Tic disorders, attention deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorders

Sensory anticipations in patients with Tourette Syndrome (TS) and obsessive-compulsive disorders (OCD)

Contact persons: Prof. Dr. V. Ro­ess­ner, Dipl.-Psych. J. Buse

Collaborators:

  • Prof. Dr. M. Smolka, Systemic Neurosciences, Dresden
  • Prof. Dr. A. Münchau, Neurology, Hamburg-Eppendorf

 

Both patients with TS and OCD often report sensory phenomena (SP) that occur prior to tics and compulsive acts. SP are experienced for example as prickling sensations, urge or “Not Just Right Experiences” . Nevertheless only a few studies so far have focused on physiological and neuronal correlates of the sensory phenomena, contributing to the etiology of these disorders. This study aims to develop a phenomenological characterization of sensory phenomena that are associated to TS and OCD and to explore their neuronal correlates based on three different paradigms using fMRI and EEG.

 

Correlation between obsessive-compulsive symptoms and the perception of harmonic expectancy violation

Contact persons: Dipl.-Psych. J. Buse, Dr. D. Dör­fel

Collaborator:

  • Prof. Dr. M. Smolka, Systemic Neurosciences, Dresden

 

Patients with OCD frequently report that their actions are driven by a sensation of incompleteness or the feeling, that something “is not just right” (“Not Just Right Experiences” –NJRE). Nevertheless only a few studies so far have focused on physiological and neuronal correlates of this NJRE, contributing to the etiology of this disorder.

This pilot study is conducted to prepare the comparison of patients with compulsions and healthy control subjects, which is part of the above mentioned main study (sensory phenomena in patients with Tourette Syndrome (TS) and obsessive-compulsive disorders (OCD)). For this purpose we concentrate in this pilot study on the question, whether the responses of subjects from a non-clinical sample (students of the TU Dresden) on experimental induction of NJRE are influenced by the severity of their obsessive-compulsive symptoms.

NJRE will be induced by using chord sequences that violate the rules of tonality (Harmonic Expectancy Violation Paradigm = HEV). A group of subjects will furthermore undergo a scan of brain activity by fMRI while they perceive and evaluate these chord sequences.

 

Familial correlations of tic disorders and ADHD

Contact person: Prof. Dr. V. Roessner, Dipl.-Psych. J. Buse

Collaborators:

  • Prof. Dr. T. Banaschewski, ZI Mannheim
  • IMAGE Consortium

 

Although tic disorders and ADHD frequently occur as comorbid disorders there is only limited data available concerning familial correlations of tic disorders and ADHD. We analyze the heritability of tic disorders in the presence of an ADHD-diagnosis by evaluating data of families that were recruited during the European IMAGE project. Additionally we examine the influence of concomitant tic disorders on psychopathological parameters in ADHD.

 

Connexin36 (Cx36) Gene and Tourette Syndrome

Contact person: Prof. Dr. V. Roessner

Collaborators:

  • Prof. Dr. J. Hebebrand, CAP, Essen
  • Prof. Dr. A. Rothenberger, CAP, UMG Göttingen
  • Diagenom GmbH

 

Connexin36 is so far the only subtype of connexin known to be exclusively localized in neurons. During prenatal brain development Cx36 shows extensive dynamic expressions, being preferentially localized at important junctions of cell membranes. In the adult brain, the Cx36 induced formation of electrical synapses predominantly regulates synchronized activity of inhibitory circuits. As recent hypotheses concerning the pathophysiology of Tourette Syndrome suggest a dysrhythmia of oscillatory networks in the CNS, we assume that the Cx36 Gene may show alterations in patients with TS.

 

Parent training for ADHD and disruptive behavior problems

Contact person: Mr Robert Haase

Collaborators:

  • Prof. Dr. Manfred Döpfner, CAP, Köln
  • Dipl. Psych. Julia Plück, CAP, Köln

 

Contribution of obsessive-compulsive symptoms to the psychopathological profile of children with chronic tic disorder and attention-deficit hyperactivity disorder

Contact person: Prof. Dr. V. Roessner

Collaborators:

  • Dr. A. Becker, CAP, UMG Göttingen
  • Prof. Dr. A. Rothenberger, CAP, UMG Göttingen
  • Fr. F. Schultze, child and adolescent psychiatric service of the Canton Zurich

 

Obsessive-compulsive disorder (OCD) as well as obsessive-compulsive symptoms (OCS) are often comorbid in chronic tic disorders (CTD) and/or attention-deficit-hyperactivity disorder (ADHD). Particularly in the case of comorbidity it is indispensable for optimal treatment to identify all symptoms, to determine their clinical relevance and to understand their association to categorical diagnoses. However to our knowledge the relative impact of OCD/OCS on children’s broadband psychopathology in CTD+ADHD has not yet been investigated. The aim of the present study was to investigate the contribution of OCS to the psychopathology of children with (CTD) or (ADHD).

 

Tic and obsessive-compulsive disorders – psychopathological alterations in the course of development

Contact person: Dipl.-Psych. Sina Wanderer

Collaborators: 

  • Dr. A. Becker, CAP, UMG Göttingen
  • Prof. Dr. R. Freeman, University of British Columbia, Vancouver
  • Prof. Dr. A. Rothenberger, CAP, UMG Göttingen
  • Tourette Syndrome International Database Consortium

 

During the development of children with Tourette Syndrome (TS) not only the core symptoms changes, but also the variety and number of frequent comorbid disorders. Although the knowledge of the typical psychopathological course is of crucial importance for diagnosis and treatment of TS, there is only little data available concerning psychopathological alterations. We are therefore evaluating an international database of more than 5000 children and adolescents with TS that requested medical attendance in tertiary carecenters. We are focusing on the influence of comorbid obsessive-compulsive disorder in patients with TS on the psychopathology in the course of development.

 

Interhemispheric connectivity in Tourette Syndrom – a research using TMS, DTI, structural and functional imaging

Contact person: Prof. Dr. V. Roessner

Collaborators: 

  • Dr. J. Baudewig, MR –research in neurology and psychiatry, UMG Göttingen
  • Ms. J. Böhm, Pediatrics, UMG Göttingen
  • PD Dr. P. Dechent, MR - research in neurology and psychiatry, UMG Göttingen
  • Dr. G. Helms, MR - research in neurology and psychiatry, UMG Göttingen
  • Ms. J. Kluth
  • Mr. S. Overlack, CAP, UMG Göttingen
  • Prof. Dr. A. Rothenberger, CAP, UMG Göttingen

 

Studies on Tourette Syndrome have consistently indicated alterations of interhemispheric connectivity. As each of these studies applied only one method or the results were strongly influenced by confounding variables like sex, comorbidity and medication, we are using a sophisticated research-design to obtain new findings concerning the pathophysiology of TS. For this purpose we apply different methods (behavioral data, TMS, DTI, structural and functional imaging) to analyze various aspects of interhemispheric connectivity in a group of patients that fulfill strict inclusion and exclusion criteria.

 

Quality of life in tic disorders

Contact person: Prof. Dr. V. Roessner

Collaborators: 

  • Prof. Dr. R. Dodel, Neurologie, Philipps-Universität Marburg
  • PD Dr. A. Ludolph, KJP, Universitätsklinikum Ulm
  • Prof. Dr. K. Müller-Vahl, Psychiatrie, MHH Hannover
  • Prof. Dr. A. Münchau, Neurologie, UKE Hamburg
  • PD. Dr. I. Neuner, Psychiatrie, RWTH Aachen
  • Dr. C. Vitt, KJP, RWTH Aachen

 

Only recently measuring quality of life specifically in patients with tic disorders became feasible due to  specific psychometric instruments. These are only available in English. Our project`s goal is to develop and validate a German version of these outstanding specific questionnaires.

 

Premonitory sensations in tic disorders

Contact person: Prof. Dr. V. Roessner

Collaborators:

  • PD Dr. A. Ludolph, KJP, Universitätsklinikum Ulm
  • Prof. Dr. K. Müller-Vahl, Psychiatrie, MHH Hannover
  • Prof. Dr. A. Münchau, Neurologie, UKE Hamburg
  • PD. Dr. I. Neuner, Psychiatrie, RWTH Aachen
  • Dr. C. Vitt, KJP, RWTH Aachen

 

With increasing age patients with a diagnosed tic disorder report premonitory sensations before tic onset. Previously developed questionnaires to record these sensory phenomena are only available in English and differ a lot from each other. This project is aiming to enhance and upgrade the existing instruments as well as to make them suitable for the German language area. Through this work the collection of data concerning a variety of different sensory phenomena and their precise localization will be facilitated.

 

Olfactory functions in tic disorders and/or ADHD

Contact person: Prof. Dr. V. Roessner

Collaborator:

  • Prof. Dr. T. Hummel, ENT, University Hospital Dresden

 

While findings concerning olfactory functions in patients with ADHD already exist, such research in the field of tic disorders is still missing. Since alterations in the dopaminergic metabolism have been proven for both disorders, we investigate the question of altered olfactory functions. Such alterations have also been  reported for early Parkinson`s disease Satz weiter hoch schieben?

 

Atopic Dermatitis and ADHD – How to explain the association?

Contact person: Prof. Dr. V. Roessner

Collaborators: 

  • PD Dr. J. Schmitt, Dermatology, University Hospital Dresden
  • Dr. A. Buske-Kirschbaum, Biopsychology, Technical University Dresden

 

Recent data show a  frequentl co-occurrence of atopic eczema and ADHD. Nevertheless there are only rudimentary findings from very small studies concerning the underlying mechanisms available. It is urgently necessary to conduct a multi-methodical analysis on possible pathophysiological similarities and differences of these diseases, based on a sufficiently large sample. The results may also offer valuable hints for the development of possible prophylaxis.

 

Influence of immunological factors in tic disorders and/or obsessive-compulsive disorders

Contact person: Prof. Dr. V. Roessner

Collaborators: 

  • G. Giovannoni, London, UK
  • A. Schrag, London, UK
  • P. Hoekstra, Groningen, Netherlands
  • D. Martino, Bari, Italy
  • N. Muller, Munchen, Germany
  • G. Orefici, Rome, Italy

 

Long-discussed is the question whether, and if so, to what extent immunological reactions (e.g. as a result of streptococcal infection) can trigger tics and/or compulsions. For the concerned patients an answer would pave the way for a new and for the first time etiological treatment approach. Indeed, previous positive study findings could not be replicated and only a small section of immunological and associated parameters have been examined so far. This study therefore uses a large pan-European sample for the multi-methodical identification of a possible subgroup of patients with immunological alterations. Beside identification, the second goal of the study is the development of a successful treatment strategy for these alterations.

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