. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.
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CHAPTER 7. BOOKS ON TOURETTE SYNDROME Overview This chapter provides bibliographic book references relating to Tourette syndrome. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on Tourette syndrome include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.
Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “Tourette syndrome” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on Tourette syndrome: •
Children With Tourette Syndrome: A Parents' Guide Source: Rockville, MD: Woodbine House, Inc. 1992. 350 p. Contact: Available from Woodbine House, Inc. 5615 Fishers Lane, Rockville, MD 20852. (800) 843-7323. PRICE: $14.95 plus shipping and handling. ISBN: 0933149441. Summary: This handbook, written for parents of children and teenagers with Tourette Syndrome, offers up-to-date, concrete information and advice for dealing with this neurological disorder. The authors offer families a foundation for understanding this complex disorder and for developing strategies that can help their child become a productive, happy adult. Topics covered include medical, educational, legal, family life, daily care, and emotional issues. The authors discuss treatments, including those for related conditions such as attention deficit disorder (ADD) and obsessive compulsive disorder (OCD); behavior management techniques; tips on handling the reactions of
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others; parent advocacy; coping with feelings of guilt and resentment; and getting help for a child at school. Coprolalia and language development are also discussed. Tables listing developmental milestones in language and other areas are included. Parent statements appear at the end of each chapter; experienced parents share feelings and practical insights that can be especially helpful to new parents. The book concludes with a detailed listing of organizations (including state-by-state resources), a reading list, a subject index, and a glossary. (AA-M).
Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “Tourette syndrome” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “Tourette syndrome” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “Tourette syndrome” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •
A Cursing Brain? The Histories of Tourette Syndrome by Howard I. Kushner; ISBN: 0674003861; http://www.amazon.com/exec/obidos/ASIN/0674003861/icongroupinterna
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Children With Tourette Syndrome: A Parent's Guide (Special Needs Collection) by Tracy Haerle (Editor), Jim Eisenreich; ISBN: 0933149441; http://www.amazon.com/exec/obidos/ASIN/0933149441/icongroupinterna
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Coping With Tourette Syndrome and Tic Disorders by Barbara Moe; ISBN: 0823929760; http://www.amazon.com/exec/obidos/ASIN/0823929760/icongroupinterna
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Don't Think About Monkeys. Extraordinary Stories Written by People with Tourette Syndrome by Adam Ward Seligman (Editor), John S. Hilkevich (Editor) (1992); ISBN: 1878267337; http://www.amazon.com/exec/obidos/ASIN/1878267337/icongroupinterna
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Echolalia. An Adult's Story of Tourette Syndrome by Adam Ward Seligman (1991); ISBN: 1878267310; http://www.amazon.com/exec/obidos/ASIN/1878267310/icongroupinterna
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Getting Personal: Stories of Life with Tourette Syndrome by Michael G. Defilippo (Editor); ISBN: 0971679525; http://www.amazon.com/exec/obidos/ASIN/0971679525/icongroupinterna
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Gilles De LA Tourette Syndrome; ISBN: 0890040575; http://www.amazon.com/exec/obidos/ASIN/0890040575/icongroupinterna
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Gilles De LA Tourette Syndrome by Arthur K. Shapiro (Photographer), et al; ISBN: 0881673404; http://www.amazon.com/exec/obidos/ASIN/0881673404/icongroupinterna
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Gilles De LA Tourette Syndrome (Advances in Neurology; V. 35) by Arnold J. and Chase, Thomas N. Friedhoff (Editor); ISBN: 0890047618; http://www.amazon.com/exec/obidos/ASIN/0890047618/icongroupinterna
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God Made Me Special: Tourette Syndrome, My Personal Story by Ryan C. Farrell (1998); ISBN: 1884825222; http://www.amazon.com/exec/obidos/ASIN/1884825222/icongroupinterna
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Hi, I'm Adam: A Child's Book About Tourette Syndrome by Adam, Buehrens (1990); ISBN: 1878267299; http://www.amazon.com/exec/obidos/ASIN/1878267299/icongroupinterna
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Kevin and Me: Tourette Syndrome and the Magic Power of Music Therapy by Patricia Heenan (2000); ISBN: 1878267027; http://www.amazon.com/exec/obidos/ASIN/1878267027/icongroupinterna
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Living With Tourette Syndrome by Elaine Fantle Shimberg, Elaine Shapiro (Introduction) (1995); ISBN: 068481160X; http://www.amazon.com/exec/obidos/ASIN/068481160X/icongroupinterna
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Out of the Darkness: A Promising Future for Tourette Syndrome by Nancy Freeman; ISBN: 1878159135; http://www.amazon.com/exec/obidos/ASIN/1878159135/icongroupinterna
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Raising Joshua: One Mother's Story of the Challenges of Parenting a Child With Tourette Syndrome by Sheryl J. Hamer (1997); ISBN: 0965750167; http://www.amazon.com/exec/obidos/ASIN/0965750167/icongroupinterna
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RYAN A Mother's Story of her Hyperactive/Tourette Syndrome Child by Susan Hughes; ISBN: 1878267256; http://www.amazon.com/exec/obidos/ASIN/1878267256/icongroupinterna
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Search for the Tourette Syndrome and Human Behavior Genes by David E. Comings (1996); ISBN: 1878267361; http://www.amazon.com/exec/obidos/ASIN/1878267361/icongroupinterna
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Taking Tourette Syndrome to School by Tira Krueger, et al (2002); ISBN: 1891383124; http://www.amazon.com/exec/obidos/ASIN/1891383124/icongroupinterna
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Teaching children with Tourette syndrome (SuDoc ED 1.310/2:429397) by Bernadette Knoblauch; ISBN: B000111XKO; http://www.amazon.com/exec/obidos/ASIN/B000111XKO/icongroupinterna
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Teaching the Tiger A Handbook for Individuals Involved in the Education of Students with Attention Deficit Disorders, Tourette Syndrome or ObsessiveCompulsive Disorder by Marilyn P., Ph.D. Dornbush, Sheryl K. Pruitt (1995); ISBN: 1878267345; http://www.amazon.com/exec/obidos/ASIN/1878267345/icongroupinterna
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The Official Parent's Sourcebook on Tourette Syndrome: A Revised and Updated Directory for the Internet Age by Icon Health Publications (2002); ISBN: 059783122X; http://www.amazon.com/exec/obidos/ASIN/059783122X/icongroupinterna
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The Unwelcome Companion: An Insider's View of Tourette Syndrome by Rick Fowler (1996); ISBN: 0964637693; http://www.amazon.com/exec/obidos/ASIN/0964637693/icongroupinterna
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Tictionary: A Reference Guide to the World of Tourette Syndrome, Asperger Syndrome, Attention Deficit Hyperactivity Disorder and Obsessive Compulsive Disorder for Parents and Professionals by Becky Ottinger, Fred Engh; ISBN:
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1931282161; http://www.amazon.com/exec/obidos/ASIN/1931282161/icongroupinterna •
Tourette Syndrome by Donald J., Md. Cohen (Editor), et al; ISBN: 0781724058; http://www.amazon.com/exec/obidos/ASIN/0781724058/icongroupinterna
•
Tourette syndrome (SuDoc HE 20.3502:T 64/995) by U.S. Dept of Health and Human Services; ISBN: B00010N9TI; http://www.amazon.com/exec/obidos/ASIN/B00010N9TI/icongroupinterna
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Tourette Syndrome (Twenty-First Century Medical Library) by Marlene Targ Brill; ISBN: 0761321012; http://www.amazon.com/exec/obidos/ASIN/0761321012/icongroupinterna
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Tourette Syndrome (Venture, Health and the Human Body) by Elaine Landau (1998); ISBN: 053111399X; http://www.amazon.com/exec/obidos/ASIN/053111399X/icongroupinterna
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Tourette Syndrome and Human Behavior by David E. Comings (1990); ISBN: 1878267280; http://www.amazon.com/exec/obidos/ASIN/1878267280/icongroupinterna
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Tourette Syndrome: A Practical Guide for Teachers, Parents and Carers (Resource Materials Forteachers) by Amber Carroll, Mary Robertson (2000); ISBN: 1853466565; http://www.amazon.com/exec/obidos/ASIN/1853466565/icongroupinterna
•
Tourette Syndrome: Genetics, Neurobiology, and Treatment (Advances in Neurology, Vol 58) by Thomas N. Chase (Editor), et al (1992); ISBN: 0881679224; http://www.amazon.com/exec/obidos/ASIN/0881679224/icongroupinterna
•
Tourette Syndrome: Index of Modern Authors & Subjects With Guide for Rapid Research by Jesse Stall Winograd (2002); ISBN: 0788329561; http://www.amazon.com/exec/obidos/ASIN/0788329561/icongroupinterna
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Tourette Syndrome: The Facts by Mary M. Robertson, Simon Baron-Cohen; ISBN: 019852398X; http://www.amazon.com/exec/obidos/ASIN/019852398X/icongroupinterna
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Triumph Over ADD, ADHD & Tourette Syndrome by Agi Lidle; ISBN: 0967169372; http://www.amazon.com/exec/obidos/ASIN/0967169372/icongroupinterna
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Understanding Tourette Syndrome, Obsessive Compulsive Disorder and Related Problems: A Developmental and Catastrophe Theory Perspective by John Michael Berecz, Gary Larson (Illustrator); ISBN: 082617390X; http://www.amazon.com/exec/obidos/ASIN/082617390X/icongroupinterna
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What Makes Ryan Tick: A Family's Triumph over Tourette Syndrome and Attention Deficiency Hyperactivity Disorder by Susan Hughes (1996); ISBN: 1878267353; http://www.amazon.com/exec/obidos/ASIN/1878267353/icongroupinterna
The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “Tourette syndrome” (or synonyms) into the search box, and select “books
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only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:11 •
The unwelcome companion: an insider's view of Tourette syndrome Author: Fowler, Rick.; Year: 1995; Cashiers, NC: Silver Run Publications, 1995; ISBN: 0964637618 http://www.amazon.com/exec/obidos/ASIN/0964637618/icongroupinterna
•
Tics, Tourette syndrome and other movement disorders: a pediatrician's guide Author: Shapiro, Arthur K.,; Year: 1994; Bayside, N.Y.:
•
Tourette syndrome and human behavior Author: Comings, David E.; Year: 1990; Duarte, Calif.: Hope Press, c1990; ISBN: 1878267272 http://www.amazon.com/exec/obidos/ASIN/1878267272/icongroupinterna
Chapters on Tourette Syndrome In order to find chapters that specifically relate to Tourette syndrome, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and Tourette syndrome using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “Tourette syndrome” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on Tourette syndrome: •
Gilles de la Tourette Syndrome Source: in Gilbert, P. A-Z Reference Book of Syndromes and Inherited Disorders. 2nd ed. London, England: Chapman and Hall. p. 134-136. Contact: Available from Singular Publishing Group, Inc. 401 West 'A' Street, Suite 325, San Diego, CA 92101-7904. (800) 521-8545 or (619) 238-6777. Fax (800) 774-8398 or (619) 238-6789. E-mail:
[email protected]. Website: www.singpub.com. PRICE: $42.95 plus shipping and handling. ISBN: 0412641208. Summary: This chapter on Gilles de la Tourette syndrome is from a practical reference book that describes inherited disorders and syndromes in both children and adults. Tourette syndrome features motor and vocal tics, obsessive behavior, and reduced attention span. Vocal tics can include coughing, sneezing, sucking, throat-clearing, sniffing, and other unusual noises. At times, the involuntary shouting of inappropriate words or phrases, including obscenities, can make life extremely difficult for parents and companions of the affected child. Topics include alternative names for the condition, incidence, history, causation, characteristics, management implications, prognosis, and self-help groups. Education for these children may be necessary in a small unit, where a variety of difficult behavior patterns can be contained. The chapter concludes with a list of support groups and organizations that can be found in England.
11
In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.
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Directories In addition to the references and resources discussed earlier in this chapter, a number of directories relating to Tourette syndrome have been published that consolidate information across various sources. The Combined Health Information Database lists the following, which you may wish to consult in your local medical library:12 •
Parent Resources: Agencies, Organizations, Support Groups Source: in DeFeo, A.B., ed. Parent Articles 2. San Antonio, TX: Communication Skill Builders. 1995. p. 213-234. Contact: Available from Communication Skill Builders. Customer Service, 555 Academic Court, San Antonio, TX 78204-2498. (800) 211-8378; Fax (800) 232-1223. PRICE: $55.00 plus shipping and handling. Order Number 076-163-0732. Summary: This appendix section is from a parent education skill builders textbook. The appendix lists agencies, organizations, and support groups that parents might want to contact as they work with developing communication skills in and with their child. National information and advocacy groups are listed, including groups for consumer information, education, financial aid, home care, legal assistance, nonoral communication, orthotics and prosthetics, psychiatry, psychology, rare disorders, rehabilitation, residential placement, self-help, severe disabilities, sibling support, social workers, and telephone usage for persons with disabilities. Also listed are national organizations for specific disabilities and conditions, including acoustic neuroma, autism, birth defects, chronic dizziness and balance disorders, cleft palate and craniofacial disorders, developmental disabilities, Down's syndrome, dyslexia, dystonia, genetic conditions, head injuries, hearing impairments, learning disabilities, mental retardation, neurofibromatosis, neurological disorders, stuttering, Tourette syndrome, and voice disorders and laryngectomies. The address and telephone number for each organization are noted.
•
Brain Connections: Your Source Guide to Information on Brain Diseases and Disorders. 5th ed Source: New York, NY: Dana Alliance for Brain Initiatives. 2000. 49 p. Contact: Available from Dana Press. Charles A. Dana Foundation, 745 Fifth Avenue, Suite 700, New York, NY 10151. Fax (212) 593-7623. Website: www.dana.org. PRICE: Single copy free. Summary: This guide lists organizations that assist people with a brain-related disorder or disease as well as those organizations that assist caregivers and health care providers in these areas. The guide lists more than 275 organizations alphabetically by disease or disorder. Listings of particular relevance to communication disorders include: acoustic neuroma, aphasia, ataxia, attention deficit hyperactivity disorder, autism, deafness and hearing loss, disability and rehabilitation, dizziness, dyslexia, dystonia, head injury,
12 You will need to limit your search to “Directory” and “tourette syndrome” using the "Detailed Search" option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find directories, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Select your preferred language and the format option “Directory.” Type “tourette syndrome” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months.
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learning disabilities, neurofibromatosis, smell and taste (chemosensory) disorders, spasmodic dysphonia, stuttering, tinnitus, Tourette syndrome, and vestibular disorders. Emphasis is placed on organizations that have a national focus, however, many of these groups sponsor local chapters or affiliates and make referrals to local medical professionals and organizations. For each organization listed, the guide notes mailing address, telephone numbers, e-mail and web sites; also provided are symbols which indicate that the organization offers support groups, referrals to doctors, referrals to other sources of information, regional chapters, availability of literature, availability of speakers, and volunteer opportunities. The guide also describes the publishing body, the Dana Alliance for Brain Initiatives, and provides a list of ways in which readers can support and further brain research. •
Self-Help Sourcebook: Finding and Forming Mutual Aid Self-Help Groups. 4th ed Source: Denville, NJ: American Self-Help Clearinghouse. 1992. 226 p. Contact: Available from American Self-Help Clearinghouse. Attn: Sourcebook, St. Clares-Riverside Medical Center, 25 Pocono Road, Denville, NJ 07834. Voice (201) 6257101; TTY (201) 625-9053. PRICE: $9.00 book rate; $10.00 first class mail. ISBN: 0963432206. Summary: This sourcebook lists self-help groups in a wide variety of topic areas, including addictions and dependencies, bereavement, disabilities, health, mental health, parenting and family, physical and/or emotional abuse, and miscellaneous categories. Topics relevant to deafness and communication disorders include acoustic neuroma, alternative/augmentative communication, autism, cleft palate and cleft lip, cochlear implants, developmental disabilities, developmentally delayed children, Down syndrome, dystonia, ear anomalies, elective mutism, hearing impairment, inner ear problems, laryngectomy, late-deafened adults, learning disabilities, Meniere's disease, neck-head-oral cancer, parents of children with hearing impairment, speech dysfunction, speech impairments, stuttering, tinnitus, Tourette syndrome, and Usher's syndrome. In addition to basic information about the self-help groups, the sourcebook lists self-help clearinghouses, toll-free helplines, resources for rare disorders, resources for genetic disorders, housing and neighborhood resources and resources for the homeless, how-to ideas for developing self-help groups, and using a home computer for mutual help. The book includes a bibliography and key word index.
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CHAPTER 8. MULTIMEDIA ON TOURETTE SYNDROME Overview In this chapter, we show you how to keep current on multimedia sources of information on Tourette syndrome. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.
Bibliography: Multimedia on Tourette Syndrome The National Library of Medicine is a rich source of information on healthcare-related multimedia productions including slides, computer software, and databases. To access the multimedia database, go to the following Web site: http://locatorplus.gov/. Select “Search LOCATORplus.” Once in the search area, simply type in Tourette syndrome (or synonyms). Then, in the option box provided below the search box, select “Audiovisuals and Computer Files.” From there, you can choose to sort results by publication date, author, or relevance. The following multimedia has been indexed on Tourette syndrome: •
Pitfalls and misunderstandings in diagnosing Tourette syndrome [videorecording] Source: Marshfield Clinic, Saint Joseph's Hospital; a presentation of the Marshfield Video Network; Year: 1994; Format: Videorecording; Marshfield, WI: The Network, [1994]
•
Tics and related disorders (Tourette syndrome) [videorecording] Source: presented by the Department of Pediatrics, Emory University, School of Medicine; Year: 1983; Format: Videorecording; Atlanta, Ga.: Emory Medical Television Network, 1983
•
Tourette syndrome [motion picture]: the sudden intruder Source: Behavioral Sciences Media Laboratory, the Neuropsychiatric Institute, Center for the Health Sciences, University of California, Los Angeles; Year: 1978; Format: Motion picture; [Berkeley, Calif]: Regents of the University of California; [Los Angeles: for loan and sale by University of California, Los Angeles, Behavioral Sciences Media Laboratory], c1978
•
What is Tourette syndrome? [videorecording] Source: [presented by] Marshfield Clinic, Saint Joseph's Hospital, Marshfield Medical Research Foundation; a presentation of the Marshfield Video Network; Year: 1992; Format: Videorecording; Marshfield, WI: Marshfield Video Network, [1992]
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CHAPTER 9. PERIODICALS AND NEWS ON TOURETTE SYNDROME Overview In this chapter, we suggest a number of news sources and present various periodicals that cover Tourette syndrome.
News Services and Press Releases One of the simplest ways of tracking press releases on Tourette syndrome is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “Tourette syndrome” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to Tourette syndrome. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “Tourette syndrome” (or synonyms). The following was recently listed in this archive for Tourette syndrome: •
Tourette syndrome linked with high migraine incidence Source: Reuters Medical News Date: November 24, 2003
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•
Tourette syndrome and migraine may go hand-in-hand Source: Reuters Health eLine Date: November 24, 2003
•
Frontostriatal pathway may be involved in Tourette syndrome pathophysiology Source: Reuters Medical News Date: January 23, 2002
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Infection may play a role in Tourette syndrome Source: Reuters Medical News Date: June 23, 1998
•
Pimozide Superior To Haloperidol For Children With Tourette's Disorder Source: Reuters Medical News Date: August 08, 1997
•
Caudate Nucleus Linked To Tourette Syndrome Severity Source: Reuters Medical News Date: August 30, 1996
•
Three Different Genes Linked To Tourette Syndrome Source: Reuters Medical News Date: June 05, 1996 The NIH
Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “Tourette syndrome” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests.
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Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “Tourette syndrome” (or synonyms). If you know the name of a company that is relevant to Tourette syndrome, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “Tourette syndrome” (or synonyms).
Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “Tourette syndrome” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on Tourette syndrome: •
Tourette Syndrome: The Anatomy of a Tic (From the Point of View of a Person With TS) Source: American Speech-Language-Hearing Association. The ASHA Leader, Vol. 7 No. 14, August 6, 2002. Contact: American Speech-Language-Hearing Association. Available from the American Speech-Language-Hearing Association. 10801 Rockville Pike, Rockville, MD 20852. Voice/TTY (800) 498-2071, available 8:30 a.m.-5:00 p.m. ET. E-mail:
[email protected]. Web site: http://professional.asha.org/. Summary: Beth Krah is an individual who suffers with Tourette syndrome (TS). She wrote this account of her personal experience in order to help parents who are raising a child with TS, as well as clinicians and friends, to have a better understanding of what an individual with TS feels, and to know how they can help. Ms. Krah describes a tic episode from the onset, to give the reader more clarity and insight into what the experience is like. Since each individual is different, she does not offer options or recommendations for treatment, but tries to improve the reader's coping skills for tic episodes when they do occur. This is a two- part article. (See also The Neurology of a Tic--From the Point of View of the Scientist.)
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•
Tourette Syndrome: The Neurology of a Tic (From the Point of View of the Scientist.) Source: American Speech-Language-Hearing Association. The ASHA Leader, Vol. 7 No. 14, August 6, 2002. Contact: American Speech-Language-Hearing Association. Available from the American Speech-Language-Hearing Association. 10801 Rockville Pike, Rockville, MD 20852. Voice/TTY (800) 498-2071, available 8:30 a.m.-5:00 p.m. ET. E-mail:
[email protected]. Web site: http://professional.asha.org/. Summary: The article looks at the pathology of Tourette syndrome (TS) including comorbidities: anxiety disorders, language and learning disorders, mood disorders, attention deficit disorder (ADD), and obsessive compulsive disorders (OCD), vocal and phonic tics, and coprolalia (blurting out obscenities or socially inappropriate words or phrases). The writers also discuss the negative impact that these symptoms can have on an individual with TS, in childhood and adult life, and appropriate speech treatment for TS. Selected references are included at the end of the article. This is a two-part article. (See also The Anatomy of a Tic--From the Point of View of a Person With TS.) Selected references.
Academic Periodicals covering Tourette Syndrome Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to Tourette syndrome. In addition to these sources, you can search for articles covering Tourette syndrome that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”
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CHAPTER 10. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.
U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for Tourette syndrome. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a non-profit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI Advice for the Patient can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with Tourette syndrome. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.).
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The following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to Tourette syndrome: Haloperidol •
Systemic - U.S. Brands: Haldol http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202278.html
Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.
Mosby’s Drug Consult Mosby’s Drug Consult database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/. PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.
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APPENDICES
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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.
NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute13: •
Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm
•
National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/
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National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html
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National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25
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National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm
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National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm
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National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375
•
National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/
13
These publications are typically written by one or more of the various NIH Institutes.
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National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm
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National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/
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National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm
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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm
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National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/
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National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/
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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm
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National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html
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National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm
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National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm
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National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm
•
National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html
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National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm
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Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp
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National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/
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National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp
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Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html
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Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm
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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.14 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:15 •
Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html
•
HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html
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NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html
•
Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/
•
Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html
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Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html
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Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/
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Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html
•
Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html
•
Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html
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MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html
14 Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 15 See http://www.nlm.nih.gov/databases/databases.html.
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•
Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html
•
Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html
The NLM Gateway16 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.17 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “Tourette syndrome” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total
Items Found 2333 36 298 0 0 2667
HSTAT18 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.19 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.20 Simply search by “Tourette syndrome” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
16
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
17
The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 18 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 19 20
The HSTAT URL is http://hstat.nlm.nih.gov/.
Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.
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Coffee Break: Tutorials for Biologists21 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.22 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.23 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.
Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •
CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.
•
Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.
The Genome Project and Tourette Syndrome In the following section, we will discuss databases and references which relate to the Genome Project and Tourette syndrome. Online Mendelian Inheritance in Man (OMIM) The Online Mendelian Inheritance in Man (OMIM) database is a catalog of human genes and genetic disorders authored and edited by Dr. Victor A. McKusick and his colleagues at Johns Hopkins and elsewhere. OMIM was developed for the World Wide Web by the National Center for Biotechnology Information (NCBI).24 The database contains textual information, pictures, and reference information. It also contains copious links to NCBI’s Entrez database of MEDLINE articles and sequence information. 21 Adapted 22
from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.
The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 23 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process. 24 Adapted from http://www.ncbi.nlm.nih.gov/. Established in 1988 as a national resource for molecular biology information, NCBI creates public databases, conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information--all for the better understanding of molecular processes affecting human health and disease.
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To search the database, go to http://www.ncbi.nlm.nih.gov/Omim/searchomim.html. Type “Tourette syndrome” (or synonyms) into the search box, and click “Submit Search.” If too many results appear, you can narrow the search by adding the word “clinical.” Each report will have additional links to related research and databases. In particular, the option “Database Links” will search across technical databases that offer an abundance of information. The following is an example of the results you can obtain from the OMIM for Tourette syndrome: •
Gilles De La Tourette Syndrome Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?137580 Genes and Disease (NCBI - Map)
The Genes and Disease database is produced by the National Center for Biotechnology Information of the National Library of Medicine at the National Institutes of Health. This Web site categorizes each disorder by system of the body. Go to http://www.ncbi.nlm.nih.gov/disease/, and browse the system pages to have a full view of important conditions linked to human genes. Since this site is regularly updated, you may wish to revisit it from time to time. The following systems and associated disorders are addressed: •
Cancer: Uncontrolled cell division. Examples: Breast and ovarian cancer, Burkitt lymphoma, chronic myeloid leukemia, colon cancer, lung cancer, malignant melanoma, multiple endocrine neoplasia, neurofibromatosis, p53 tumor suppressor, pancreatic cancer, prostate cancer, Ras oncogene, RB: retinoblastoma, von Hippel-Lindau syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Cancer.html
•
Immune System: Fights invaders. Examples: Asthma, autoimmune polyglandular syndrome, Crohn’s disease, DiGeorge syndrome, familial Mediterranean fever, immunodeficiency with Hyper-IgM, severe combined immunodeficiency. Web site: http://www.ncbi.nlm.nih.gov/disease/Immune.html
•
Metabolism: Food and energy. Examples: Adreno-leukodystrophy, atherosclerosis, Best disease, Gaucher disease, glucose galactose malabsorption, gyrate atrophy, juvenile-onset diabetes, obesity, paroxysmal nocturnal hemoglobinuria, phenylketonuria, Refsum disease, Tangier disease, Tay-Sachs disease. Web site: http://www.ncbi.nlm.nih.gov/disease/Metabolism.html
•
Muscle and Bone: Movement and growth. Examples: Duchenne muscular dystrophy, Ellis-van Creveld syndrome, Marfan syndrome, myotonic dystrophy, spinal muscular atrophy. Web site: http://www.ncbi.nlm.nih.gov/disease/Muscle.html
•
Nervous System: Mind and body. Examples: Alzheimer disease, amyotrophic lateral sclerosis, Angelman syndrome, Charcot-Marie-Tooth disease, epilepsy, essential tremor, fragile X syndrome, Friedreich’s ataxia, Huntington disease, Niemann-Pick disease, Parkinson disease, Prader-Willi syndrome, Rett syndrome, spinocerebellar atrophy, Williams syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Brain.html
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•
Signals: Cellular messages. Examples: Ataxia telangiectasia, Cockayne syndrome, glaucoma, male-patterned baldness, SRY: sex determination, tuberous sclerosis, Waardenburg syndrome, Werner syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Signals.html
•
Transporters: Pumps and channels. Examples: Cystic fibrosis, deafness, diastrophic dysplasia, Hemophilia A, long-QT syndrome, Menkes syndrome, Pendred syndrome, polycystic kidney disease, sickle cell anemia, Wilson’s disease, Zellweger syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Transporters.html Entrez
Entrez is a search and retrieval system that integrates several linked databases at the National Center for Biotechnology Information (NCBI). These databases include nucleotide sequences, protein sequences, macromolecular structures, whole genomes, and MEDLINE through PubMed. Entrez provides access to the following databases: •
3D Domains: Domains from Entrez Structure, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo
•
Books: Online books, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=books
•
Genome: Complete genome assemblies, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Genome
•
NCBI’s Protein Sequence Information Survey Results: Web site: http://www.ncbi.nlm.nih.gov/About/proteinsurvey/
•
Nucleotide Sequence Database (Genbank): Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Nucleotide
•
OMIM: Online Mendelian Inheritance in Man, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=OMIM
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PopSet: Population study data sets, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Popset
•
ProbeSet: Gene Expression Omnibus (GEO), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo
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Protein Sequence Database: Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Protein
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PubMed: Biomedical literature (PubMed), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
•
Structure: Three-dimensional macromolecular structures, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Structure
•
Taxonomy: Organisms in GenBank, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Taxonomy
To access the Entrez system at the National Center for Biotechnology Information, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=genome, and then
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select the database that you would like to search. The databases available are listed in the drop box next to “Search.” Enter “Tourette syndrome” (or synonyms) into the search box and click “Go.” Jablonski’s Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes Database25 This online resource has been developed to facilitate the identification and differentiation of syndromic entities. Special attention is given to the type of information that is usually limited or completely omitted in existing reference sources due to space limitations of the printed form. At http://www.nlm.nih.gov/mesh/jablonski/syndrome_toc/toc_a.html, you can search across syndromes using an alphabetical index. Search by keywords at http://www.nlm.nih.gov/mesh/jablonski/syndrome_db.html. The Genome Database26 Established at Johns Hopkins University in Baltimore, Maryland in 1990, the Genome Database (GDB) is the official central repository for genomic mapping data resulting from the Human Genome Initiative. In the spring of 1999, the Bioinformatics Supercomputing Centre (BiSC) at the Hospital for Sick Children in Toronto, Ontario assumed the management of GDB. The Human Genome Initiative is a worldwide research effort focusing on structural analysis of human DNA to determine the location and sequence of the estimated 100,000 human genes. In support of this project, GDB stores and curates data generated by researchers worldwide who are engaged in the mapping effort of the Human Genome Project (HGP). GDB’s mission is to provide scientists with an encyclopedia of the human genome which is continually revised and updated to reflect the current state of scientific knowledge. Although GDB has historically focused on gene mapping, its focus will broaden as the Genome Project moves from mapping to sequence, and finally, to functional analysis. To access the GDB, simply go to the following hyperlink: http://www.gdb.org/. Search “All Biological Data” by “Keyword.” Type “Tourette syndrome” (or synonyms) into the search box, and review the results. If more than one word is used in the search box, then separate each one with the word “and” or “or” (using “or” might be useful when using synonyms).
25 Adapted from the National Library of Medicine: http://www.nlm.nih.gov/mesh/jablonski/about_syndrome.html. 26 Adapted from the Genome Database: http://gdbwww.gdb.org/gdb/aboutGDB.html - mission.
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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on Tourette syndrome can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internetbased services that post them.
Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to Tourette syndrome. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to Tourette syndrome. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “Tourette syndrome”:
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•
Guides on Tourette syndrome Tourette Syndrome http://www.nlm.nih.gov/medlineplus/tourettesyndrome.html
•
Other guides Attention Deficit Disorder with Hyperactivity http://www.nlm.nih.gov/medlineplus/attentiondeficitdisorderwithhyperactivity.t ml Child Mental Health http://www.nlm.nih.gov/medlineplus/childmentalhealth.html Degenerative Nerve Diseases http://www.nlm.nih.gov/medlineplus/degenerativenervediseases.html Developmental Disabilities http://www.nlm.nih.gov/medlineplus/developmentaldisabilities.html Down Syndrome http://www.nlm.nih.gov/medlineplus/downsyndrome.html Eating Disorders http://www.nlm.nih.gov/medlineplus/eatingdisorders.html Genetic Disorders http://www.nlm.nih.gov/medlineplus/geneticdisorders.html Immune System and Disorders http://www.nlm.nih.gov/medlineplus/immunesystemanddisorders.html Metabolic Disorders http://www.nlm.nih.gov/medlineplus/metabolicdisorders.html Movement Disorders http://www.nlm.nih.gov/medlineplus/movementdisorders.html Multiple Sclerosis http://www.nlm.nih.gov/medlineplus/multiplesclerosis.html Neurologic Diseases http://www.nlm.nih.gov/medlineplus/neurologicdiseases.html Obsessive-Compulsive Disorder http://www.nlm.nih.gov/medlineplus/obsessivecompulsivedisorder.html Speech & Communication Disorders http://www.nlm.nih.gov/medlineplus/speechcommunicationdisorders.html Trigeminal Neuralgia http://www.nlm.nih.gov/medlineplus/trigeminalneuralgia.html Turner's Syndrome http://www.nlm.nih.gov/medlineplus/turnerssyndrome.html
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Within the health topic page dedicated to Tourette syndrome, the following was listed: •
General/Overviews Frequently Asked Questions About Tourette Syndrome Source: Tourette Syndrome Association http://www.tsa-usa.org/what_is/Faqs.html Tourette Syndrome Source: We Move http://www.wemove.org/ts.html
•
Diagnosis/Symptoms Guide to the Diagnosis and Treatment of Tourette Syndrome Source: Tourette Syndrome Association http://www.tsa-usa.org/research/guidetodiagnosis.html
•
Treatment Medications and Dosages: Current Pharmacology of Tourette Syndrome Source: Tourette Syndrome Association http://www.tsa-usa.org/research/medicationsanddosages.html
•
Specific Conditions/Aspects Famous People with Tourette Syndrome Source: Tourette Syndrome Association http://www.tsa-usa.org/what_is/famous.html PANDAS Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections Source: National Institute of Mental Health http://intramural.nimh.nih.gov/research/pdn/web.htm
•
Children Story of Tourette Syndrome Source: Nemours Foundation http://kidshealth.org/kid/health_problems/brain/k_tourette.html Tics Source: American Academy of Pediatrics http://www.medem.com/search/article_display.cfm?path=n:&mstr=/ZZZKN2BP 8FC.html&soc=AAP&srch_typ=NAV_SERCH Tics and Tourette's Syndrome Source: American Academy of Family Physicians http://familydoctor.org/378.xml Tourette Syndrome Source: Nemours Foundation http://kidshealth.org/parent/medical/brain/tourette.html
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•
From the National Institutes of Health Tourette Syndrome Source: National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/health_and_medical/pubs/tourette_syndrome.htm
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Latest News Tourette Syndrome And Migraine May Go Hand-in-hand Source: 11/24/2003, Reuters Health http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_14811 .html
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Organizations National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/ Tourette Syndrome Association, Inc. Source: Tourette Syndrome Association http://www.tsa-usa.org/ We Move http://www.wemove.org/
•
Teenagers Tourette Syndrome Source: Nemours Foundation http://kidshealth.org/teen/diseases_conditions/brain_nervous/tourette.html
You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on Tourette syndrome. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •
Q and A: Questions and Answers about Tourette Syndrome Source: Bayside, NY: Tourette Syndrome Association, Inc. 1994. 4 p.
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Contact: Available from Tourette Syndrome Association, Inc. 42-40 Bell Boulevard, Bayside, NY 11361-2874. (718) 224-2999; Fax (718) 279-9596. PRICE: Single copy free. Summary: This brochure provides answers to some common questions about Tourette Syndrome (TS), a neurological disorder characterized by involuntary, rapid, sudden movements or vocalizations that occur repeatedly. The brochure covers topics including the spectrum of symptoms of TS; the causes of TS; diagnostic considerations; the classification of TS tics; treatment options, notably medications to help control the symptoms of TS when they interfere with functioning; the need for early diagnosis and treatment of TS; behaviors that are often associated with TS, including attention deficit disorders, learning disabilities, difficulties with impulse control, sleep disorders, and compulsions or ritualistic behaviors; the special educational needs of students with TS; the genetic components of TS; the prognosis for TS over a person's lifetime; the incidence and history of TS; the current focus of research in this area; and the types of family services that exist. The brochure concludes with a description of the Tourette Syndrome Association (TSA), including the organization's goals and activities, and member benefits; a membership form is also included. Healthfinder™ Healthfinder™ is sponsored by the U.S. Department of Health and Human Services and offers links to hundreds of other sites that contain healthcare information. This Web site is located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database: •
Tourette Syndrome (TS) Source: National Institute of Neurological Disorders and Stroke, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=794 The NIH Search Utility
The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to Tourette syndrome. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. PEDBASE Similar to NORD, PEDBASE covers relatively rare disorders, limited mainly to pediatric conditions. PEDBASE was designed by Dr. Alan Gandy. To access the database, which is more oriented to researchers than patients, you can view the current list of health topics covered at the following Web site: http://www.icondata.com/health/pedbase/pedlynx.htm.
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Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats
•
Family Village: http://www.familyvillage.wisc.edu/specific.htm
•
Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/
•
Med Help International: http://www.medhelp.org/HealthTopics/A.html
•
Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/
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Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/
•
WebMDHealth: http://my.webmd.com/health_topics
Associations and Tourette Syndrome The following is a list of associations that provide information on and resources relating to Tourette syndrome: •
Tourette Syndrome Association, Inc Telephone: (718) 224-2999 Toll-free: (888) 486-8738 Fax: (718) 279-9596 Email:
[email protected] Web Site: http://www.tsa-usa.org Background: The Tourette Syndrome Association, Inc. (TSA) is a national nonprofit organization dedicated to serving the needs of individuals affected by Tourette syndrome and their families. Tourette syndrome (TS) is a hereditary neurologic movement disorder characterized by repetitive motor and vocal tics. Symptoms may include involuntary movement of the extremities, shoulders, and face accompanied by uncontrollable sounds and/or inappropriate words. Symptoms tend to be variable and follow a chronic waxing and waning course. Founded in 1972 and currently consisting of 50 chapters and approximately 8,000 members, TSA's mission is to identify the cause, find a cure, and control the effects of Tourette syndrome. To this end, TSA facilitates a research grant award program and is guided by both a volunteer national Medical Advisory Board and a Scientific Advisory Board. The Association produces a variety of educational materials including brochures, a quarterly newsletter, and videotapes. In addition, TSA maintains a crisis hotline, provides physician referral listings, and engages in patient advocacy. Relevant area(s) of interest: Tourette Syndrome
•
Tourette Syndrome Foundation of Canada Telephone: (416) 861-8398 Toll-free: (800) 361-3120 Fax: (416) 861-2472 Email:
[email protected]
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Web Site: http://www.tourette.ca Background: The Tourette Syndrome Foundation of Canada (TSFC) is a national voluntary health organization dedicated to providing support and information to Canadian families affected by Tourette Syndrome. Tourette Syndrome (TS) is a hereditary neurologic movement disorder characterized by repetitive motor and vocal tics. Symptoms may include involuntary movements of the extremities, shoulders, and face accompanied by uncontrollable sounds and/or inappropriate words. Symptoms tend to be variable and follow a chronic waxing and waning course. TSFC's mission is to help families affected by Tourette Syndrome by gathering and distributing information about the disorder; promoting local self-help and professional services; and stimulating and funding research into the cause, treatment, and potential cure of TS. TSFC organizes workshops and symposiums for healthcare professionals; develops and maintains lists of physicians who diagnose and treat TS; and supports the Brain Bank Program and collaborates with other agencies dealing with neurological disorders. The Foundation publishes a tri-annual newsletter entitled 'The Green Leaflet' and provides brochures, pamphlets, reports, and audiovisual aids. Relevant area(s) of interest: Chronic Motor Tic, Chronic Multiple Tics, Habit Spasms, Tourette Syndrome
Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to Tourette syndrome. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with Tourette syndrome. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about Tourette syndrome. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “Tourette syndrome” (or a synonym), and you will receive information on all relevant organizations listed in the database.
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Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “Tourette syndrome”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “Tourette syndrome” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “Tourette syndrome” (or a synonym) into the search box, and click “Submit Query.”
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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.
Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.27
Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.
Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of
27
Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.
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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)28: •
Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/
•
Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)
•
Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm
•
California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html
•
California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html
•
California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html
•
California: Gateway Health Library (Sutter Gould Medical Foundation)
•
California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/
•
California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp
•
California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html
•
California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/
•
California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/
•
California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/
•
California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html
•
California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/
•
Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/
•
Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/
•
Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/
28
Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.
Finding Medical Libraries
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•
Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml
•
Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm
•
Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html
•
Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm
•
Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp
•
Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/
•
Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm
•
Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html
•
Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/
•
Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm
•
Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/
•
Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/
•
Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/
•
Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm
•
Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html
•
Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm
•
Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/
•
Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/
•
Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10
•
Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/
134 Tourette Syndrome
•
Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html
•
Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp
•
Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp
•
Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/
•
Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html
•
Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm
•
Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp
•
Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/
•
Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html
•
Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/
•
Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm
•
Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/
•
Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html
•
Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm
•
Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330
•
Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)
•
National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html
•
National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/
•
National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/
Finding Medical Libraries
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Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm
•
New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/
•
New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm
•
New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm
•
New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/
•
New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html
•
New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/
•
New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html
•
New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/
•
Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm
•
Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp
•
Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/
•
Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/
•
Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml
•
Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html
•
Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html
•
Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml
•
Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp
•
Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm
•
Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/
136 Tourette Syndrome
•
South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp
•
Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/
•
Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/
•
Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72
137
ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •
ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html
•
MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp
•
Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/
•
Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html
•
On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/
•
Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp
•
Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm
Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on Tourette syndrome: •
Basic Guidelines for Tourette Syndrome Chronic motor tic disorder Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000745.htm
•
Signs & Symptoms for Tourette Syndrome Seizure Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003200.htm Stress Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003211.htm
•
Background Topics for Tourette Syndrome Incidence Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002387.htm Physical examination Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002274.htm
138 Tourette Syndrome
Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •
Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical
•
MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html
•
Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/
•
Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine
139
TOURETTE SYNDROME DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Aberrant: Wandering or deviating from the usual or normal course. [EU] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acid Phosphatase: An enzyme that catalyzes the conversion of an orthophosphoric monoester and water to an alcohol and orthophosphate. EC 3.1.3.2. [NIH] Acoustic: Having to do with sound or hearing. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adjuvant: A substance which aids another, such as an auxiliary remedy; in immunology, nonspecific stimulator (e.g., BCG vaccine) of the immune response. [EU] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenal Medulla: The inner part of the adrenal gland; it synthesizes, stores and releases catecholamines. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and
140 Tourette Syndrome
stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Agoraphobia: Obsessive, persistent, intense fear of open places. [NIH] Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [NIH] Akathisia: 1. A condition of motor restlessness in which there is a feeling of muscular quivering, an urge to move about constantly, and an inability to sit still, a common extrapyramidal side effect of neuroleptic drugs. 2. An inability to sit down because of intense anxiety at the thought of doing so. [EU] Alexia: The inability to recognize or comprehend written or printed words. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH] Allylamine: Possesses an unusual and selective cytotoxicity for vascular smooth muscle cells in dogs and rats. Useful for experiments dealing with arterial injury, myocardial fibrosis or cardiac decompensation. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amenorrhea: Absence of menstruation. [NIH] Amine: An organic compound containing nitrogen; any member of a group of chemical compounds formed from ammonia by replacement of one or more of the hydrogen atoms by organic (hydrocarbon) radicals. The amines are distinguished as primary, secondary, and tertiary, according to whether one, two, or three hydrogen atoms are replaced. The amines include allylamine, amylamine, ethylamine, methylamine, phenylamine, propylamine, and many other compounds. [EU] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH]
Dictionary 141
Amphetamine: A powerful central nervous system stimulant and sympathomimetic. Amphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulation of release of monamines, and inhibiting monoamine oxidase. Amphetamine is also a drug of abuse and a psychotomimetic. The l- and the d,l-forms are included here. The l-form has less central nervous system activity but stronger cardiovascular effects. The d-form is dextroamphetamine. [NIH] Amygdala: Almond-shaped group of basal nuclei anterior to the inferior horn of the lateral ventricle of the brain, within the temporal lobe. The amygdala is part of the limbic system. [NIH]
Anaphylatoxins: The family of peptides C3a, C4a, C5a, and C5a des-arginine produced in the serum during complement activation. They produce smooth muscle contraction, mast cell histamine release, affect platelet aggregation, and act as mediators of the local inflammatory process. The order of anaphylatoxin activity from strongest to weakest is C5a, C3a, C4a, and C5a des-arginine. The latter is the so-called "classical" anaphylatoxin but shows no spasmogenic activity though it contains some chemotactic ability. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Angina: Chest pain that originates in the heart. [NIH] Angina Pectoris: The symptom of paroxysmal pain consequent to myocardial ischemia usually of distinctive character, location and radiation, and provoked by a transient stressful situation during which the oxygen requirements of the myocardium exceed the capacity of the coronary circulation to supply it. [NIH] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Anomalies: Birth defects; abnormalities. [NIH] Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or company. [NIH] Anorexia Nervosa: The chief symptoms are inability to eat, weight loss, and amenorrhea. [NIH]
Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Antiallergic: Counteracting allergy or allergic conditions. [EU] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]
Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign
142 Tourette Syndrome
substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticholinergic: An agent that blocks the parasympathetic nerves. Called also parasympatholytic. [EU] Anticonvulsant: An agent that prevents or relieves convulsions. [EU] Antidepressant: A drug used to treat depression. [NIH] Antidote: A remedy for counteracting a poison. [EU] Antiemetic: An agent that prevents or alleviates nausea and vomiting. Also antinauseant. [EU]
Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] Antihypertensive: An agent that reduces high blood pressure. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antipsychotic: Effective in the treatment of psychosis. Antipsychotic drugs (called also neuroleptic drugs and major tranquilizers) are a chemically diverse (including phenothiazines, thioxanthenes, butyrophenones, dibenzoxazepines, dibenzodiazepines, and diphenylbutylpiperidines) but pharmacologically similar class of drugs used to treat schizophrenic, paranoid, schizoaffective, and other psychotic disorders; acute delirium and dementia, and manic episodes (during induction of lithium therapy); to control the movement disorders associated with Huntington's chorea, Gilles de la Tourette's syndrome, and ballismus; and to treat intractable hiccups and severe nausea and vomiting. Antipsychotic agents bind to dopamine, histamine, muscarinic cholinergic, a-adrenergic, and serotonin receptors. Blockade of dopaminergic transmission in various areas is thought to be responsible for their major effects : antipsychotic action by blockade in the mesolimbic and mesocortical areas; extrapyramidal side effects (dystonia, akathisia, parkinsonism, and tardive dyskinesia) by blockade in the basal ganglia; and antiemetic effects by blockade in the chemoreceptor trigger zone of the medulla. Sedation and autonomic side effects (orthostatic hypotension, blurred vision, dry mouth, nasal congestion and constipation) are caused by blockade of histamine, cholinergic, and adrenergic receptors. [EU] Antiseptic: A substance that inhibits the growth and development of microorganisms without necessarily killing them. [EU] Antiviral: Destroying viruses or suppressing their replication. [EU] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Anxiety Disorders: Disorders in which anxiety (persistent feelings of apprehension, tension,
Dictionary 143
or uneasiness) is the predominant disturbance. [NIH] Apathy: Lack of feeling or emotion; indifference. [EU] Aphasia: A cognitive disorder marked by an impaired ability to comprehend or express language in its written or spoken form. This condition is caused by diseases which affect the language areas of the dominant hemisphere. Clinical features are used to classify the various subtypes of this condition. General categories include receptive, expressive, and mixed forms of aphasia. [NIH] Aphidicolin: An antiviral antibiotic produced by Cephalosporium aphidicola and other fungi. It inhibits the growth of eukaryotic cells and certain animal viruses by selectively inhibiting the cellular replication of DNA polymerase II or the viral-induced DNA polymerases. The drug may be useful for controlling excessive cell proliferation in patients with cancer, psoriasis or other dermatitis with little or no adverse effect upon nonmultiplying cells. [NIH] Apnea: A transient absence of spontaneous respiration. [NIH] Apomorphine: A derivative of morphine that is a dopamine D2 agonist. It is a powerful emetic and has been used for that effect in acute poisoning. It has also been used in the diagnosis and treatment of parkinsonism, but its adverse effects limit its use. [NIH] Aptitude: The ability to acquire general or special types of knowledge or skill. [NIH] Aqueous: Having to do with water. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Astringent: Causing contraction, usually locally after topical application. [EU] Astrocytes: The largest and most numerous neuroglial cells in the brain and spinal cord. Astrocytes (from "star" cells) are irregularly shaped with many long processes, including those with "end feet" which form the glial (limiting) membrane and directly and indirectly contribute to the blood brain barrier. They regulate the extracellular ionic and chemical environment, and "reactive astrocytes" (along with microglia) respond to injury. Astrocytes have high- affinity transmitter uptake systems, voltage-dependent and transmitter-gated ion channels, and can release transmitter, but their role in signaling (as in many other functions) is not well understood. [NIH] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU]
144 Tourette Syndrome
Audiovisual Aids: Auditory and visual instructional materials. [NIH] Auditory: Pertaining to the sense of hearing. [EU] Autoantibodies: Antibodies that react with self-antigens (autoantigens) of the organism that produced them. [NIH] Autoantigens: Endogenous tissue constituents that have the ability to interact with autoantibodies and cause an immune response. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Autonomic Nervous System: The enteric, parasympathetic, and sympathetic nervous systems taken together. Generally speaking, the autonomic nervous system regulates the internal environment during both peaceful activity and physical or emotional stress. Autonomic activity is controlled and integrated by the central nervous system, especially the hypothalamus and the solitary nucleus, which receive information relayed from visceral afferents; these and related central and sensory structures are sometimes (but not here) considered to be part of the autonomic nervous system itself. [NIH] Autoradiography: A process in which radioactive material within an object produces an image when it is in close proximity to a radiation sensitive emulsion. [NIH] Axons: Nerve fibers that are capable of rapidly conducting impulses away from the neuron cell body. [NIH] Baclofen: A GABA derivative that is a specific agonist at GABA-B receptors. It is used in the treatment of spasticity, especially that due to spinal cord damage. Its therapeutic effects result from actions at spinal and supraspinal sites, generally the reduction of excitatory transmission. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Behavior Therapy: The application of modern theories of learning and conditioning in the treatment of behavior disorders. [NIH] Behavioral Symptoms: Observable manifestions of impaired psychological functioning. [NIH]
Benzodiazepines: A two-ring heterocyclic compound consisting of a benzene ring fused to a diazepine ring. Permitted is any degree of hydrogenation, any substituents and any Hisomer. [NIH] Bereavement: Refers to the whole process of grieving and mourning and is associated with a deep sense of loss and sadness. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its
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composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Binding Sites: The reactive parts of a macromolecule that directly participate in its specific combination with another molecule. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological Transport: The movement of materials (including biochemical substances and drugs) across cell membranes and epithelial layers, usually by passive diffusion. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bipolar Disorder: A major affective disorder marked by severe mood swings (manic or major depressive episodes) and a tendency to remission and recurrence. [NIH] Bladder: The organ that stores urine. [NIH] Blepharospasm: Excessive winking; tonic or clonic spasm of the orbicularis oculi muscle. [NIH]
Blinking: Brief closing of the eyelids by involuntary normal periodic closing, as a protective measure, or by voluntary action. [NIH] Bloating: Fullness or swelling in the abdomen that often occurs after meals. [NIH] Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blood-Brain Barrier: Specialized non-fenestrated tightly-joined endothelial cells (tight junctions) that form a transport barrier for certain substances between the cerebral capillaries and the brain tissue. [NIH] Bone scan: A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brain Stem: The part of the brain that connects the cerebral hemispheres with the spinal cord. It consists of the mesencephalon, pons, and medulla oblongata. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]
Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Buccal mucosa: The inner lining of the cheeks and lips. [NIH]
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Bulimia: Episodic binge eating. The episodes may be associated with the fear of not being able to stop eating, depressed mood, or self-deprecating thoughts (binge-eating disorder) and may frequently be terminated by self-induced vomiting (bulimia nervosa). [NIH] Butyric Acid: A four carbon acid, CH3CH2CH2COOH, with an unpleasant odor that occurs in butter and animal fat as the glycerol ester. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Cannabidiol: Compound isolated from Cannabis sativa extract. [NIH] Cannabinoids: Compounds extracted from Cannabis sativa L. and metabolites having the cannabinoid structure. The most active constituents are tetrahydrocannabinol, cannabinol, and cannabidiol. [NIH] Cannabinol: A physiologically inactive constituent of Cannabis sativa L. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinogens: Substances that increase the risk of neoplasms in humans or animals. Both genotoxic chemicals, which affect DNA directly, and nongenotoxic chemicals, which induce neoplasms by other mechanism, are included. [NIH] Cardia: That part of the stomach surrounded by the esophagogastric junction, characterized by the lack of acid-forming cells. [NIH] Cardiac: Having to do with the heart. [NIH] Cardioselective: Having greater activity on heart tissue than on other tissue. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Cardiovascular System: The heart and the blood vessels by which blood is pumped and circulated through the body. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH]
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Catechol: A chemical originally isolated from a type of mimosa tree. Catechol is used as an astringent, an antiseptic, and in photography, electroplating, and making other chemicals. It can also be man-made. [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Caudate Nucleus: Elongated gray mass of the neostriatum located adjacent to the lateral ventricle of the brain. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Division: The fission of a cell. [NIH] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Cell Respiration: The metabolic process of all living cells (animal and plant) in which oxygen is used to provide a source of energy for the cell. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Central Nervous System Diseases: Diseases of any component of the brain (including the cerebral hemispheres, diencephalon, brain stem, and cerebellum) or the spinal cord. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebellar Diseases: Diseases that affect the structure or function of the cerebellum. Cardinal manifestations of cerebellar dysfunction include dysmetria, gait ataxia, and muscle hypotonia. [NIH] Cerebellum: Part of the metencephalon that lies in the posterior cranial fossa behind the brain stem. It is concerned with the coordination of movement. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral hemispheres: The two halves of the cerebrum, the part of the brain that controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. The right hemisphere controls muscle movement on the left side of the body, and the left hemisphere controls muscle movement on the right side of the body. [NIH] Cerebrospinal: Pertaining to the brain and spinal cord. [EU] Cerebrospinal fluid: CSF. The fluid flowing around the brain and spinal cord. Cerebrospinal fluid is produced in the ventricles in the brain. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Chemoreceptor: A receptor adapted for excitation by chemical substances, e.g., olfactory and gustatory receptors, or a sense organ, as the carotid body or the aortic (supracardial) bodies, which is sensitive to chemical changes in the blood stream, especially reduced oxygen content, and reflexly increases both respiration and blood pressure. [EU]
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Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or immunologic activity, that attract leukocytes, macrophages, or other cells to the site of infection or insult. [NIH] Child Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders in children. [NIH] Chlorpromazine: The prototypical phenothiazine antipsychotic drug. Like the other drugs in this class chlorpromazine's antipsychotic actions are thought to be due to long-term adaptation by the brain to blocking dopamine receptors. Chlorpromazine has several other actions and therapeutic uses, including as an antiemetic and in the treatment of intractable hiccup. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Choline: A basic constituent of lecithin that is found in many plants and animal organs. It is important as a precursor of acetylcholine, as a methyl donor in various metabolic processes, and in lipid metabolism. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Chorea: Involuntary, forcible, rapid, jerky movements that may be subtle or become confluent, markedly altering normal patterns of movement. Hypotonia and pendular reflexes are often associated. Conditions which feature recurrent or persistent episodes of chorea as a primary manifestation of disease are referred to as choreatic disorders. Chorea is also a frequent manifestation of basal ganglia diseases. [NIH] Choreatic Disorders: Acquired and hereditary conditions which feature chorea as a primary manifestation of the disease process. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Circadian: Repeated more or less daily, i. e. on a 23- to 25-hour cycle. [NIH] Circadian Rhythm: The regular recurrence, in cycles of about 24 hours, of biological processes or activities, such as sensitivity to drugs and stimuli, hormone secretion, sleeping, feeding, etc. This rhythm seems to be set by a 'biological clock' which seems to be set by recurring daylight and darkness. [NIH] Clarithromycin: A semisynthetic macrolide antibiotic derived from erythromycin that is active against a variety of microorganisms. It can inhibit protein synthesis in bacteria by reversibly binding to the 50S ribosomal subunits. This inhibits the translocation of aminoacyl transfer-RNA and prevents peptide chain elongation. [NIH] Cleft Palate: Congenital fissure of the soft and/or hard palate, due to faulty fusion. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]
Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case
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reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Clonazepam: An anticonvulsant used for several types of seizures, including myotonic or atonic seizures, photosensitive epilepsy, and absence seizures, although tolerance may develop. It is seldom effective in generalized tonic-clonic or partial seizures. The mechanism of action appears to involve the enhancement of gaba receptor responses. [NIH] Clonic: Pertaining to or of the nature of clonus. [EU] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Clozapine: A tricylic dibenzodiazepine, classified as an atypical antipsychotic agent. It binds several types of central nervous system receptors, and displays a unique pharmacological profile. Clozapine is a serotonin antagonist, with strong binding to 5-HT 2A/2C receptor subtype. It also displays strong affinity to several dopaminergic receptors, but shows only weak antagonism at the dopamine D2 receptor, a receptor commonly thought to modulate neuroleptic activity. Agranulocytosis is a major adverse effect associated with administration of this agent. [NIH] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH] Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH] Cochlea: The part of the internal ear that is concerned with hearing. It forms the anterior part of the labyrinth, is conical, and is placed almost horizontally anterior to the vestibule. [NIH]
Cochlear: Of or pertaining to the cochlea. [EU] Cochlear Diseases: Diseases of the cochlea, the part of the inner ear that is concerned with hearing. [NIH] Cochlear Implants: Electronic devices implanted beneath the skin with electrodes to the cochlear nerve to create sound sensation in persons with sensorineural deafness. [NIH] Cochlear Nerve: The cochlear part of the 8th cranial nerve (vestibulocochlear nerve). The cochlear nerve fibers originate from neurons of the spiral ganglion and project peripherally to cochlear hair cells and centrally to the cochlear nuclei (cochlear nucleus) of the brain stem. They mediate the sense of hearing. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] Colitis: Inflammation of the colon. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all
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consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Coloboma: Congenital anomaly in which some of the structures of the eye are absent due to incomplete fusion of the fetal intraocular fissure during gestation. [NIH] Combination Therapy: Association of 3 drugs to treat AIDS (AZT + DDC or DDI + protease inhibitor). [NIH] Communication Disorders: Disorders of verbal and nonverbal communication caused by receptive or expressive language disorders, cognitive dysfunction (e.g., mental retardation), psychiatric conditions, and hearing disorders. [NIH] Comorbidity: The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such
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as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Compulsions: In psychology, an irresistible urge, sometimes amounting to obsession to perform a particular act which usually is carried out against the performer's will or better judgment. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Computer Simulation: Computer-based representation of physical systems and phenomena such as chemical processes. [NIH] Computerized axial tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography (CT scan), or computerized tomography. [NIH] Confusion: A mental state characterized by bewilderment, emotional disturbance, lack of clear thinking, and perceptual disorientation. [NIH] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constriction: The act of constricting. [NIH] Consultation: A deliberation between two or more physicians concerning the diagnosis and the proper method of treatment in a case. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]
Convulsive: Relating or referring to spasm; affected with spasm; characterized by a spasm or spasms. [NIH] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD
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results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Corpus: The body of the uterus. [NIH] Corpus Luteum: The yellow glandular mass formed in the ovary by an ovarian follicle that has ruptured and discharged its ovum. [NIH] Corpus Striatum: Striped gray and white matter consisting of the neostriatum and paleostriatum (globus pallidus). It is located in front of and lateral to the thalamus in each cerebral hemisphere. The gray substance is made up of the caudate nucleus and the lentiform nucleus (the latter consisting of the globus pallidus and putamen). The white matter is the internal capsule. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Corticosteroid: Any of the steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to the release of corticotrophin (adrenocorticotropic hormone) by the pituitary gland, to any of the synthetic equivalents of these steroids, or to angiotensin II. They are divided, according to their predominant biological activity, into three major groups: glucocorticoids, chiefly influencing carbohydrate, fat, and protein metabolism; mineralocorticoids, affecting the regulation of electrolyte and water balance; and C19 androgens. Some corticosteroids exhibit both types of activity in varying degrees, and others exert only one type of effect. The corticosteroids are used clinically for hormonal replacement therapy, for suppression of ACTH secretion by the anterior pituitary, as antineoplastic, antiallergic, and anti-inflammatory agents, and to suppress the immune response. Called also adrenocortical hormone and corticoid. [EU] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Crossing-over: The exchange of corresponding segments between chromatids of homologous chromosomes during meiosia, forming a chiasma. [NIH] Cues: Signals for an action; that specific portion of a perceptual field or pattern of stimuli to which a subject has learned to respond. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cyanide: An extremely toxic class of compounds that can be lethal on inhaling of ingesting in minute quantities. [NIH] Cytogenetics: A branch of genetics which deals with the cytological and molecular behavior of genes and chromosomes during cell division. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU]
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Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Delirium: (DSM III-R) an acute, reversible organic mental disorder characterized by reduced ability to maintain attention to external stimuli and disorganized thinking as manifested by rambling, irrelevant, or incoherent speech; there are also a reduced level of consciousness, sensory misperceptions, disturbance of the sleep-wakefulness cycle and level of psychomotor activity, disorientation to time, place, or person, and memory impairment. Delirium may be caused by a large number of conditions resulting in derangement of cerebral metabolism, including systemic infection, poisoning, drug intoxication or withdrawal, seizures or head trauma, and metabolic disturbances such as hypoxia, hypoglycaemia, fluid, electrolyte, or acid-base imbalances, or hepatic or renal failure. Called also acute confusional state and acute brain syndrome. [EU] Delusions: A false belief regarding the self or persons or objects outside the self that persists despite the facts, and is not considered tenable by one's associates. [NIH] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Dendritic: 1. Branched like a tree. 2. Pertaining to or possessing dendrites. [EU] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dental Caries: Localized destruction of the tooth surface initiated by decalcification of the enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked, the cavity may penetrate the enamel and dentin and reach the pulp. The three most prominent theories used to explain the etiology of the disase are that acids produced by bacteria lead to decalcification; that micro-organisms destroy the enamel protein; or that keratolytic micro-organisms produce chelates that lead to decalcification. [NIH]
Depersonalization: Alteration in the perception of the self so that the usual sense of one's own reality is lost, manifested in a sense of unreality or self-estrangement, in changes of body image, or in a feeling that one does not control his own actions and speech; seen in depersonalization disorder, schizophrenic disorders, and schizotypal personality disorder. Some do not draw a distinction between depersonalization and derealization, using depersonalization to include both. [EU] Depressive Disorder: An affective disorder manifested by either a dysphoric mood or loss of interest or pleasure in usual activities. The mood disturbance is prominent and relatively persistent. [NIH] Derealization: Is characterized by the loss of the sense of reality concerning one's surroundings. [NIH] Dermatitis: Any inflammation of the skin. [NIH] Desipramine: A tricyclic dibenzazepine compound that potentiates neurotransmission. Desipramine selectively blocks reuptake of norepinephrine from the neural synapse, and also appears to impair serotonin transport. This compound also possesses minor anticholingeric activity, through its affinity to muscarinic receptors. [NIH] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH]
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Dextroamphetamine: The d-form of amphetamine. It is a central nervous system stimulant and a sympathomimetic. It has also been used in the treatment of narcolepsy and of attention deficit disorders and hyperactivity in children. Dextroamphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulating release of monamines, and inhibiting monoamine oxidase. It is also a drug of abuse and a psychotomimetic. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Diastolic blood pressure: The minimum pressure that remains within the artery when the heart is at rest. [NIH] Diencephalon: The paired caudal parts of the prosencephalon from which the thalamus, hypothalamus, epithalamus, and subthalamus are derived. [NIH] Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Diploid: Having two sets of chromosomes. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Disease Susceptibility: A constitution or condition of the body which makes the tissues react in special ways to certain extrinsic stimuli and thus tends to make the individual more than usually susceptible to certain diseases. [NIH] Dizziness: An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness. [NIH] Dopa: The racemic or DL form of DOPA, an amino acid found in various legumes. The dextro form has little physiologic activity but the levo form (levodopa) is a very important physiologic mediator and precursor and pharmacological agent. [NIH] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Dorsum: A plate of bone which forms the posterior boundary of the sella turcica. [NIH] Doxepin: A dibenzoxepin tricyclic compound. It displays a range of pharmacological actions including maintaining adrenergic innervation. Its mechanism of action is not fully understood, but it appears to block reuptake of monoaminergic neurotransmitters into presynaptic terminals. It also possesses anticholinergic activity and modulates antagonism
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of histamine H(1)- and H(2)-receptors. [NIH] Drive: A state of internal activity of an organism that is a necessary condition before a given stimulus will elicit a class of responses; e.g., a certain level of hunger (drive) must be present before food will elicit an eating response. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Dyskinesia: Impairment of the power of voluntary movement, resulting in fragmentary or incomplete movements. [EU] Dyslexia: Partial alexia in which letters but not words may be read, or in which words may be read but not understood. [NIH] Dysphonia: Difficulty or pain in speaking; impairment of the voice. [NIH] Dysphoric: A feeling of unpleasantness and discomfort. [NIH] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Dyspnea: Difficult or labored breathing. [NIH] Dystonia: Disordered tonicity of muscle. [EU] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Eating Disorders: A group of disorders characterized by physiological and psychological disturbances in appetite or food intake. [NIH] Echolalia: The pathological repetition by imitation of the speech of another. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Effector cell: A cell that performs a specific function in response to a stimulus; usually used to describe cells in the immune system. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Ejaculation: The release of semen through the penis during orgasm. [NIH] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU] Electroencephalography: Recording of electric currents developed in the brain by means of electrodes applied to the scalp, to the surface of the brain, or placed within the substance of the brain. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electromyography: Recording of the changes in electric potential of muscle by means of surface or needle electrodes. [NIH] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Electrophysiological: Pertaining to electrophysiology, that is a branch of physiology that is concerned with the electric phenomena associated with living bodies and involved in their functional activity. [EU]
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Electroplating: Coating with a metal or alloy by electrolysis. [NIH] Elementary Particles: Individual components of atoms, usually subatomic; subnuclear particles are usually detected only when the atomic nucleus decays and then only transiently, as most of them are unstable, often yielding pure energy without substance, i.e., radiation. [NIH] Emetic: An agent that causes vomiting. [EU] Empirical: A treatment based on an assumed diagnosis, prior to receiving confirmatory laboratory test results. [NIH] Emulsion: A preparation of one liquid distributed in small globules throughout the body of a second liquid. The dispersed liquid is the discontinuous phase, and the dispersion medium is the continuous phase. When oil is the dispersed liquid and an aqueous solution is the continuous phase, it is known as an oil-in-water emulsion, whereas when water or aqueous solution is the dispersed phase and oil or oleaginous substance is the continuous phase, it is known as a water-in-oil emulsion. Pharmaceutical emulsions for which official standards have been promulgated include cod liver oil emulsion, cod liver oil emulsion with malt, liquid petrolatum emulsion, and phenolphthalein in liquid petrolatum emulsion. [EU] Endocrine System: The system of glands that release their secretions (hormones) directly into the circulatory system. In addition to the endocrine glands, included are the chromaffin system and the neurosecretory systems. [NIH] Endometrial: Having to do with the endometrium (the layer of tissue that lines the uterus). [NIH]
Endometrium: The layer of tissue that lines the uterus. [NIH] Endotoxins: Toxins closely associated with the living cytoplasm or cell wall of certain microorganisms, which do not readily diffuse into the culture medium, but are released upon lysis of the cells. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]
Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epithalamus: The dorsal posterior subdivision of the diencephalon. The epithalamus is generally considered to include the habenular nuclei (habenula) and associated fiber bundles, the pineal body, and the epithelial roof of the third ventricle. The anterior and posterior paraventricular nuclei of the thalamus are included with the thalamic nuclei although they develop from the same pronuclear mass as the epithalamic nuclei and are sometimes considered part of the epithalamus. [NIH]
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Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Erythromycin: A bacteriostatic antibiotic substance produced by Streptomyces erythreus. Erythromycin A is considered its major active component. In sensitive organisms, it inhibits protein synthesis by binding to 50S ribosomal subunits. This binding process inhibits peptidyl transferase activity and interferes with translocation of amino acids during translation and assembly of proteins. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]
Essential Tremor: A rhythmic, involuntary, purposeless, oscillating movement resulting from the alternate contraction and relaxation of opposing groups of muscles. [NIH] Estrogen: One of the two female sex hormones. [NIH] Ether: One of a class of organic compounds in which any two organic radicals are attached directly to a single oxygen atom. [NIH] Eukaryotic Cells: Cells of the higher organisms, containing a true nucleus bounded by a nuclear membrane. [NIH] Evacuation: An emptying, as of the bowels. [EU] Evoked Potentials: The electric response evoked in the central nervous system by stimulation of sensory receptors or some point on the sensory pathway leading from the receptor to the cortex. The evoked stimulus can be auditory, somatosensory, or visual, although other modalities have been reported. Event-related potentials is sometimes used synonymously with evoked potentials but is often associated with the execution of a motor, cognitive, or psychophysiological task, as well as with the response to a stimulus. [NIH] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Excitatory: When cortical neurons are excited, their output increases and each new input they receive while they are still excited raises their output markedly. [NIH] Expiration: The act of breathing out, or expelling air from the lungs. [EU] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extrapyramidal: Outside of the pyramidal tracts. [EU] Facial: Of or pertaining to the face. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]
Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Fetal Alcohol Syndrome: A disorder occurring in children born to alcoholic women who continue to drink heavily during pregnancy. Common abnormalities are growth deficiency (prenatal and postnatal), altered morphogenesis, mental deficiency, and characteristic facies
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- small eyes and flattened nasal bridge. Fine motor dysfunction and tremulousness are observed in the newborn. [NIH] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fissure: Any cleft or groove, normal or otherwise; especially a deep fold in the cerebral cortex which involves the entire thickness of the brain wall. [EU] Flumazenil: A potent benzodiazepine receptor antagonist. Since it reverses the sedative and other actions of benzodiazepines, it has been suggested as an antidote to benzodiazepine overdoses. [NIH] Fluorine: A nonmetallic, diatomic gas that is a trace element and member of the halogen family. It is used in dentistry as flouride to prevent dental caries. [NIH] Fluoxetine: The first highly specific serotonin uptake inhibitor. It is used as an antidepressant and often has a more acceptable side-effects profile than traditional antidepressants. [NIH] Fluphenazine: A phenothiazine used in the treatment of psychoses. Its properties and uses are generally similar to those of chlorpromazine. [NIH] Flush: Transient, episodic redness of the face and neck caused by certain diseases, ingestion of certain drugs or other substances, heat, emotional factors, or physical exertion. [EU] Frontal Lobe: The anterior part of the cerebral hemisphere. [NIH] Functional Disorders: Disorders such as irritable bowel syndrome. These conditions result from poor nerve and muscle function. Symptoms such as gas, pain, constipation, and diarrhea come back again and again, but there are no signs of disease or damage. Emotional stress can trigger symptoms. Also called motility disorders. [NIH] Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH] GABA: The most common inhibitory neurotransmitter in the central nervous system. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Ganglionic Blockers: Agents having as their major action the interruption of neural transmission at nicotinic receptors on postganglionic autonomic neurons. Because their actions are so broad, including blocking of sympathetic and parasympathetic systems, their therapeutic use has been largely supplanted by more specific drugs. They may still be used in the control of blood pressure in patients with acute dissecting aortic aneurysm and for the induction of hypotension in surgery. [NIH] Gap Junctions: Connections between cells which allow passage of small molecules and electric current. Gap junctions were first described anatomically as regions of close apposition between cells with a narrow (1-2 nm) gap between cell membranes. The variety in the properties of gap junctions is reflected in the number of connexins, the family of proteins which form the junctions. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body
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through the rectum (flatus) or the mouth (burp). [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Acid: Hydrochloric acid present in gastric juice. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]
Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]
Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Genetic Engineering: Directed modification of the gene complement of a living organism by such techniques as altering the DNA, substituting genetic material by means of a virus, transplanting whole nuclei, transplanting cell hybrids, etc. [NIH] Genetic Markers: A phenotypically recognizable genetic trait which can be used to identify a genetic locus, a linkage group, or a recombination event. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genomics: The systematic study of the complete DNA sequences (genome) of organisms. [NIH]
Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Globus Pallidus: The representation of the phylogenetically oldest part of the corpus striatum called the paleostriatum. It forms the smaller, more medial part of the lentiform nucleus. [NIH] Glucocorticoids: A group of corticosteroids that affect carbohydrate metabolism (gluconeogenesis, liver glycogen deposition, elevation of blood sugar), inhibit corticotropin secretion, and possess pronounced anti-inflammatory activity. They also play a role in fat and protein metabolism, maintenance of arterial blood pressure, alteration of the connective tissue response to injury, reduction in the number of circulating lymphocytes, and functioning of the central nervous system. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glutamate: Excitatory neurotransmitter of the brain. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]
Glycerol: A trihydroxy sugar alcohol that is an intermediate in carbohydrate and lipid metabolism. It is used as a solvent, emollient, pharmaceutical agent, and sweetening agent. [NIH]
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Gonad: A sex organ, such as an ovary or a testicle, which produces the gametes in most multicellular animals. [NIH] Gonadal: Pertaining to a gonad. [EU] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Guanfacine: A centrally acting antihypertensive agent. The drug lowers both systolic and diastolic blood pressure by activating the central nervous system alpha-2 adrenoreceptors, which results in reduced sympathetic outflow leading to reduced vascular tone. Its adverse reactions include dry mouth, sedation, and constipation. [NIH] Gyrus Cinguli: One of the convolutions on the medial surface of the cerebral hemisphere. It surrounds the rostral part of the brain and interhemispheric commissure and forms part of the limbic system. [NIH] Half-Life: The time it takes for a substance (drug, radioactive nuclide, or other) to lose half of its pharmacologic, physiologic, or radiologic activity. [NIH] Halogens: A family of nonmetallic, generally electronegative, elements of group VIIa of the periodic table. They are all multivalent and have oxidation numbers of -1 (the most common), 1, 3, 5, and 7. [NIH] Haloperidol: Butyrophenone derivative. [NIH] Handicap: A handicap occurs as a result of disability, but disability does not always constitute a handicap. A handicap may be said to exist when a disability causes a substantial and continuing reduction in a person's capacity to function socially and vocationally. [NIH] Haplotypes: The genetic constitution of individuals with respect to one member of a pair of allelic genes, or sets of genes that are closely linked and tend to be inherited together such as those of the major histocompatibility complex. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Hearing Disorders: Conditions that impair the transmission or perception of auditory impulses and information from the level of the ear to the temporal cortices, including the sensorineural pathways. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH]
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Hemoglobinuria: The presence of free hemoglobin in the urine. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]
Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Hippocampus: A curved elevation of gray matter extending the entire length of the floor of the temporal horn of the lateral ventricle (Dorland, 28th ed). The hippocampus, subiculum, and dentate gyrus constitute the hippocampal formation. Sometimes authors include the entorhinal cortex in the hippocampal formation. [NIH] Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Homogeneous: Consisting of or composed of similar elements or ingredients; of a uniform quality throughout. [EU] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrogen Cyanide: HCN. A toxic liquid or colorless gas. It is found in the smoke of various tobacco products and released by combustion of nitrogen-containing organic materials. [NIH] Hydrogen Peroxide: A strong oxidizing agent used in aqueous solution as a ripening agent, bleach, and topical anti-infective. It is relatively unstable and solutions deteriorate over time unless stabilized by the addition of acetanilide or similar organic materials. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hyperthyroidism: Excessive functional activity of the thyroid gland. [NIH] Hypnotherapy: Sleeping-cure. [NIH] Hypokinesia: Slow or diminished movement of body musculature. It may be associated with basal ganglia diseases; mental disorders; prolonged inactivity due to illness; experimental protocols used to evaluate the physiologic effects of immobility; and other conditions. [NIH]
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Hypotension: Abnormally low blood pressure. [NIH] Hypotensive: Characterized by or causing diminished tension or pressure, as abnormally low blood pressure. [EU] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Imaging procedures: Methods of producing pictures of areas inside the body. [NIH] Imipramine: The prototypical tricyclic antidepressant. It has been used in major depression, dysthymia, bipolar depression, attention-deficit disorders, agoraphobia, and panic disorders. It has less sedative effect than some other members of this therapeutic group. [NIH]
Immune function: Production and action of cells that fight disease or infection. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]
Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunohistochemistry: Histochemical localization of immunoreactive substances using labeled antibodies as reagents. [NIH] Immunology: The study of the body's immune system. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Impulse Control Disorders: Disorders whose essential features are the failure to resist an impulse, drive, or temptation to perform an act that is harmful to the individual or to others. Individuals experience an increased sense of tension prior to the act and pleasure, gratification, or release of tension at the time of committing the act. [NIH] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In Situ Hybridization: A technique that localizes specific nucleic acid sequences within intact chromosomes, eukaryotic cells, or bacterial cells through the use of specific nucleic acid-labeled probes. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infantile: Pertaining to an infant or to infancy. [EU]
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Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]
Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Inflammatory bowel disease: A general term that refers to the inflammation of the colon and rectum. Inflammatory bowel disease includes ulcerative colitis and Crohn's disease. [NIH]
Ingestion: Taking into the body by mouth [NIH] Inner ear: The labyrinth, comprising the vestibule, cochlea, and semicircular canals. [NIH] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Inotropic: Affecting the force or energy of muscular contractions. [EU] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insomnia: Difficulty in going to sleep or getting enough sleep. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Interneurons: Most generally any neurons which are not motor or sensory. Interneurons may also refer to neurons whose axons remain within a particular brain region as contrasted with projection neurons which have axons projecting to other brain regions. [NIH] Intestinal: Having to do with the intestines. [NIH] Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intracranial Hypertension: Increased pressure within the cranial vault. This may result from several conditions, including hydrocephalus; brain edema; intracranial masses; severe systemic hypertension; pseudotumor cerebri; and other disorders. [NIH] Intraocular: Within the eye. [EU] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]
Involuntary: Reaction occurring without intention or volition. [NIH] Ion Channels: Gated, ion-selective glycoproteins that traverse membranes. The stimulus for channel gating can be a membrane potential, drug, transmitter, cytoplasmic messenger, or a
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mechanical deformation. Ion channels which neurotransmitter receptors are not included. [NIH]
are
integral
parts
of
ionotropic
Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Irritable Bowel Syndrome: A disorder that comes and goes. Nerves that control the muscles in the GI tract are too active. The GI tract becomes sensitive to food, stool, gas, and stress. Causes abdominal pain, bloating, and constipation or diarrhea. Also called spastic colon or mucous colitis. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Labyrinth: The internal ear; the essential part of the organ of hearing. It consists of an osseous and a membranous portion. [NIH] Lactation: The period of the secretion of milk. [EU] Lag: The time elapsing between application of a stimulus and the resulting reaction. [NIH] Language Development: The gradual expansion in complexity and meaning of symbols and sounds as perceived and interpreted by the individual through a maturational and learning process. Stages in development include babbling, cooing, word imitation with cognition, and use of short sentences. [NIH] Language Disorders: Conditions characterized by deficiencies of comprehension or expression of written and spoken forms of language. These include acquired and developmental disorders. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Laryngeal: Having to do with the larynx. [NIH] Laryngectomy: Total or partial excision of the larynx. [NIH] Larynx: An irregularly shaped, musculocartilaginous tubular structure, lined with mucous membrane, located at the top of the trachea and below the root of the tongue and the hyoid bone. It is the essential sphincter guarding the entrance into the trachea and functioning secondarily as the organ of voice. [NIH] Learning Disorders: Conditions characterized by a significant discrepancy between an individual's perceived level of intellect and their ability to acquire new language and other cognitive skills. These disorders may result from organic or psychological conditions. Relatively common subtypes include dyslexia, dyscalculia, and dysgraphia. [NIH] Lesion: An area of abnormal tissue change. [NIH] Lethal: Deadly, fatal. [EU] Leukemia: Cancer of blood-forming tissue. [NIH]
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Levo: It is an experimental treatment for heroin addiction that was developed by German scientists around 1948 as an analgesic. Like methadone, it binds with opioid receptors, but it is longer acting. [NIH] Levodopa: The naturally occurring form of dopa and the immediate precursor of dopamine. Unlike dopamine itself, it can be taken orally and crosses the blood-brain barrier. It is rapidly taken up by dopaminergic neurons and converted to dopamine. It is used for the treatment of parkinsonism and is usually given with agents that inhibit its conversion to dopamine outside of the central nervous system. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]
Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Ligands: A RNA simulation method developed by the MIT. [NIH] Limbic: Pertaining to a limbus, or margin; forming a border around. [EU] Limbic System: A set of forebrain structures common to all mammals that is defined functionally and anatomically. It is implicated in the higher integration of visceral, olfactory, and somatic information as well as homeostatic responses including fundamental survival behaviors (feeding, mating, emotion). For most authors, it includes the amygdala, epithalamus, gyrus cinguli, hippocampal formation (see hippocampus), hypothalamus, parahippocampal gyrus, septal nuclei, anterior nuclear group of thalamus, and portions of the basal ganglia. (Parent, Carpenter's Human Neuroanatomy, 9th ed, p744; NeuroNames, http://rprcsgi.rprc.washington.edu/neuronames/index.html (September 2, 1998)). [NIH] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Linkage Disequilibrium: Nonrandom association of linked genes. This is the tendency of the alleles of two separate but already linked loci to be found together more frequently than would be expected by chance alone. [NIH] Lip: Either of the two fleshy, full-blooded margins of the mouth. [NIH] Lipid: Fat. [NIH] Lithium: An element in the alkali metals family. It has the atomic symbol Li, atomic number 3, and atomic weight 6.94. Salts of lithium are used in treating manic-depressive disorders. [NIH]
Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver scan: An image of the liver created on a computer screen or on film. A radioactive substance is injected into a blood vessel and travels through the bloodstream. It collects in the liver, especially in abnormal areas, and can be detected by the scanner. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Locomotor: Of or pertaining to locomotion; pertaining to or affecting the locomotive apparatus of the body. [EU]
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Longitudinal Studies: Studies in which variables relating to an individual or group of individuals are assessed over a period of time. [NIH] Long-Term Care: Care over an extended period, usually for a chronic condition or disability, requiring periodic, intermittent, or continuous care. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lumbar puncture: A procedure in which a needle is put into the lower part of the spinal column to collect cerebrospinal fluid or to give anticancer drugs intrathecally. Also called a spinal tap. [NIH] Luteal Phase: The period of the menstrual cycle that begins with ovulation and ends with menstruation. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Magnetic Resonance Spectroscopy: Spectroscopic method of measuring the magnetic moment of elementary particles such as atomic nuclei, protons or electrons. It is employed in clinical applications such as NMR Tomography (magnetic resonance imaging). [NIH] Major Histocompatibility Complex: The genetic region which contains the loci of genes which determine the structure of the serologically defined (SD) and lymphocyte-defined (LD) transplantation antigens, genes which control the structure of the immune responseassociated (Ia) antigens, the immune response (Ir) genes which control the ability of an animal to respond immunologically to antigenic stimuli, and genes which determine the structure and/or level of the first four components of complement. [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]
Mania: Excitement of psychotic proportions manifested by mental and physical hyperactivity, disorganization of behaviour, and elevation of mood. [EU] Manic: Affected with mania. [EU] Manic-depressive psychosis: One of a group of psychotic reactions, fundamentally marked by severe mood swings and a tendency to remission and recurrence. [NIH] Man-made: Ionizing radiation emitted by artificial or concentrated natural, radioactive material or resulting from the operation of high voltage apparatus, such as X-ray apparatus or particle accelerators, of nuclear reactors, or from nuclear explosions. [NIH] Mecamylamine: A nicotinic antagonist that is well absorbed from the gastrointestinal tract and crosses the blood-brain barrier. Mecamylamine has been used as a ganglionic blocker in treating hypertension, but, like most ganglionic blockers, is more often used now as a research tool. [NIH] Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU]
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Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Meiosis: A special method of cell division, occurring in maturation of the germ cells, by means of which each daughter nucleus receives half the number of chromosomes characteristic of the somatic cells of the species. [NIH] Melanin: The substance that gives the skin its color. [NIH] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental deficiency: A condition of arrested or incomplete development of mind from inherent causes or induced by disease or injury. [NIH] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH] Mental Processes: Conceptual functions or thinking in all its forms. [NIH] Mental Retardation: Refers to sub-average general intellectual functioning which originated during the developmental period and is associated with impairment in adaptive behavior. [NIH]
Mentors: Senior professionals who provide guidance, direction and support to those persons desirous of improvement in academic positions, administrative positions or other career development situations. [NIH] Mesolimbic: Inner brain region governing emotion and drives. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU]
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Methylphenidate: A central nervous system stimulant used most commonly in the treatment of attention-deficit disorders in children and for narcolepsy. Its mechanisms appear to be similar to those of dextroamphetamine. [NIH] Methyltransferase: A drug-metabolizing enzyme. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Microwaves: That portion of the electromagnetic spectrum lying between UHF (ultrahigh frequency) radio waves and heat (infrared) waves. Microwaves are used to generate heat, especially in some types of diathermy. They may cause heat damage to tissues. [NIH] Mineralocorticoids: A group of corticosteroids primarily associated with the regulation of water and electrolyte balance. This is accomplished through the effect on ion transport in renal tubules, resulting in retention of sodium and loss of potassium. Mineralocorticoid secretion is itself regulated by plasma volume, serum potassium, and angiotensin II. [NIH] Mode of Transmission: Hepatitis A [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecular Structure: The location of the atoms, groups or ions relative to one another in a molecule, as well as the number, type and location of covalent bonds. [NIH] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoamine: Enzyme that breaks down dopamine in the astrocytes and microglia. [NIH] Monoamine Oxidase: An enzyme that catalyzes the oxidative deamination of naturally occurring monoamines. It is a flavin-containing enzyme that is localized in mitochondrial membranes, whether in nerve terminals, the liver, or other organs. Monoamine oxidase is important in regulating the metabolic degradation of catecholamines and serotonin in neural or target tissues. Hepatic monoamine oxidase has a crucial defensive role in inactivating circulating monoamines or those, such as tyramine, that originate in the gut and are absorbed into the portal circulation. (From Goodman and Gilman's, The Pharmacological Basis of Therapeutics, 8th ed, p415) EC 1.4.3.4. [NIH] Monotherapy: A therapy which uses only one drug. [EU] Mood Disorders: Those disorders that have a disturbance in mood as their predominant feature. [NIH] Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH]
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Morphogenesis: The development of the form of an organ, part of the body, or organism. [NIH]
Morphological: Relating to the configuration or the structure of live organs. [NIH] Motility: The ability to move spontaneously. [EU] Motivations: The most compelling inner determinants of human behavior; also called drives, urges, impulses, needs, wants, tensions, and willful cravings. [NIH] Movement Disorders: Syndromes which feature dyskinesias as a cardinal manifestation of the disease process. Included in this category are degenerative, hereditary, post-infectious, medication-induced, post-inflammatory, and post-traumatic conditions. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Multivalent: Pertaining to a group of 5 or more homologous or partly homologous chromosomes during the zygotene stage of prophase to first metaphasis in meiosis. [NIH] Muscle Fibers: Large single cells, either cylindrical or prismatic in shape, that form the basic unit of muscle tissue. They consist of a soft contractile substance enclosed in a tubular sheath. [NIH] Muscular Atrophy: Derangement in size and number of muscle fibers occurring with aging, reduction in blood supply, or following immobilization, prolonged weightlessness, malnutrition, and particularly in denervation. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] Mutism: Inability or refusal to speak. [EU] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myotonic Dystrophy: A condition presenting muscle weakness and wasting which may be progressive. [NIH] Naive: Used to describe an individual who has never taken a certain drug or class of drugs (e. g., AZT-naive, antiretroviral-naive), or to refer to an undifferentiated immune system cell. [NIH] Naloxone: A specific opiate antagonist that has no agonist activity. It is a competitive antagonist at mu, delta, and kappa opioid receptors. [NIH] Narcolepsy: A condition of unknown cause characterized by a periodic uncontrollable tendency to fall asleep. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH]
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Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nephropathy: Disease of the kidneys. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuroanatomy: Study of the anatomy of the nervous system as a specialty or discipline. [NIH]
Neuroendocrine: Having to do with the interactions between the nervous system and the endocrine system. Describes certain cells that release hormones into the blood in response to stimulation of the nervous system. [NIH] Neuroleptic: A term coined to refer to the effects on cognition and behaviour of antipsychotic drugs, which produce a state of apathy, lack of initiative, and limited range of emotion and in psychotic patients cause a reduction in confusion and agitation and normalization of psychomotor activity. [EU] Neurologic: Having to do with nerves or the nervous system. [NIH] Neurology: A medical specialty concerned with the study of the structures, functions, and diseases of the nervous system. [NIH] Neuroma: A tumor that arises in nerve cells. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuromuscular Junction: The synapse between a neuron and a muscle. [NIH] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropeptide: A member of a class of protein-like molecules made in the brain. Neuropeptides consist of short chains of amino acids, with some functioning as neurotransmitters and some functioning as hormones. [NIH] Neurosis: Functional derangement due to disorders of the nervous system which does not affect the psychic personality of the patient. [NIH] Neurotoxin: A substance that is poisonous to nerve tissue. [NIH] Neurotransmitters: Endogenous signaling molecules that alter the behavior of neurons or effector cells. Neurotransmitter is used here in its most general sense, including not only messengers that act directly to regulate ion channels, but also those that act through second messenger systems, and those that act at a distance from their site of release. Included are neuromodulators, neuroregulators, neuromediators, and neurohumors, whether or not acting at synapses. [NIH] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are
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unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Niacin: Water-soluble vitamin of the B complex occurring in various animal and plant tissues. Required by the body for the formation of coenzymes NAD and NADP. Has pellagra-curative, vasodilating, and antilipemic properties. [NIH] Nicotine: Nicotine is highly toxic alkaloid. It is the prototypical agonist at nicotinic cholinergic receptors where it dramatically stimulates neurons and ultimately blocks synaptic transmission. Nicotine is also important medically because of its presence in tobacco smoke. [NIH] Nitrates: Inorganic or organic salts and esters of nitric acid. These compounds contain the NO3- radical. [NIH] Nitric acid: A toxic, corrosive, colorless liquid used to make fertilizers, dyes, explosives, and other chemicals. [NIH] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nonverbal Communication: Transmission of emotions, ideas, and attitudes between individuals in ways other than the spoken language. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleus Accumbens: Collection of pleomorphic cells in the caudal part of the anterior horn of the lateral ventricle, in the region of the olfactory tubercle, lying between the head of the caudate nucleus and the anterior perforated substance. It is part of the so-called ventral striatum, a composite structure considered part of the basal ganglia. [NIH] Obsession: A recurrent, persistent thought, image, or impulse that is unwanted and distressing (ego-dystonic) and comes involuntarily to mind despite attempts to ignore or suppress it. Common obsessions involve thoughts of violence, contamination, and selfdoubt. [EU] Obsessive Behavior: Persistent, unwanted idea or impulse which is considered normal when it does not markedly interfere with mental processes or emotional adjustment. [NIH] Oculi: Globe or ball of the eye. [NIH]
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Oncogene: A gene that normally directs cell growth. If altered, an oncogene can promote or allow the uncontrolled growth of cancer. Alterations can be inherited or caused by an environmental exposure to carcinogens. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Optic Chiasm: The X-shaped structure formed by the meeting of the two optic nerves. At the optic chiasm the fibers from the medial part of each retina cross to project to the other side of the brain while the lateral retinal fibers continue on the same side. As a result each half of the brain receives information about the contralateral visual field from both eyes. [NIH]
Orbicularis: A thin layer of fibers that originates at the posterior lacrimal crest and passes outward and forward, dividing into two slips which surround the canaliculi. [NIH] Orgasm: The crisis of sexual excitement in either humans or animals. [NIH] Orthostatic: Pertaining to or caused by standing erect. [EU] Overdose: An accidental or deliberate dose of a medication or street drug that is in excess of what is normally used. [NIH] Ovulation: The discharge of a secondary oocyte from a ruptured graafian follicle. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]
Oxygen Consumption: The oxygen consumption is determined by calculating the difference between the amount of oxygen inhaled and exhaled. [NIH] Oxytocin: A nonapeptide posterior pituitary hormone that causes uterine contractions and stimulates lactation. [NIH] Palate: The structure that forms the roof of the mouth. It consists of the anterior hard palate and the posterior soft palate. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic cancer: Cancer of the pancreas, a salivary gland of the abdomen. [NIH] Panic: A state of extreme acute, intense anxiety and unreasoning fear accompanied by disorganization of personality function. [NIH] Panic Disorder: A type of anxiety disorder characterized by unexpected panic attacks that last minutes or, rarely, hours. Panic attacks begin with intense apprehension, fear or terror and, often, a feeling of impending doom. Symptoms experienced during a panic attack include dyspnea or sensations of being smothered; dizziness, loss of balance or faintness; choking sensations; palpitations or accelerated heart rate; shakiness; sweating; nausea or other form of abdominal distress; depersonalization or derealization; paresthesias; hot flashes or chills; chest discomfort or pain; fear of dying and fear of not being in control of oneself or going crazy. Agoraphobia may also develop. Similar to other anxiety disorders, it
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may be inherited as an autosomal dominant trait. [NIH] Paresthesias: Abnormal touch sensations, such as burning or prickling, that occur without an outside stimulus. [NIH] Parkinsonism: A group of neurological disorders characterized by hypokinesia, tremor, and muscular rigidity. [EU] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]
Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologies: The study of abnormality, especially the study of diseases. [NIH] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Advocacy: Promotion and protection of the rights of patients, frequently through a legal process. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]
Pelvic: Pertaining to the pelvis. [EU] Penis: The external reproductive organ of males. It is composed of a mass of erectile tissue enclosed in three cylindrical fibrous compartments. Two of the three compartments, the corpus cavernosa, are placed side-by-side along the upper part of the organ. The third compartment below, the corpus spongiosum, houses the urethra. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Peptide Chain Elongation: The process whereby an amino acid is joined through a substituted amide linkage to a chain of peptides. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Pergolide: A long-acting dopamine agonist which is effective in the treatment of Parkinson's disease and hyperprolactinemia. It has also been observed to have antihypertensive effects. [NIH]
Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharmacotherapy: A regimen of using appetite suppressant medications to manage obesity by decreasing appetite or increasing the feeling of satiety. These medications decrease appetite by increasing serotonin or catecholamine—two brain chemicals that affect mood and appetite. [NIH] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phenylalanine: An aromatic amino acid that is essential in the animal diet. It is a precursor of melanin, dopamine, noradrenalin, and thyroxine. [NIH] Phobia: A persistent, irrational, intense fear of a specific object, activity, or situation (the phobic stimulus), fear that is recognized as being excessive or unreasonable by the individual himself. When a phobia is a significant source of distress or interferes with social functioning, it is considered a mental disorder; phobic disorder (or neurosis). In DSM III
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phobic disorders are subclassified as agoraphobia, social phobias, and simple phobias. Used as a word termination denoting irrational fear of or aversion to the subject indicated by the stem to which it is affixed. [EU] Phobic Disorders: Anxiety disorders in which the essential feature is persistent and irrational fear of a specific object, activity, or situation that the individual feels compelled to avoid. The individual recognizes the fear as excessive or unreasonable. [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]
Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Pitch: The subjective awareness of the frequency or spectral distribution of a sound. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Pleomorphic: Occurring in various distinct forms. In terms of cells, having variation in the size and shape of cells or their nuclei. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Polymerase: An enzyme which catalyses the synthesis of DNA using a single DNA strand as a template. The polymerase copies the template in the 5'-3'direction provided that sufficient quantities of free nucleotides, dATP and dTTP are present. [NIH] Polymorphism: The occurrence together of two or more distinct forms in the same population. [NIH] Pons: The part of the central nervous system lying between the medulla oblongata and the mesencephalon, ventral to the cerebellum, and consisting of a pars dorsalis and a pars ventralis. [NIH] Post partum: After childbirth, or after delivery. [EU]
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Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postnatal: Occurring after birth, with reference to the newborn. [EU] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Post-synaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Post-traumatic: Occurring as a result of or after injury. [EU] Post-traumatic stress disorder: A psychological disorder that develops in some individuals after a major traumatic experience such as war, rape, domestic violence, or accident. [NIH] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Potentiates: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Prefrontal Cortex: The rostral part of the frontal lobe, bounded by the inferior precentral fissure in humans, which receives projection fibers from the mediodorsal nucleus of the thalamus. The prefrontal cortex receives afferent fibers from numerous structures of the diencephalon, mesencephalon, and limbic system as well as cortical afferents of visual, auditory, and somatic origin. [NIH] Premenstrual: Occurring before menstruation. [EU] Premenstrual Syndrome: A syndrome occurring most often during the last week of the menstrual cycle and ending soon after the onset of menses. Some of the symptoms are emotional instability, insomnia, headache, nausea, vomiting, abdominal distension, and painful breasts. [NIH] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Presynaptic: Situated proximal to a synapse, or occurring before the synapse is crossed. [EU] Presynaptic Terminals: The distal terminations of axons which are specialized for the release of neurotransmitters. Also included are varicosities along the course of axons which have similar specializations and also release transmitters. Presynaptic terminals in both the central and peripheral nervous systems are included. [NIH] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare
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the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Prone: Having the front portion of the body downwards. [NIH] Prophase: The first phase of cell division, in which the chromosomes become visible, the nucleus starts to lose its identity, the spindle appears, and the centrioles migrate toward opposite poles. [NIH] Propranolol: A widely used non-cardioselective beta-adrenergic antagonist. Propranolol is used in the treatment or prevention of many disorders including acute myocardial infarction, arrhythmias, angina pectoris, hypertension, hypertensive emergencies, hyperthyroidism, migraine, pheochromocytoma, menopause, and anxiety. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Protriptyline: Tricyclic antidepressant similar in action and side effects to imipramine. It may produce excitation. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Psoriasis: A common genetically determined, chronic, inflammatory skin disease characterized by rounded erythematous, dry, scaling patches. The lesions have a predilection for nails, scalp, genitalia, extensor surfaces, and the lumbosacral region. Accelerated epidermopoiesis is considered to be the fundamental pathologic feature in psoriasis. [NIH] Psychiatric: Pertaining to or within the purview of psychiatry. [EU]
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Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychogenic: Produced or caused by psychic or mental factors rather than organic factors. [EU]
Psychological Tests: Standardized tests designed to measure abilities, as in intelligence, aptitude, and achievement tests, or to evaluate personality traits. [NIH] Psychology: The science dealing with the study of mental processes and behavior in man and animals. [NIH] Psychomotor: Pertaining to motor effects of cerebral or psychic activity. [EU] Psychopathology: The study of significant causes and processes in the development of mental illness. [NIH] Psychosis: A mental disorder characterized by gross impairment in reality testing as evidenced by delusions, hallucinations, markedly incoherent speech, or disorganized and agitated behaviour without apparent awareness on the part of the patient of the incomprehensibility of his behaviour; the term is also used in a more general sense to refer to mental disorders in which mental functioning is sufficiently impaired as to interfere grossly with the patient's capacity to meet the ordinary demands of life. Historically, the term has been applied to many conditions, e.g. manic-depressive psychosis, that were first described in psychotic patients, although many patients with the disorder are not judged psychotic. [EU] Psychosomatic: Pertaining to the mind-body relationship; having bodily symptoms of psychic, emotional, or mental origin; called also psychophysiologic. [EU] Psychosomatic Medicine: A system of medicine which aims at discovering the exact nature of the relationship between the emotions and bodily function, affirming the principle that the mind and body are one. [NIH] Psychotherapy: A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication. [NIH] Psychotomimetic: Psychosis miming. [NIH] Psychotropic: Exerting an effect upon the mind; capable of modifying mental activity; usually applied to drugs that effect the mental state. [EU] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]
Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]
Pyramidal Tracts: Fibers that arise from cells within the cerebral cortex, pass through the medullary pyramid, and descend in the spinal cord. Many authorities say the pyramidal tracts include both the corticospinal and corticobulbar tracts. [NIH] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH]
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Raclopride: A substituted benzamide that has antipsychotic properties. It is a dopamine D2 receptor antagonist. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radio Waves: That portion of the electromagnetic spectrum beyond the microwaves, with wavelengths as high as 30 KM. They are used in communications, including television. Short Wave or HF (high frequency), UHF (ultrahigh frequency) and VHF (very high frequency) waves are used in citizen's band communication. [NIH] Radioactive: Giving off radiation. [NIH] Radioisotope: An unstable element that releases radiation as it breaks down. Radioisotopes can be used in imaging tests or as a treatment for cancer. [NIH] Rage: Fury; violent, intense anger. [NIH] Random Allocation: A process involving chance used in therapeutic trials or other research endeavor for allocating experimental subjects, human or animal, between treatment and control groups, or among treatment groups. It may also apply to experiments on inanimate objects. [NIH] Randomization: Also called random allocation. Is allocation of individuals to groups, e.g., for experimental and control regimens, by chance. Within the limits of chance variation, random allocation should make the control and experimental groups similar at the start of an investigation and ensure that personal judgment and prejudices of the investigator do not influence allocation. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Rape: Unlawful sexual intercourse without consent of the victim. [NIH] Reaction Time: The time from the onset of a stimulus until the organism responds. [NIH] Reality Testing: The individual's objective evaluation of the external world and the ability to differentiate adequately between it and the internal world; considered to be a primary ego function. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Receptors, Serotonin: Cell-surface proteins that bind serotonin and trigger intracellular changes which influence the behavior of cells. Several types of serotonin receptors have been recognized which differ in their pharmacology, molecular biology, and mode of action. [NIH] Recombination: The formation of new combinations of genes as a result of segregation in crosses between genetically different parents; also the rearrangement of linked genes due to crossing-over. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflex: An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord. [NIH]
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Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Retching: Dry vomiting. [NIH] Retinoblastoma: An eye cancer that most often occurs in children younger than 5 years. It occurs in hereditary and nonhereditary (sporadic) forms. [NIH] Ribosome: A granule of protein and RNA, synthesized in the nucleolus and found in the cytoplasm of cells. Ribosomes are the main sites of protein synthesis. Messenger RNA attaches to them and there receives molecules of transfer RNA bearing amino acids. [NIH] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Risperidone: A selective blocker of dopamine D2 and serotonin-5-HT-2 receptors that acts as an atypical antipsychotic agent. It has been shown to improve both positive and negative symptoms in the treatment of schizophrenia. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Satellite: Applied to a vein which closely accompanies an artery for some distance; in cytogenetics, a chromosomal agent separated by a secondary constriction from the main body of the chromosome. [NIH] Scans: Pictures of structures inside the body. Scans often used in diagnosing, staging, and monitoring disease include liver scans, bone scans, and computed tomography (CT) or computerized axial tomography (CAT) scans and magnetic resonance imaging (MRI) scans. In liver scanning and bone scanning, radioactive substances that are injected into the bloodstream collect in these organs. A scanner that detects the radiation is used to create pictures. In CT scanning, an x-ray machine linked to a computer is used to produce detailed pictures of organs inside the body. MRI scans use a large magnet connected to a computer to create pictures of areas inside the body. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH]
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Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Second Messenger Systems: Systems in which an intracellular signal is generated in response to an intercellular primary messenger such as a hormone or neurotransmitter. They are intermediate signals in cellular processes such as metabolism, secretion, contraction, phototransduction, and cell growth. Examples of second messenger systems are the adenyl cyclase-cyclic AMP system, the phosphatidylinositol diphosphate-inositol triphosphate system, and the cyclic GMP system. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] Sedative: 1. Allaying activity and excitement. 2. An agent that allays excitement. [EU] Segregation: The separation in meiotic cell division of homologous chromosome pairs and their contained allelomorphic gene pairs. [NIH] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Self-Help Groups: Organizations which provide an environment encouraging social interactions through group activities or individual relationships especially for the purpose of rehabilitating or supporting patients, individuals with common health problems, or the elderly. They include therapeutic social clubs. [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Semicircular canal: Three long canals of the bony labyrinth of the ear, forming loops and opening into the vestibule by five openings. [NIH] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] Septal: An abscess occurring at the root of the tooth on the proximal surface. [NIH] Septal Nuclei: Neural nuclei situated in the septal region. They have afferent and cholinergic efferent connections with a variety of forebrain and brainstem areas including the hippocampus, the lateral hypothalamus, the tegmentum, and the amygdala. Included are the dorsal, lateral, medial, and triangular septal nuclei, septofimbrial nucleus, nucleus of diagonal band, nucleus of anterior commissure, and the nucleus of stria terminalis. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important
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physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Determination: The biological characteristics which distinguish human beings as female or male. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Sleep apnea: A serious, potentially life-threatening breathing disorder characterized by repeated cessation of breathing due to either collapse of the upper airway during sleep or absence of respiratory effort. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Sneezing: Sudden, forceful, involuntary expulsion of air from the nose and mouth caused by irritation to the mucous membranes of the upper respiratory tract. [NIH] Social Work: The use of community resources, individual case work, or group work to promote the adaptive capacities of individuals in relation to their social and economic environments. It includes social service agencies. [NIH] Solitary Nucleus: Gray matter located in the dorsomedial part of the medulla oblongata associated with the solitary tract. The solitary nucleus receives inputs from most organ systems including the terminations of the facial, glossopharyngeal, and vagus nerves. It is a major coordinator of autonomic nervous system regulation of cardiovascular, respiratory, gustatory, gastrointestinal, and chemoreceptive aspects of homeostasis. The solitary nucleus is also notable for the large number of neurotransmitters which are found therein. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Spasm: An involuntary contraction of a muscle or group of muscles. Spasms may involve skeletal muscle or smooth muscle. [NIH] Spasmodic: Of the nature of a spasm. [EU] Spastic: 1. Of the nature of or characterized by spasms. 2. Hypertonic, so that the muscles are stiff and the movements awkward. 3. A person exhibiting spasticity, such as occurs in spastic paralysis or in cerebral palsy. [EU] Spasticity: A state of hypertonicity, or increase over the normal tone of a muscle, with heightened deep tendon reflexes. [EU] Spatial disorientation: Loss of orientation in space where person does not know which way is up. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of
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bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sperm: The fecundating fluid of the male. [NIH] Spike: The activation of synapses causes changes in the permeability of the dendritic membrane leading to changes in the membrane potential. This difference of the potential travels along the axon of the neuron and is called spike. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinal tap: A procedure in which a needle is put into the lower part of the spinal column to collect cerebrospinal fluid or to give anticancer drugs intrathecally. Also called a lumbar puncture. [NIH] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Staging: Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. [NIH]
Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]
Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Streptococcal: Caused by infection due to any species of streptococcus. [NIH] Streptococcal Infections: Infections with bacteria of the genus Streptococcus. [NIH] Streptococcus: A genus of gram-positive, coccoid bacteria whose organisms occur in pairs or chains. No endospores are produced. Many species exist as commensals or parasites on man or animals with some being highly pathogenic. A few species are saprophytes and occur in the natural environment. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stria: 1. A streak, or line. 2. A narrow bandlike structure; a general term for such longitudinal collections of nerve fibres in the brain. [EU] Striatum: A higher brain's domain thus called because of its stripes. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and
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peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]
Superoxide: Derivative of molecular oxygen that can damage cells. [NIH] Superoxide Dismutase: An oxidoreductase that catalyzes the reaction between superoxide anions and hydrogen to yield molecular oxygen and hydrogen peroxide. The enzyme protects the cell against dangerous levels of superoxide. EC 1.15.1.1. [NIH] Support group: A group of people with similar disease who meet to discuss how better to cope with their cancer and treatment. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Supraspinal: Above the spinal column or any spine. [NIH] Sympathetic Nervous System: The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral column of the spinal cord and project to the paravertebral and prevertebral ganglia, which in turn project to target organs. The sympathetic nervous system mediates the body's response to stressful situations, i.e., the fight or flight reactions. It often acts reciprocally to the parasympathetic system. [NIH] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Symptomatic treatment: Therapy that eases symptoms without addressing the cause of disease. [NIH] Symptomatology: 1. That branch of medicine with treats of symptoms; the systematic discussion of symptoms. 2. The combined symptoms of a disease. [EU] Synapses: Specialized junctions at which a neuron communicates with a target cell. At classical synapses, a neuron's presynaptic terminal releases a chemical transmitter stored in synaptic vesicles which diffuses across a narrow synaptic cleft and activates receptors on the postsynaptic membrane of the target cell. The target may be a dendrite, cell body, or axon of another neuron, or a specialized region of a muscle or secretory cell. Neurons may also communicate through direct electrical connections which are sometimes called electrical synapses; these are not included here but rather in gap junctions. [NIH] Synapsis: The pairing between homologous chromosomes of maternal and paternal origin during the prophase of meiosis, leading to the formation of gametes. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synaptic Transmission: The communication from a neuron to a target (neuron, muscle, or secretory cell) across a synapse. In chemical synaptic transmission, the presynaptic neuron releases a neurotransmitter that diffuses across the synaptic cleft and binds to specific synaptic receptors. These activated receptors modulate ion channels and/or secondmessenger systems to influence the postsynaptic cell. Electrical transmission is less common
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in the nervous system, and, as in other tissues, is mediated by gap junctions. [NIH] Synaptic Vesicles: Membrane-bound compartments which contain transmitter molecules. Synaptic vesicles are concentrated at presynaptic terminals. They actively sequester transmitter molecules from the cytoplasm. In at least some synapses, transmitter release occurs by fusion of these vesicles with the presynaptic membrane, followed by exocytosis of their contents. [NIH] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Tardive: Marked by lateness, late; said of a disease in which the characteristic lesion is late in appearing. [EU] Telangiectasia: The permanent enlargement of blood vessels, causing redness in the skin or mucous membranes. [NIH] Telencephalon: Paired anteriolateral evaginations of the prosencephalon plus the lamina terminalis. The cerebral hemispheres are derived from it. Many authors consider cerebrum a synonymous term to telencephalon, though a minority include diencephalon as part of the cerebrum (Anthoney, 1994). [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Temporal Lobe: Lower lateral part of the cerebral hemisphere. [NIH] Terminalis: A groove on the lateral surface of the right atrium. [NIH] Tetrahydrocannabinol: A psychoactive compound extracted from the resin of Cannabis sativa (marihuana, hashish). The isomer delta-9-tetrahydrocannabinol (THC) is considered the most active form, producing characteristic mood and perceptual changes associated with this compound. Dronabinol is a synthetic form of delta-9-THC. [NIH] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Thalamic Diseases: Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, movement disorders; ataxia, pain syndromes, visual disorders, a variety of neuropsychological conditions, and coma. Relatively common etiologies include cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia; intracranial hemorrhages; and infectious processes. [NIH] Thalamus: Paired bodies containing mostly gray substance and forming part of the lateral wall of the third ventricle of the brain. The thalamus represents the major portion of the diencephalon and is commonly divided into cellular aggregates known as nuclear groups. [NIH]
Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Third Ventricle: A narrow cleft inferior to the corpus callosum, within the diencephalon, between the paired thalami. Its floor is formed by the hypothalamus, its anterior wall by the lamina terminalis, and its roof by ependyma. It communicates with the fourth ventricle by the cerebral aqueduct, and with the lateral ventricles by the interventricular foramina. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH]
Dictionary 185
Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Tic: An involuntary compulsive, repetitive, stereotyped movement, resembling a purposeful movement because it is coordinated and involves muscles in their normal synergistic relationships; tics usually involve the face and shoulders. [EU] Tinnitus: Sounds that are perceived in the absence of any external noise source which may take the form of buzzing, ringing, clicking, pulsations, and other noises. Objective tinnitus refers to noises generated from within the ear or adjacent structures that can be heard by other individuals. The term subjective tinnitus is used when the sound is audible only to the affected individual. Tinnitus may occur as a manifestation of cochlear diseases; vestibulocochlear nerve diseases; intracranial hypertension; craniocerebral trauma; and other conditions. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Tonic: 1. Producing and restoring the normal tone. 2. Characterized by continuous tension. 3. A term formerly used for a class of medicinal preparations believed to have the power of restoring normal tone to tissue. [EU] Tonicity: The normal state of muscular tension. [NIH] Torticollis: Wryneck; a contracted state of the cervical muscles, producing twisting of the neck and an unnatural position of the head. [EU] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Tracer: A substance (such as a radioisotope) used in imaging procedures. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Translational: The cleavage of signal sequence that directs the passage of the protein through a cell or organelle membrane. [NIH] Translocation: The movement of material in solution inside the body of the plant. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH]
186 Tourette Syndrome
Tremor: Cyclical movement of a body part that can represent either a physiologic process or a manifestation of disease. Intention or action tremor, a common manifestation of cerebellar diseases, is aggravated by movement. In contrast, resting tremor is maximal when there is no attempt at voluntary movement, and occurs as a relatively frequent manifestation of Parkinson disease. [NIH] Trichotillomania: Compulsion to pull out one's hair. [NIH] Tricyclic: Containing three fused rings or closed chains in the molecular structure. [EU] Trigger zone: Dolorogenic zone (= producing or causing pain). [EU] Trimipramine: Tricyclic antidepressant similar to imipramine, but with more antihistaminic and sedative properties. [NIH] Trisomy: The possession of a third chromosome of any one type in an otherwise diploid cell. [NIH]
Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tubercle: A rounded elevation on a bone or other structure. [NIH] Tuberous Sclerosis: A rare congenital disease in which the essential pathology is the appearance of multiple tumors in the cerebrum and in other organs, such as the heart or kidneys. [NIH] Tyramine: An indirect sympathomimetic. Tyramine does not directly activate adrenergic receptors, but it can serve as a substrate for adrenergic uptake systems and monoamine oxidase so it prolongs the actions of adrenergic transmitters. It also provokes transmitter release from adrenergic terminals. Tyramine may be a neurotransmitter in some invertebrate nervous systems. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]
Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Uterine Contraction: Contraction of the uterine muscle. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasodilator: An agent that widens blood vessels. [NIH] VE: The total volume of gas either inspired or expired in one minute. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH]
Dictionary 187
Venlafaxine: An antidepressant drug that is being evaluated for the treatment of hot flashes in women who have breast cancer. [NIH] Venous: Of or pertaining to the veins. [EU] Ventral: 1. Pertaining to the belly or to any venter. 2. Denoting a position more toward the belly surface than some other object of reference; same as anterior in human anatomy. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Vesicular: 1. Composed of or relating to small, saclike bodies. 2. Pertaining to or made up of vesicles on the skin. [EU] Vestibular: Pertaining to or toward a vestibule. In dental anatomy, used to refer to the tooth surface directed toward the vestibule of the mouth. [EU] Vestibule: A small, oval, bony chamber of the labyrinth. The vestibule contains the utricle and saccule, organs which are part of the balancing apparatus of the ear. [NIH] Vestibulocochlear Nerve: The 8th cranial nerve. The vestibulocochlear nerve has a cochlear part (cochlear nerve) which is concerned with hearing and a vestibular part (vestibular nerve) which mediates the sense of balance and head position. The fibers of the cochlear nerve originate from neurons of the spiral ganglion and project to the cochlear nuclei (cochlear nucleus). The fibers of the vestibular nerve arise from neurons of Scarpa's ganglion and project to the vestibular nuclei. [NIH] Vestibulocochlear Nerve Diseases: Diseases of the vestibular and/or cochlear (acoustic) nerves, which join to form the vestibulocochlear nerve. Vestibular neuritis, cochlear neuritis, and acoustic neuromas are relatively common conditions that affect these nerves. Clinical manifestations vary with which nerve is primarily affected, and include hearing loss, vertigo, and tinnitus. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Viruses: Minute infectious agents whose genomes are composed of DNA or RNA, but not both. They are characterized by a lack of independent metabolism and the inability to replicate outside living host cells. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Visceral Afferents: The sensory fibers innervating the viscera. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Voice Disorders: Disorders of voice pitch, loudness, or quality. Dysphonia refers to impaired utterance of sounds by the vocal folds. [NIH] Volition: Voluntary activity without external compulsion. [NIH] War: Hostile conflict between organized groups of people. [NIH] Weight Gain: Increase in body weight over existing weight. [NIH] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as
188 Tourette Syndrome
may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH]
189
INDEX A Abdominal, 77, 139, 164, 172, 175 Abdominal Pain, 139, 164 Aberrant, 17, 139 Acetylcholine, 89, 139, 148 Acid Phosphatase, 21, 44, 139 Acoustic, 20, 102, 103, 139, 187 Adjustment, 18, 139, 171 Adjuvant, 64, 139 Adrenal Cortex, 139, 152, 175 Adrenal Medulla, 139, 147, 156, 171 Adrenergic, 17, 84, 89, 139, 142, 154, 156, 176, 183, 186 Adverse Effect, 139, 143, 149, 181 Afferent, 139, 175, 180 Affinity, 139, 143, 149, 153 Agonist, 16, 17, 84, 89, 139, 143, 144, 154, 169, 171, 173 Agoraphobia, 140, 162, 172, 174 Airway, 140, 181 Akathisia, 140, 142 Alexia, 140, 155 Algorithms, 140, 145 Alkaloid, 140, 149, 168, 171 Alleles, 140, 165 Allylamine, 140 Alpha Particles, 140, 178 Alternative medicine, 108, 140 Amenorrhea, 140, 141 Amine, 23, 49, 93, 140, 161 Amino Acid Sequence, 140, 141 Amino Acids, 39, 52, 140, 157, 170, 173, 176, 179, 185, 186 Ammonia, 140, 186 Amphetamine, 7, 8, 10, 141, 154 Amygdala, 11, 141, 144, 165, 180, 184 Anaphylatoxins, 141, 150 Anatomical, 141, 143, 162, 180 Androgens, 139, 141, 152 Anemia, 121, 141 Angina, 141, 176 Angina Pectoris, 141, 176 Anions, 141, 164, 183 Anomalies, 103, 141 Anorexia, 80, 89, 141 Anorexia Nervosa, 80, 141 Antagonism, 141, 149, 154 Antiallergic, 141, 152
Antibacterial, 141, 182 Antibiotic, 141, 143, 148, 157, 182 Antibodies, 21, 141, 142, 144, 162, 174 Antibody, 139, 141, 142, 150, 161, 163, 167 Anticholinergic, 142, 154 Anticonvulsant, 142, 149 Antidepressant, 32, 93, 142, 158, 162, 176, 186, 187 Antidote, 142, 158 Antiemetic, 142, 148 Antigen, 139, 141, 142, 150, 161, 163, 167 Antigen-Antibody Complex, 142, 150 Antihypertensive, 142, 160, 173 Anti-inflammatory, 142, 152, 159 Anti-Inflammatory Agents, 142, 152 Antineoplastic, 142, 152 Antipsychotic, 92, 142, 148, 149, 170, 178, 179 Antiseptic, 142, 147 Antiviral, 142, 143 Anxiety, 5, 58, 89, 90, 91, 92, 93, 94, 110, 140, 142, 172, 174, 176 Anxiety Disorders, 92, 94, 110, 142, 172 Apathy, 143, 170 Aphasia, 102, 143 Aphidicolin, 41, 64, 143 Apnea, 143 Apomorphine, 16, 143 Aptitude, 143, 177 Aqueous, 143, 144, 156, 161 Arterial, 140, 143, 159, 161, 176, 184 Arteries, 143, 145, 151, 168, 169 Assay, 6, 143 Astringent, 143, 147 Astrocytes, 143, 168 Ataxia, 102, 120, 121, 143, 147, 184 Atrium, 143, 184, 187 Atrophy, 13, 120, 143 Atypical, 14, 20, 58, 84, 143, 149, 179 Audiovisual Aids, 129, 144 Auditory, 43, 144, 157, 160, 175 Autoantibodies, 144 Autoantigens, 5, 144 Autonomic, 48, 89, 90, 139, 142, 144, 158, 171, 181, 183 Autonomic Nervous System, 90, 144, 181, 183 Autoradiography, 11, 144
190 Tourette Syndrome
Axons, 144, 163, 175 B Baclofen, 16, 22, 144 Bacteria, 141, 142, 144, 148, 153, 157, 168, 182, 186 Basal Ganglia, 7, 11, 22, 40, 46, 90, 142, 143, 144, 148, 161, 165, 171 Basal Ganglia Diseases, 143, 144, 148, 161 Base, 93, 144, 153, 164, 184 Behavior Therapy, 68, 144 Behavioral Symptoms, 92, 144 Benzodiazepines, 144, 158 Bereavement, 103, 144 Bile, 144, 158, 165, 182 Binding Sites, 89, 145 Biochemical, 79, 140, 145, 180 Biological Transport, 145, 154 Biotechnology, 18, 19, 101, 108, 117, 119, 120, 121, 145 Bipolar Disorder, 6, 51, 78, 88, 94, 145 Bladder, 145, 176, 186 Blepharospasm, 92, 145 Blinking, 77, 78, 88, 92, 145 Bloating, 145, 164 Blood Platelets, 145, 180 Blood pressure, 142, 145, 146, 147, 158, 159, 161, 162, 168 Blood vessel, 145, 146, 147, 164, 165, 182, 184, 185, 186 Blood-Brain Barrier, 145, 165, 166 Bone scan, 145, 179 Bowel, 145, 154, 163, 182 Bowel Movement, 145, 154, 182 Brain Stem, 13, 145, 147, 149 Branch, 83, 135, 145, 152, 155, 173, 181, 183, 184 Buccal, 14, 145 Buccal mucosa, 14, 145 Bulimia, 72, 89, 91, 93, 146 Butyric Acid, 16, 146 C Calcium, 146, 150 Cannabidiol, 146 Cannabinoids, 64, 68, 146 Cannabinol, 146 Carbohydrate, 146, 152, 159 Carbon Dioxide, 79, 146, 174, 179 Carcinogenic, 146, 182 Carcinogens, 146, 172 Cardia, 89, 146 Cardiac, 91, 140, 146, 156, 169, 182 Cardioselective, 146, 176
Cardiovascular, 89, 90, 91, 141, 146, 181 Cardiovascular disease, 91, 146 Cardiovascular System, 90, 146 Case report, 25, 26, 30, 36, 45, 59, 146, 149 Case series, 146, 149 Catechol, 24, 45, 64, 147 Catecholamine, 147, 154, 173 Caudal, 147, 154, 162, 171, 175 Caudate Nucleus, 108, 144, 147, 152, 171 Cell Division, 120, 144, 147, 152, 167, 174, 176, 180 Cell proliferation, 143, 147 Cell Respiration, 147, 179 Central Nervous System Diseases, 16, 147 Cerebellar, 143, 147, 178, 186 Cerebellar Diseases, 143, 147, 186 Cerebellum, 147, 174, 178 Cerebral, 16, 30, 90, 143, 144, 145, 147, 152, 153, 156, 158, 160, 177, 181, 184 Cerebral hemispheres, 144, 145, 147, 184 Cerebrospinal, 82, 147, 166, 182 Cerebrospinal fluid, 82, 147, 166, 182 Cerebrovascular, 144, 146, 147, 184 Cerebrum, 147, 184, 186 Cervical, 147, 185 Chemoreceptor, 142, 147 Chemotactic Factors, 148, 150 Child Psychiatry, 9, 89, 148 Chlorpromazine, 148, 158 Cholesterol, 145, 148, 151, 182 Choline, 54, 55, 148 Cholinergic, 13, 142, 148, 171, 180 Chorea, 5, 142, 148 Choreatic Disorders, 148 Chromosomal, 6, 9, 15, 41, 148, 179 Chromosome, 6, 17, 18, 31, 44, 46, 148, 165, 179, 180, 186 Chronic, 6, 12, 77, 78, 82, 84, 90, 91, 102, 120, 128, 129, 137, 148, 156, 163, 164, 166, 174, 176 Chronic renal, 148, 174 Circadian, 69, 94, 148 Circadian Rhythm, 69, 94, 148 Clarithromycin, 58, 148 Cleft Palate, 102, 103, 148 Clinical Medicine, 148, 175 Clinical study, 19, 148 Clinical trial, 4, 5, 77, 85, 117, 149, 151, 176, 178 Clonazepam, 89, 149 Clonic, 145, 149 Cloning, 15, 145, 149
Index 191
Clozapine, 14, 149 Coca, 149 Cocaine, 10, 149 Cochlea, 149, 163 Cochlear, 103, 149, 185, 187 Cochlear Diseases, 149, 185 Cochlear Implants, 103, 149 Cochlear Nerve, 149, 187 Cofactor, 149, 176 Cognition, 30, 71, 90, 149, 164, 170 Colitis, 149, 163, 164 Collagen, 149, 158 Collapse, 150, 181 Coloboma, 17, 150 Combination Therapy, 5, 150 Communication Disorders, 3, 30, 53, 79, 85, 102, 103, 116, 124, 150 Comorbidity, 41, 58, 150 Complement, 13, 141, 150, 159, 166 Complementary and alternative medicine, 67, 74, 150 Complementary medicine, 67, 150 Compulsions, 127, 151 Computational Biology, 117, 119, 151 Computed tomography, 151, 179 Computer Simulation, 15, 151 Computerized axial tomography, 151, 179 Confusion, 151, 170 Congestion, 142, 151 Connective Tissue, 149, 151, 158, 159 Consciousness, 151, 153 Constipation, 89, 142, 151, 158, 160, 164 Constriction, 151, 164, 179 Consultation, 70, 151 Contraindications, ii, 151 Controlled study, 6, 19, 49, 64, 151 Convulsive, 90, 151 Coordination, 12, 147, 151 Coronary, 141, 146, 151, 152, 168, 169 Coronary heart disease, 146, 151 Coronary Thrombosis, 152, 168, 169 Corpus, 152, 159, 173, 175, 184 Corpus Luteum, 152, 175 Corpus Striatum, 152, 159 Cortex, 4, 90, 143, 152, 157, 158, 161, 175, 177, 178 Cortical, 14, 45, 46, 69, 152, 157, 175, 180, 184 Corticosteroid, 40, 152 Craniocerebral Trauma, 144, 152, 160, 184, 185 Crossing-over, 152, 178
Cues, 15, 152 Curative, 152, 171, 184 Cyanide, 16, 152 Cytogenetics, 9, 152, 179 D Databases, Bibliographic, 117, 152 Deamination, 152, 168, 186 Degenerative, 124, 152, 169 Deletion, 17, 153 Delirium, 142, 153 Delusions, 153, 177 Dementia, 78, 89, 90, 94, 142, 153 Dendrites, 153, 170 Dendritic, 153, 167, 182 Density, 7, 8, 13, 27, 65, 71, 81, 153, 172 Dental Caries, 153, 158 Depersonalization, 153, 172, 180 Depressive Disorder, 94, 153, 165 Derealization, 153, 172 Dermatitis, 143, 153 Desipramine, 93, 153 Deuterium, 153, 161 Dextroamphetamine, 141, 154, 168 Diagnostic procedure, 87, 108, 154 Diarrhea, 89, 154, 158, 164 Diastolic, 154, 160, 161 Diastolic blood pressure, 154, 160 Diencephalon, 147, 154, 156, 162, 175, 184 Diffusion, 8, 145, 154 Digestive system, 85, 154 Diploid, 154, 174, 186 Direct, iii, 7, 111, 148, 154, 178, 183 Disease Susceptibility, 10, 154 Dizziness, 102, 154, 172 Dopa, 17, 29, 154, 165 Dorsal, 7, 154, 156, 175, 180 Dorsum, 154 Doxepin, 93, 154 Drive, ii, vi, 63, 155, 162 Drug Interactions, 112, 155 Dyskinesia, 88, 89, 92, 94, 142, 155 Dyslexia, 102, 155, 164 Dysphonia, 92, 103, 155, 187 Dysphoric, 153, 155 Dysplasia, 121, 155 Dyspnea, 155, 172 Dystonia, 14, 16, 17, 29, 102, 103, 142, 155 Dystrophy, 120, 155 E Eating Disorders, 90, 124, 155 Echolalia, 92, 98, 155 Effector, 11, 139, 150, 155, 170
192 Tourette Syndrome
Effector cell, 155, 170 Efficacy, 5, 13, 83, 84, 93, 155 Ejaculation, 90, 91, 155, 180 Elective, 103, 155 Electroencephalography, 78, 155 Electrolyte, 152, 153, 155, 168, 175 Electromyography, 78, 155 Electrons, 144, 155, 164, 166, 172, 178 Electrophysiological, 4, 14, 30, 155 Electroplating, 147, 156 Elementary Particles, 155, 156, 166, 170, 176 Emetic, 143, 156 Empirical, 18, 156 Emulsion, 144, 156 Endocrine System, 156, 170 Endometrial, 91, 156 Endometrium, 156, 167 Endotoxins, 150, 156 End-stage renal, 148, 156, 174 Environmental Exposure, 156, 172 Environmental Health, 116, 118, 156 Enzymatic, 146, 150, 153, 156, 161 Enzyme, 139, 155, 156, 168, 174, 176, 183, 187 Epinephrine, 139, 154, 156, 171, 186 Epithalamus, 154, 156, 165 Erythrocytes, 141, 157 Erythromycin, 148, 157 Esophagus, 154, 157, 182 Essential Tremor, 120, 157 Estrogen, 11, 31, 64, 91, 157 Ether, 91, 157 Eukaryotic Cells, 143, 157, 162 Evacuation, 151, 157 Evoked Potentials, 43, 69, 157 Excitation, 147, 157, 176 Excitatory, 13, 144, 157, 159 Expiration, 157, 179 Extracellular, 143, 151, 157, 158 Extracellular Matrix, 151, 157, 158 Extrapyramidal, 89, 90, 140, 142, 154, 157 F Facial, 77, 88, 157, 181 Family Planning, 117, 157 Fat, 146, 151, 152, 157, 159, 165 Fatigue, 90, 91, 157 Feces, 151, 157, 182 Fetal Alcohol Syndrome, 4, 157 Fibroblasts, 39, 45, 158 Fibrosis, 121, 140, 158, 180 Fissure, 148, 150, 158, 175
Flumazenil, 81, 158 Fluorine, 37, 158 Fluoxetine, 89, 158 Fluphenazine, 38, 89, 158 Flush, 90, 91, 158 Frontal Lobe, 46, 158, 175 Functional Disorders, 13, 158 Fungi, 143, 158, 168, 188 G GABA, 16, 81, 92, 144, 149, 158 Gallbladder, 139, 154, 158 Ganglia, 11, 22, 90, 139, 144, 158, 170, 183 Ganglionic Blockers, 158, 166 Gap Junctions, 158, 183, 184 Gas, 140, 146, 154, 158, 161, 164, 171, 186 Gastric, 89, 159, 161 Gastric Acid, 89, 159 Gastrin, 159, 161 Gastrointestinal, 89, 90, 156, 159, 166, 180, 181, 183 Gastrointestinal tract, 90, 159, 166, 180 Gene, 6, 8, 9, 17, 21, 28, 29, 32, 34, 41, 44, 48, 57, 82, 101, 121, 122, 140, 145, 159, 172, 180 Gene Expression, 6, 9, 82, 121, 159 Genetic Engineering, 145, 149, 159 Genetic Markers, 40, 159 Genomics, 9, 159 Genotype, 6, 159, 173 Gestation, 150, 159, 174 Gland, 139, 159, 161, 172, 174, 176, 180, 182, 185 Globus Pallidus, 23, 144, 152, 159 Glucocorticoids, 139, 152, 159 Glucose, 13, 79, 120, 159, 160, 179 Glutamate, 92, 159 Glutamic Acid, 39, 159 Glycerol, 146, 159 Gonad, 160 Gonadal, 11, 160, 182 Governing Board, 160, 175 Graft, 160, 161 Growth, 14, 16, 23, 120, 141, 142, 143, 147, 157, 160, 166, 170, 172, 174, 180, 185, 186 Guanfacine, 84, 160 Gyrus Cinguli, 160, 165 H Half-Life, 15, 160 Halogens, 91, 160 Haloperidol, 23, 37, 38, 65, 69, 70, 88, 108, 112, 160 Handicap, 36, 160
Index 193
Haplotypes, 6, 29, 160 Headache, 160, 175 Hearing Disorders, 150, 160 Heart attack, 146, 160 Hemoglobin, 141, 157, 160, 161 Hemoglobinuria, 120, 161 Hemorrhage, 152, 160, 161, 182 Hemostasis, 161, 181 Hereditary, 128, 129, 148, 161, 169, 179 Heredity, 159, 161 Hippocampus, 161, 165, 180 Histamine, 141, 142, 155, 161 Homogeneous, 15, 39, 161 Homologous, 6, 140, 152, 161, 169, 180, 183 Hormonal, 143, 152, 161 Hormone, 11, 17, 23, 148, 152, 156, 159, 161, 172, 175, 180, 185 Host, 3, 161, 187 Hydrogen, 16, 93, 140, 144, 146, 153, 161, 168, 170, 172, 176, 183 Hydrogen Cyanide, 16, 161 Hydrogen Peroxide, 161, 183 Hypersensitivity, 88, 161 Hypertension, 89, 146, 161, 163, 166, 176 Hyperthyroidism, 161, 176 Hypnotherapy, 68, 70, 161 Hypokinesia, 161, 173 Hypotension, 142, 158, 162 Hypotensive, 91, 162 Hypothalamus, 11, 144, 154, 162, 165, 174, 180, 184 I Id, 66, 73, 128, 134, 136, 162 Idiopathic, 10, 13, 162 Imaging procedures, 162, 185 Imipramine, 93, 162, 176, 186 Immune function, 71, 162 Immune response, 139, 142, 144, 152, 162, 166, 183 Immune system, 155, 162, 169, 186 Immunodeficiency, 120, 162 Immunohistochemistry, 14, 162 Immunology, 139, 162 Impairment, 77, 90, 92, 103, 143, 153, 155, 162, 167, 177 Impulse Control Disorders, 90, 91, 162 In situ, 14, 162 In Situ Hybridization, 14, 162 In vitro, 10, 162 In vivo, 10, 13, 83, 162 Incision, 162, 163
Indicative, 98, 162, 173, 186 Induction, 141, 142, 158, 162 Infancy, 162 Infantile, 26, 162 Infarction, 163 Infection, 108, 148, 153, 162, 163, 182 Inflammation, 142, 149, 153, 158, 163 Inflammatory bowel disease, 89, 163 Ingestion, 158, 163, 174 Inner ear, 103, 149, 163 Innervation, 7, 10, 154, 163 Inotropic, 154, 163 Insight, 8, 13, 41, 109, 163 Insomnia, 163, 175 Intermittent, 42, 163, 166 Interneurons, 14, 163 Intestinal, 163, 166 Intestines, 139, 157, 159, 163 Intoxication, 153, 163, 188 Intracellular, 163, 175, 178, 180 Intracranial Hypertension, 160, 163, 185 Intraocular, 150, 163 Intrinsic, 14, 139, 163 Invasive, 48, 163, 166 Involuntary, 12, 77, 89, 101, 127, 128, 129, 144, 145, 148, 157, 163, 169, 178, 181, 185 Ion Channels, 143, 163, 170, 183 Ions, 144, 155, 161, 164, 168 Irritable Bowel Syndrome, 89, 158, 164 Ischemia, 141, 143, 164 K Kb, 116, 164 Kidney Disease, 85, 116, 121, 164 L Labile, 150, 164 Labyrinth, 149, 163, 164, 180, 187 Lactation, 164, 172 Lag, 8, 164 Language Development, 4, 98, 164 Language Disorders, 150, 164 Large Intestine, 154, 163, 164, 178, 181 Laryngeal, 79, 164 Laryngectomy, 103, 164 Larynx, 164 Learning Disorders, 110, 164 Lesion, 4, 164, 165, 184 Lethal, 152, 164 Leukemia, 120, 164 Levo, 154, 165 Levodopa, 17, 56, 65, 154, 165 Library Services, 134, 165 Ligament, 165, 176
194 Tourette Syndrome
Ligands, 13, 89, 90, 94, 165 Limbic, 11, 34, 73, 90, 141, 160, 165, 175 Limbic System, 90, 141, 160, 165, 175 Linkage, 6, 34, 35, 42, 43, 44, 49, 57, 159, 165, 173 Linkage Disequilibrium, 6, 49, 165 Lip, 103, 165 Lipid, 148, 159, 165 Lithium, 142, 165 Liver, 139, 144, 154, 156, 157, 158, 159, 165, 168, 179, 186 Liver scan, 165, 179 Localization, 162, 165 Localized, 15, 153, 163, 165, 168, 174 Locomotion, 165, 174 Locomotor, 11, 17, 165 Longitudinal Studies, 17, 166 Long-Term Care, 9, 166 Lumbar, 31, 166, 182 Lumbar puncture, 31, 166, 182 Luteal Phase, 93, 166 Lymphoid, 141, 166 Lymphoma, 120, 166 M Magnetic Resonance Imaging, 7, 77, 80, 81, 82, 166, 179 Magnetic Resonance Spectroscopy, 80, 166 Major Histocompatibility Complex, 160, 166 Malabsorption, 120, 166 Malignant, 120, 142, 166 Malnutrition, 143, 166, 169 Mania, 35, 94, 166 Manic, 142, 145, 165, 166, 177 Manic-depressive psychosis, 166, 177 Man-made, 147, 166 Mecamylamine, 64, 88, 166 Medial, 11, 159, 160, 166, 172, 180 Mediate, 10, 14, 149, 154, 166 Mediator, 154, 167, 181 Medical Records, 15, 167 MEDLINE, 117, 119, 121, 167 Meiosis, 167, 169, 183 Melanin, 167, 173, 186 Melanocytes, 167 Melanoma, 120, 167 Membrane, 10, 11, 143, 150, 157, 163, 164, 167, 169, 182, 183, 184, 185 Memory, 89, 90, 141, 153, 167 Meninges, 147, 152, 167 Menopause, 167, 176
Menstrual Cycle, 166, 167, 175, 176 Menstruation, 140, 166, 167, 175 Mental deficiency, 157, 167 Mental Disorders, 79, 85, 148, 161, 167, 177 Mental Health, iv, 4, 5, 78, 80, 83, 85, 88, 103, 116, 118, 124, 125, 167 Mental Processes, 167, 171, 177 Mental Retardation, 51, 102, 122, 150, 167 Mentors, 9, 167 Mesolimbic, 142, 167 Metabolite, 93, 167 Methylphenidate, 5, 7, 31, 45, 70, 168 Methyltransferase, 24, 45, 64, 168 MI, 54, 138, 168 Microbiology, 143, 168 Microorganism, 149, 168, 187 Microscopy, 10, 168 Microwaves, 168, 178 Mineralocorticoids, 139, 152, 168 Mode of Transmission, 26, 168 Molecular, 6, 9, 14, 16, 21, 24, 25, 117, 119, 145, 151, 152, 168, 178, 183, 186 Molecular Structure, 168, 186 Molecule, 142, 144, 145, 150, 155, 157, 168, 172, 178 Monitor, 78, 168, 171 Monoamine, 10, 11, 45, 93, 141, 154, 168, 186 Monoamine Oxidase, 93, 141, 154, 168, 186 Monotherapy, 64, 168 Mood Disorders, 92, 94, 110, 168 Morphine, 143, 168 Morphogenesis, 157, 169 Morphological, 14, 167, 169 Motility, 89, 90, 158, 169, 181 Motivations, 5, 169 Movement Disorders, 21, 27, 29, 37, 38, 39, 56, 61, 69, 88, 92, 101, 124, 142, 169, 184 Mucosa, 169 Multivalent, 160, 169 Muscle Fibers, 169 Muscular Atrophy, 120, 169 Muscular Dystrophies, 155, 169 Mutism, 103, 169 Myocardial infarction, 152, 168, 169, 176 Myocardium, 141, 168, 169 Myotonic Dystrophy, 120, 169 N Naive, 31, 65, 70, 71, 169 Naloxone, 47, 64, 89, 169
Index 195
Narcolepsy, 154, 168, 169 Nausea, 142, 169, 172, 175 NCI, 1, 85, 115, 169 Necrosis, 163, 168, 169 Need, 3, 8, 90, 94, 97, 101, 102, 109, 127, 130, 148, 170, 185 Neoplasia, 120, 170 Neoplastic, 166, 170 Nephropathy, 164, 170 Nerve, 124, 139, 143, 144, 149, 153, 158, 163, 167, 168, 170, 175, 180, 182, 185, 187 Nervous System, 12, 79, 90, 91, 94, 120, 139, 141, 144, 147, 149, 154, 157, 158, 159, 160, 165, 167, 168, 170, 174, 175, 180, 183, 184, 186 Neural, 7, 139, 153, 158, 168, 170, 180 Neuroanatomy, 19, 34, 165, 170 Neuroendocrine, 47, 64, 89, 90, 170 Neuroleptic, 14, 58, 83, 84, 88, 92, 94, 140, 142, 149, 170 Neurologic, 5, 21, 22, 26, 31, 34, 46, 57, 79, 124, 128, 129, 170 Neuroma, 102, 103, 170 Neuromuscular, 139, 170 Neuromuscular Junction, 139, 170 Neuronal, 10, 21, 51, 170 Neurons, 10, 11, 14, 149, 153, 157, 158, 163, 165, 170, 171, 183, 187 Neuropeptide, 11, 82, 170 Neurosis, 170, 173 Neurotoxin, 10, 17, 170 Neurotransmitters, 93, 154, 170, 175, 181 Neutrons, 140, 170, 178 Niacin, 171, 186 Nicotine, 64, 65, 71, 88, 90, 171 Nitrates, 91, 171 Nitric acid, 171 Nitrogen, 91, 140, 141, 161, 171, 186 Nonverbal Communication, 150, 171, 177 Norepinephrine, 11, 17, 90, 93, 139, 153, 154, 171 Nuclear, 21, 27, 144, 155, 157, 165, 166, 169, 171, 184 Nuclei, 90, 140, 141, 149, 155, 156, 159, 166, 170, 171, 174, 176, 180, 187 Nucleic acid, 162, 171 Nucleus, 11, 17, 19, 149, 152, 153, 156, 157, 159, 167, 171, 175, 176, 180, 181, 184, 187 Nucleus Accumbens, 17, 19, 171 O Obsession, 151, 171 Obsessive Behavior, 101, 171
Oculi, 145, 171 Oncogene, 120, 172 Opacity, 153, 172 Optic Chiasm, 162, 172 Orbicularis, 145, 172 Orgasm, 155, 172 Orthostatic, 142, 172 Overdose, 44, 172 Ovulation, 166, 172 Ovum, 152, 159, 172, 176 Oxidation, 160, 172 Oxygen Consumption, 172, 179 Oxytocin, 11, 172 P Palate, 148, 172 Palliative, 172, 184 Pancreas, 139, 154, 172 Pancreatic, 120, 172 Pancreatic cancer, 120, 172 Panic, 89, 92, 162, 172 Panic Disorder, 92, 162, 172 Paresthesias, 172, 173 Parkinsonism, 10, 94, 142, 143, 165, 173 Paroxysmal, 120, 141, 173 Pathogenesis, 10, 13, 41, 51, 54, 88, 173 Pathologic, 151, 161, 173, 176 Pathologies, 15, 173 Pathophysiology, 7, 8, 11, 41, 51, 71, 108, 173 Patient Advocacy, 128, 173 Patient Education, 126, 132, 134, 138, 173 Pelvic, 173, 176 Penis, 155, 173 Peptide, 148, 173, 176 Peptide Chain Elongation, 148, 173 Perception, 4, 27, 153, 160, 173, 180 Pergolide, 51, 65, 83, 173 Pharmacologic, 14, 93, 160, 173, 185 Pharmacotherapy, 14, 88, 173 Phenotype, 9, 17, 18, 31, 51, 173 Phenylalanine, 173, 186 Phobia, 58, 90, 91, 173 Phobic Disorders, 174 Physical Examination, 77, 174 Physiologic, 140, 154, 160, 161, 167, 174, 178, 186 Physiology, 7, 13, 68, 155, 174 Pigment, 167, 174 Pilot study, 12, 17, 55, 72, 174 Pitch, 174, 187 Pituitary Gland, 152, 174 Placenta, 174, 175
196 Tourette Syndrome
Plants, 140, 146, 148, 149, 159, 171, 174, 179 Plasma, 10, 11, 30, 82, 141, 160, 161, 168, 174, 180 Plasma cells, 141, 174 Pleomorphic, 171, 174 Poisoning, 143, 153, 163, 169, 174 Polycystic, 121, 174 Polymerase, 143, 174 Polymorphism, 6, 48, 57, 174 Pons, 145, 174 Post partum, 90, 91, 174 Posterior, 143, 147, 154, 156, 172, 175 Postnatal, 157, 175 Postsynaptic, 51, 72, 175, 183 Post-synaptic, 8, 175 Post-traumatic, 90, 91, 93, 169, 175 Post-traumatic stress disorder, 90, 91, 93, 175 Potassium, 14, 168, 175 Potentiates, 65, 153, 175 Potentiation, 65, 175 Practice Guidelines, 118, 175 Precursor, 16, 148, 154, 155, 156, 165, 171, 173, 175, 186 Prefrontal Cortex, 7, 175 Premenstrual, 90, 91, 93, 175 Premenstrual Syndrome, 90, 91, 93, 175 Prenatal, 157, 175 Presynaptic, 17, 72, 154, 175, 183, 184 Presynaptic Terminals, 154, 175, 184 Prevalence, 18, 26, 45, 52, 53, 92, 175 Progesterone, 31, 175, 182 Progressive, 148, 153, 160, 169, 176 Projection, 7, 163, 171, 175, 176, 178 Prone, 12, 176 Prophase, 169, 176, 183 Propranolol, 24, 30, 176 Prostate, 6, 120, 176 Protease, 150, 176 Protein C, 140, 176, 186 Protein S, 101, 121, 145, 148, 157, 176, 179 Proteins, 10, 140, 142, 150, 157, 158, 168, 171, 173, 174, 176, 178, 181 Proteolytic, 150, 176 Protocol, 16, 68, 80, 176 Protons, 140, 161, 166, 176, 178 Protriptyline, 93, 176 Proximal, 175, 176, 180 Psoriasis, 143, 176 Psychiatric, 9, 14, 16, 43, 46, 54, 78, 83, 150, 167, 176
Psychic, 170, 177, 180 Psychogenic, 60, 177 Psychological Tests, 25, 177 Psychology, 4, 32, 41, 102, 151, 177 Psychomotor, 153, 170, 177 Psychopathology, 19, 177 Psychosis, 89, 142, 177 Psychosomatic, 21, 25, 28, 29, 35, 39, 70, 177 Psychosomatic Medicine, 70, 177 Psychotherapy, 64, 70, 177 Psychotomimetic, 141, 154, 177 Psychotropic, 65, 71, 177 Public Policy, 117, 177 Publishing, 18, 101, 103, 177 Pulse, 168, 177 Pyramidal Tracts, 157, 177 R Race, 154, 177 Raclopride, 7, 178 Radiation, 81, 82, 141, 144, 156, 166, 178, 179, 188 Radio Waves, 77, 80, 81, 82, 168, 178 Radioactive, 79, 81, 82, 144, 145, 160, 161, 165, 166, 171, 178, 179 Radioisotope, 15, 178, 185 Rage, 25, 88, 178 Random Allocation, 178 Randomization, 84, 178 Randomized, 27, 69, 83, 84, 155, 178 Rape, 175, 178 Reaction Time, 20, 178 Reality Testing, 177, 178 Receptors, Serotonin, 178, 181 Recombination, 6, 159, 178 Rectum, 145, 154, 159, 163, 164, 176, 178 Recurrence, 54, 145, 148, 166, 178 Red Nucleus, 143, 178 Refer, 1, 145, 150, 154, 158, 163, 165, 169, 170, 171, 177, 178, 187 Reflex, 20, 55, 178 Refraction, 179, 181 Regimen, 155, 173, 179 Remission, 145, 166, 178, 179 Respiration, 90, 143, 146, 147, 168, 179 Retching, 61, 179 Retinoblastoma, 120, 179 Ribosome, 179, 185 Rigidity, 173, 174, 179 Risk factor, 31, 179 Risperidone, 14, 20, 56, 69, 83, 84, 89, 179
Index 197
S Salivary, 154, 172, 179 Salivary glands, 154, 179 Saponins, 179, 182 Satellite, 12, 179 Scans, 79, 82, 179 Schizoid, 179, 188 Schizophrenia, 4, 6, 10, 14, 24, 36, 72, 78, 83, 88, 94, 179, 180, 188 Schizotypal Personality Disorder, 153, 180, 188 Sclerosis, 11, 120, 124, 180 Screening, 57, 149, 180 Second Messenger Systems, 170, 180 Secretion, 89, 148, 152, 159, 161, 164, 168, 180 Secretory, 180, 183 Sedative, 158, 162, 180, 186 Segregation, 26, 34, 178, 180 Seizures, 149, 153, 173, 180 Self-Help Groups, 101, 103, 180 Semen, 155, 176, 180 Semicircular canal, 163, 180 Semisynthetic, 148, 180 Septal, 165, 180 Septal Nuclei, 165, 180 Serotonin, 8, 13, 23, 50, 83, 90, 91, 93, 142, 149, 153, 158, 168, 173, 178, 179, 180, 186 Serum, 141, 150, 168, 181 Sex Determination, 121, 181 Side effect, 13, 17, 84, 89, 111, 139, 140, 142, 176, 181, 185 Sleep apnea, 42, 181 Small intestine, 161, 163, 181 Sneezing, 101, 181 Social Work, 102, 181 Solitary Nucleus, 144, 181 Somatic, 165, 167, 175, 181 Spasm, 145, 151, 181 Spasmodic, 92, 103, 181 Spastic, 164, 181 Spasticity, 16, 144, 181 Spatial disorientation, 154, 181 Specialist, 129, 181 Species, 17, 156, 167, 177, 181, 182 Spectrum, 7, 9, 21, 41, 42, 127, 168, 178, 181 Sperm, 141, 148, 182 Spike, 14, 182 Spinal cord, 143, 144, 145, 147, 148, 167, 170, 177, 178, 182, 183 Spinal tap, 166, 182
Sporadic, 179, 182 Staging, 179, 182 Steroid, 11, 179, 182 Stimulant, 5, 7, 141, 154, 161, 168, 182 Stimulus, 155, 157, 163, 164, 173, 178, 182, 184 Stomach, 139, 146, 154, 157, 159, 161, 163, 169, 181, 182 Stool, 164, 182 Streptococcal, 71, 125, 182 Streptococcal Infections, 71, 125, 182 Streptococcus, 182 Stress, 31, 137, 144, 147, 158, 164, 169, 182 Stria, 11, 180, 182 Striatum, 7, 10, 14, 17, 171, 182 Stroke, 77, 78, 80, 81, 82, 85, 116, 126, 127, 146, 182 Subspecies, 181, 182 Substance P, 157, 167, 180, 182 Superoxide, 52, 183 Superoxide Dismutase, 52, 183 Support group, 101, 102, 103, 183 Suppression, 78, 82, 152, 183 Supraspinal, 144, 183 Sympathetic Nervous System, 144, 183 Sympathomimetic, 141, 154, 156, 171, 183, 186 Symphysis, 176, 183 Symptomatic, 13, 37, 64, 183 Symptomatic treatment, 37, 64, 183 Symptomatology, 24, 54, 183 Synapses, 7, 170, 182, 183, 184 Synapsis, 183 Synaptic, 7, 8, 13, 47, 171, 183, 184 Synaptic Transmission, 171, 183 Synaptic Vesicles, 183, 184 Synergistic, 5, 184, 185 Systolic, 160, 161, 184 T Tardive, 88, 89, 92, 94, 142, 184 Telangiectasia, 121, 184 Telencephalon, 144, 184 Temporal, 141, 160, 161, 184 Temporal Lobe, 141, 184 Terminalis, 11, 180, 184 Tetrahydrocannabinol, 27, 41, 64, 69, 70, 73, 146, 184 Thalamic, 53, 143, 156, 184 Thalamic Diseases, 143, 184 Thalamus, 57, 152, 154, 156, 165, 175, 184 Therapeutics, 9, 71, 112, 168, 184 Third Ventricle, 156, 162, 184
198 Tourette Syndrome
Thorax, 166, 184 Threshold, 161, 184 Thrombosis, 176, 182, 185 Thyroid, 161, 185, 186 Tinnitus, 103, 185, 187 Tolerance, 149, 185 Tomography, 8, 13, 15, 16, 52, 79, 81, 82, 151, 166, 185 Tonic, 145, 149, 185 Tonicity, 155, 185 Torticollis, 92, 185 Toxic, iv, 152, 156, 161, 171, 185 Toxicity, 155, 185 Toxicology, 118, 185 Trace element, 158, 185 Tracer, 16, 185 Transfection, 145, 185 Translation, 9, 20, 35, 157, 185 Translational, 10, 17, 185 Translocation, 24, 43, 46, 148, 157, 185 Transmitter, 139, 143, 154, 163, 167, 171, 183, 184, 185, 186 Tremor, 60, 173, 186 Trichotillomania, 22, 80, 186 Tricyclic, 93, 153, 154, 162, 176, 186 Trigger zone, 142, 186 Trimipramine, 93, 186 Trisomy, 48, 186 Tryptophan, 23, 32, 150, 180, 186 Tubercle, 171, 186 Tuberous Sclerosis, 11, 121, 186 Tyramine, 168, 186 Tyrosine, 7, 48, 154, 186 U Unconscious, 162, 186 Urea, 94, 186 Urethra, 173, 176, 186 Urinary, 49, 60, 186
Urine, 82, 145, 161, 186 Uterine Contraction, 172, 186 Uterus, 147, 152, 156, 167, 176, 186 V Vaccine, 139, 176, 186 Vascular, 140, 160, 163, 174, 186 Vasodilator, 154, 161, 186 VE, 18, 186 Vein, 81, 82, 171, 179, 186 Venlafaxine, 93, 187 Venous, 176, 187 Ventral, 7, 162, 171, 174, 187 Ventricle, 141, 147, 161, 171, 177, 184, 187 Ventricular, 55, 187 Vesicular, 10, 11, 187 Vestibular, 103, 187 Vestibule, 149, 163, 180, 187 Vestibulocochlear Nerve, 149, 185, 187 Vestibulocochlear Nerve Diseases, 185, 187 Veterinary Medicine, 117, 187 Viral, 143, 187 Viruses, 142, 143, 168, 186, 187 Visceral, 144, 165, 187 Visceral Afferents, 144, 187 Vitro, 10, 187 Vivo, 83, 187 Voice Disorders, 102, 187 Volition, 163, 187 W War, 175, 187 Weight Gain, 89, 187 Withdrawal, 5, 89, 153, 187 X X-ray, 151, 166, 171, 179, 188 Y Yeasts, 158, 173, 188
Index 199
200 Tourette Syndrome
