Re: Asperger's and Tics

[Guest guest]

I do. My oldest daughter has Aspergers - actually pretty severe case of it. She had SEVERE tics for around 4 years, mainly face hand and neck. She takes seroquel and lexapro which do well for a lot of her syptoms, but I have found that stress of any sort aggravates the tics a lotSavasnia <Savasnia@...> wrote: My eleven year old son has Asperger's and I was wondering if anyone else has an AS child with tics? Based on what little I know he has mild tics. I am just coming to realize that some of his behaviors are probably tics. I was wondering if his tics will improve or worsen in the future. He has the following tics: tongue-thrusting-chewing, whistling, making unintelligible noises, meowing, cracking knuckles, animal sounds, erasing, and fidgeting. I'm not a 100% sure if the meowing is a tic or echolalea because he mostly meows when he hears our cat doing it. Jeanette A great teacher never strives to explain his vision - he simply invites you to stand beside him and see for yourself.... The Rev. R. Inman Children are likely to live up to

what you believe of them - Lady Bird Treat a child as though he already is the person he's capable of becoming - Haim Gnott

Check out the all-new beta - Fire up a more powerful email and get things done faster.

[Guest guest]

Jeanette, I was just wondering if you have every had your son tested for TS. Tic usually occur with TS also. I know that I see a lot of similarities with my son and my best friends son who has TS. I know that probably doesn't help but I was just wondering.Savasnia <Savasnia@...> wrote: My eleven year old son has Asperger's and I was wondering if anyone else has an AS child with tics? Based on what little I know he has mild tics. I am just coming to realize that some of his behaviors are probably tics. I was wondering if his tics will improve or worsen in the future. He has the following tics: tongue-thrusting-chewing, whistling, making unintelligible noises, meowing, cracking knuckles, animal sounds, erasing, and fidgeting. I'm not a 100% sure if the meowing is a tic or echolalea because he mostly meows when he hears our cat doing it. Jeanette KELLY

Sponsored LinkMortgage rates near 39yr lows. $510,000 Mortgage for $1,698/mo - Calculate new house payment

[Guest guest]

This is really common for AS/high fx autism, and I find it most useful

to make efforts at intervention aimed at reduction of tics. (If not,

it may get worse, or at least become a fairly permanent addition to

your life.)

Some of the interventions may involve removal of items and some may

involve direct behavioral work. (If you use traditional methods, you

may find that you are typically exchanging one less-preferred tic for

a more-preferred tic ... or you may end up with reduced output of tics

.... If you reduce enough, it may begin to appear WNL.)

(Oh, and the meowing is probably a combo. That output can be reduced,

too.)

[Guest guest]

In a message dated 11/19/2006 5:56:59 P.M. Eastern Standard Time, krbenglish@... writes:

I was wondering if his tics will improve or worsen in the future.

I vote for improve!

[Guest guest]

In a message dated 11/19/2006 5:53:14 P.M. Eastern Standard Time, avianrights@... writes:

What sort of direct behavioral work do you mean? I have also wondered if there was anything I could do to at least lessen the tics my child exhibits. He has what looks like a "whole body shiver" whenever he's overstimulated. I'd love to find some way to mitigate this so that he can fit in with his friends and at school better, without being such a target.

Dear ,

I don't want to offer a prayer (without asking if you want it) which I used effectively for my God-granddaughter when she was younger and did a whole body thing I think like you're talking about. It stopped pretty soon after it occurred to me to pray by myself and with her.

Francine

[Guest guest]

What sort of direct behavioral work do you mean? I have also wondered if there was anything I could do to at least lessen the tics my child exhibits. He has what looks like a " whole body shiver " whenever he's overstimulated. I'd love to find some way to mitigate this so that he can fit in with his friends and at school better, without being such a target.

On 11/19/06, jhsgpsy <june.shapiro@...> wrote:

This is really common for AS/high fx autism, and I find it most usefulto make efforts at intervention aimed at reduction of tics. (If not,it may get worse, or at least become a fairly permanent addition to

your life.)Some of the interventions may involve removal of items and some mayinvolve direct behavioral work. (If you use traditional methods, youmay find that you are typically exchanging one less-preferred tic for

a more-preferred tic ... or you may end up with reduced output of tics... If you reduce enough, it may begin to appear WNL.) (Oh, and the meowing is probably a combo. That output can be reduced,too.)

-- Margison

Don't Breed, Don't Buy, Adopt!www.avianwelfare.org

[Guest guest]

My eleven year old son has Asperger's and

I was wondering if anyone else has an AS child with tics?

Based on what little I know he has mild

tics. I am just coming to realize that some of his behaviors are probably

tics. I was wondering if his tics will improve or worsen in the future.

He has the following tics:

tongue-thrusting-chewing, whistling, making unintelligible noises,

meowing, cracking knuckles, animal sounds, erasing, and fidgeting. I'm not a

100% sure if the meowing is a tic or echolalea because he mostly meows when he

hears our cat doing it.

Jeanette

***********Hi Jeanette, my 14 year old has

Tourette’s, and your descriptions sound like Tourette’s to me. A

good site to look at would be the Tourette’s Society, http://www.tsa.usa.org/ My

son started with the throat clearing and repeated swallowing at 9. The tongue

thrusting caught my eye on your post as well. Most would not know my son has

Tourette’s. He has been on Seroquel for 3 years. Because of tremendous

weight gain, we are now trying Clonidine which is working except for some sleep

issues. Without medication, his tongue would be moving constantly creating huge

sores around his mouth within a few hours. My son was diagnosed with OCD at 9,

Asperger’s at almost 10 and Tourette’s at 12. When he was 9 I questioned if he didn’t

have Tourette’s, as it came up when I was researching OCD. My son is

doing quite well considering many challenges. Often times Tourette’s and

OCD go hand in hand. My son’s biggest worry is poison. Tourette’s

often goes undiagnosed for some time. Ask any questions. Gail A.

[Guest guest]

Hi Jeanette,

My almost 13 year-old daughter has Aspergers

and her psychiatrist pointed out her facial tics. It’s not terribly

severe but still noticeable. She chews her nails to no end as well. The doctor

said 75% of all kids tic in some way but that doesn’t necessarily make me

feel any better.

From:

Autism and Aspergers Treatment [mailto:Autism and Aspergers Treatment ] On Behalf Of lilies

Sent: Monday, November 20, 2006

9:46 AM

To:

Autism and Aspergers Treatment

Subject: RE:

Asperger's and Tics

My eleven year old son has Asperger's and I was wondering if anyone else has an

AS child with tics?

Based on what little I know he has mild tics. I am just coming to realize that

some of his behaviors are probably tics. I was wondering if his tics will

improve or worsen in the future.

He has the following tics: tongue-thrusting-chewing, whistling, making

unintelligible noises, meowing, cracking knuckles, animal sounds, erasing, and

fidgeting. I'm not a 100% sure if the meowing is a tic or echolalea because he

mostly meows when he hears our cat doing it.

Jeanette

***********Hi Jeanette, my 14 year old has Tourette’s, and

your descriptions sound like Tourette’s to me. A good site to look at

would be the Tourette’s Society, http://www.tsa.usa.org/

My son started with the throat

clearing and repeated swallowing at 9. The tongue thrusting caught my eye on

your post as well. Most would not know my son has Tourette’s. He has been

on Seroquel for 3 years. Because of tremendous weight gain, we are now trying

Clonidine which is working except for some sleep issues. Without medication,

his tongue would be moving constantly creating huge sores around his mouth

within a few hours. My son was diagnosed with OCD at 9, Asperger’s at

almost 10 and Tourette’s at 12. When he was 9 I questioned if he

didn’t have Tourette’s, as it came up when I was researching OCD.

My son is doing quite well considering many challenges. Often times

Tourette’s and OCD go hand in hand. My son’s biggest worry is

poison. Tourette’s often goes undiagnosed for some time. Ask any

questions. Gail A.

[Guest guest]

,

I have not had him tested for Tourette's.

Jeanette

[Guest guest]

My AU child thankfully does not have tics. My eldest son however has

Tourette Syndrome. The criteria for being dx with TS are tics of any

kind being present for a year. They may wax and wane as is common and

may even migrate, goes from blinking to eye rolling to sniffing to

vocal tics and so on. Picking and chewing are other tics and he has

picked holes in pillows, mattresses, bedsheets. He use to chew every

pen top he got his hands on however now keeps a guitar pick in his

mouth at all times. (Yes I am terrified he will choke one day however

he hates gum and could easily choke on gum as well.) He goes through

periods of echolalia especially if stressed. His corprolalia is

mainly what I call casual swearing or strange comments. He speaks

before thinking including blurting and manages a negative and or

sarcastic view and tone even when joking. A level of this is normal

for TS due to the way the brain is wired however a percent is also

due to the bullying and teasing over the years that he faced. My son

will have tics present sometimes for weeks then they are gone for

weeks only to return with a vengence that may included rages and that

is when he struggles most in school. He will get headaches as well

especially if his facial tics are severe and some kids even pull

muscles. He is able to surpress most of his tics while in school

however has to let them out once he gets home. It does in fact take a

great deal of effort and consentration to surpress the tics in a

child that already has ADHD. Nervousness makes him tic more. Teachers

will think that he is rolling his eyes out of disrespect and his

penmanship will wax and wane as well. In fact in the 3rd grade that

was the first sign of TS though I did not know it at the time. His

penmanship became so bad that the teacher would throw away his papers

and give him a zero. I have read that tic disorders and autism are

related and can be co-morbid. In 2004 a study came out that found

that areas of the brain that involve memory are effected in TS

patients. Especially working memory that requires a person to

remember several steps in order. I am fighting to get his IEP back

and to include the use of a tape recorder in class for lectures and

note taking. Some kids can type faster than writing and should also

be allowed a laptop for note taking. Eye rolling and blinking makes

it hard for him to stay on track and he will lose his place when

reading. Tics should most certainly be talked about with the

neurologist. Medications for tics can make ADD worse as medications

for ADD can make tics worse. There have been many studies done and

most support that a balance of medications for both chemicals in the

brain that are effected by ADD and TS is best. I have seen this first

hand in my son. He no longer medicates (his choice)and we mainly

focus on cognitive behavioral tools.

Hope this helps some.

Beth

[Guest guest]

I wanted to add something here - my oldest daughter - AS, BP, PTSD - was misdiagnosed as TS for around 3 years. She has the very ocd type AS behavior along with constant "stimming". English <krbenglish@...> wrote: Jeanette, I was just wondering if

you have every had your son tested for TS. Tic usually occur with TS also. I know that I see a lot of similarities with my son and my best friends son who has TS. I know that probably doesn't help but I was just wondering.Savasnia <Savasniacomcast (DOT) net> wrote: My eleven year old son has Asperger's and I was wondering if anyone else has an AS child with tics? Based on what little I know he has mild tics. I am just coming to realize that some of his behaviors are probably tics. I was wondering if his tics will improve or worsen in the future. He has the following tics: tongue-thrusting-chewing, whistling, making unintelligible noises, meowing, cracking knuckles, animal sounds, erasing, and fidgeting. I'm not a 100% sure if the meowing is a tic or echolalea because he mostly meows when he hears our cat doing it. Jeanette KELLY Sponsored LinkMortgage rates near 39yr lows. $510,000 Mortgage for $1,698/mo - Calculate new house payment A great teacher never strives to explain his vision - he simply invites you to stand beside him and see for yourself.... The Rev. R. Inman Children are likely to live up to what you believe of them - Lady Bird Treat a child as though he already is the person he's capable of becoming - Haim Gnott

Sponsored LinkMortgage rates near 39yr lows. $510,000 Mortgage for $1,698/mo - Calculate new house payment

[Guest guest]

I am still on the list for TS - however, I will say that AS has the obsessive issue as well. Perhaps one day we will all in fact find out that all of these "sub disorders" are actually markers of the spectrum. That is my feeling.lilies <lilies@...> wrote: My eleven year old son has Asperger's and I was wondering if anyone else has an AS child with tics? Based on what little I know he has mild tics. I am just coming to realize that some of his behaviors are probably tics. I was wondering if his tics will improve or worsen in the future. He has the following tics: tongue-thrusting-chewing, whistling, making unintelligible noises, meowing, cracking knuckles, animal sounds, erasing, and fidgeting. I'm not a 100% sure if the meowing is a tic or echolalea because he mostly meows when he hears our cat doing it. Jeanette ***********Hi Jeanette, my 14 year old has Tourette’s, and your descriptions sound like Tourette’s to me. A good site to look at would be the Tourette’s Society, http://www.tsa.usa.org/ My son started with the throat clearing and repeated swallowing at 9. The tongue thrusting caught my eye on your post as well. Most would not know my son has Tourette’s. He has been on Seroquel for 3 years. Because of tremendous weight gain, we are now trying Clonidine which is working except for some sleep issues. Without medication, his tongue would be moving constantly creating huge sores around his mouth within a few hours. My son was diagnosed with OCD at 9, Asperger’s at almost 10 and Tourette’s at 12. When he was 9 I questioned if he didn’t have

Tourette’s, as it came up when I was researching OCD. My son is doing quite well considering many challenges. Often times Tourette’s and OCD go hand in hand. My son’s biggest worry is poison. Tourette’s often goes undiagnosed for some time. Ask any questions. Gail A. A great teacher never strives to explain his vision - he simply invites you to stand beside him and see for yourself.... The Rev. R. Inman Children are likely to live up to what you believe of them - Lady Bird Treat a child as though he already is the person he's capable of becoming - Haim Gnott

Sponsored LinkMortgage rates near 39yr lows. $510,000 Mortgage for $1,698/mo - Calculate new house payment

[Guest guest]

In a message dated 11/20/2006 11:42:42 P.M. Eastern Standard Time, diegowench@... writes:

She has the very ocd type AS behavior along with constant "stimming".

The "very odd type AS"?

[Guest guest]

My 7 yr old was just diagnosed with Aspergers (he was diagnosed with

SEVERE ADHD at age 5). He has the joint popping -hands, ankles,

wrists, neck, etc). He also clears his throat constantly, and wipes

his mouth a lot. Some of his ADHD meds made the symptoms worse. He

has been on every one known to man, and either they don't work at all,

or the side effects are worse than the cure. Right now he is on

Clonidine and omega oils. It's not a perfect system, but it's the

best we have found so far.

>

> My eleven year old son has Asperger's and I was wondering if

anyone else has an AS child with tics?

>

> Based on what little I know he has mild tics. I am just coming

to realize that some of his behaviors are probably tics. I was

wondering if his tics will improve or worsen in the future.

>

> He has the following tics: tongue-thrusting-chewing, whistling,

making unintelligible noises, meowing, cracking knuckles, animal

sounds, erasing, and fidgeting. I'm not a 100% sure if the meowing is

a tic or echolalea because he mostly meows when he hears our cat doing it.

>

> Jeanette

>

[Guest guest]

Sounds like Tourette syndrome (TS), to me. Vocal and motor tics...a

diagnose of ADHD usually precedes a diagnosis of Tourette's by about

two years (hunh. 5+2=7). It's not unusual to find Tourette's and ADHD

and high-functioning autism in the same child. When I was heavily

involved with the Southern California chapter of the Tourette

Syndrome Association, we noticed that a lot of our kids with

Tourette's were also starting to get diagnoses of PDD, PDD-NOS,

Asperger's, and HFA. This was about 10 years ago.

Considering that these disorders share a lot of symptomatology,

that's not surprising. Does a child with Asperger's/HFA have OCD,

too, or is it just a manifestation of his disorder? Is the stimming

of autism related to the motor tics of Tourette's? Are the

attentional problems full-blown ADHD, or yet another manifestation of

his autism, or of his Tourette's? Why do so many people with

neurological disorders have sensory integration disorder and

depression? Maybe because our brain is so interdependent and not

compartmentalized.

The meowing is probably echolalia. Have you ever thought of something

someone else said and either mimicked them out loud in private or

responded out loud to a conversation going on in your head?

My son has HFA AND severe TS. I have a mostly mild form of TS and

some shadow issues with the HFA. My son can't take anything for the

ADHD, but he takes Anafranil (clomipramine) for the OCD issues,

Risperdal and Abilify for the tics (we had to drop the amount of

Risperdal because he was getting signs of tardive diskinesia, a

potentially permanent state of affairs), and lithium to control his

rages. As he's gotten older, he's been able to lower the amount of

most of these, but he used to be on the maximum dose possible for

Risperdal, and still his tics sometimes broke through pretty badly

and painfully. These meds help with the ADHD a little, and I can

always tell when he hasn't taken his pills.

Theresa Mesa

Mesa Design House

http://mesadesignhouse.com

909-335-9710

Hours: By appointment only

On Nov 30, 2006, at 10:48 AM, DJ wrote:

> My 7 yr old was just diagnosed with Aspergers (he was diagnosed with

> SEVERE ADHD at age 5). He has the joint popping -hands, ankles,

> wrists, neck, etc). He also clears his throat constantly, and wipes

> his mouth a lot. Some of his ADHD meds made the symptoms worse. He

> has been on every one known to man, and either they don't work at all,

> or the side effects are worse than the cure. Right now he is on

> Clonidine and omega oils. It's not a perfect system, but it's the

> best we have found so far.

>

>

> >

> > My eleven year old son has Asperger's and I was wondering if

> anyone else has an AS child with tics?

> >

> > Based on what little I know he has mild tics. I am just coming

> to realize that some of his behaviors are probably tics. I was

> wondering if his tics will improve or worsen in the future.

> >

> > He has the following tics: tongue-thrusting-chewing, whistling,

> making unintelligible noises, meowing, cracking knuckles, animal

> sounds, erasing, and fidgeting. I'm not a 100% sure if the meowing is

> a tic or echolalea because he mostly meows when he hears our cat

> doing it.

> >

> > Jeanette

> >

>

>

>

[Guest guest]

>Thanks to all who kept up with the discussion.

Yes, WNL = Within Normal Limits. Sorry I use jargon - it's part of me

after 25 years in the field (Clinical Psych). I also don't keep up

with discussions, but check in every so often. Am a bit tied up -

homeschooling five kids (one autism, passes for PDD), practice much to

the side.

Yes, hand flapping and other things listed count ... and they are

common enough. Repetitive words/phrases/sounds/turning into a

radio/car alarm/bunch of people talking/dogs/trains, are all things

I've seen at home and out and about.

Techniques vary. Many (parents) have developed their own. Some

techniques work primarily because they calm down parents, some work

because they avoid reinforcing the current behaviors, so new behaviors

crop up. Some techniques focus on training new behaviors so old ones

decrease. How's that for vague but covering it all?

Sometimes it's worth it to seek professional help in devising a

behavioral program that is right for you. And sometimes it is quite

harmful, especially when that 'expert' professional is none of that.

(If you seek services, you most likely want to clarify that you would

like an extremely specific and highly individualized program - and to

use the clinician as a consultant.)

[Guest guest]

Oh, and AS may look very much like ADD, ADHD, OCD, Sensory Integration

Disorder, any type of auditory processing problem, etc., to most

clinicians. That is why so many kids are dually diagnosed, etc.

[Guest guest]

" Some of his ADHD meds made the symptoms worse. He

> has been on every one known to man, and either they don't work at all,

> or the side effects are worse than the cure. Right now he is on

> Clonidine and omega oils. It's not a perfect system, but it's the

> best we have found so far. "

ADD medication and Medication for TS has to be balanced. Think of it

like a see-saw. Add meds make the TS end go up, and TS meds make the

ADD end go up. You have to get the right balance of both meds if it is

going to help.

Another thing is that when people think of TS they most of the time

only consider the tics. In fact TS effects how the brain works.

Especially memory and cognitive functioning. Just as ADD effects the

brain in different areas and abilities. TS is finally getting more

attention and they are finding new information in the past couple of

years. Here are a couple of links I have found helpful.

http://www.schoolbehavior.com/conditions_ts.htm

http://www.ninds.nih.gov/disorders/tourette/detail_tourette.htm

Take care,

Beth

[Guest guest]

Actually, a study in the last few years proved that ADD meds do NOT

make the tics of TS worse. Don't know that I believe it, though...

OTOH, TS does NOT affect memory and cognitive functioning, unless one

has comorbid ADHD and/or learning disabilities.

I used to edit lay medical books about TS, ADHD, autism, OCS, and

learning disabilities written by medical doctors and therapists. One

of my biggest clients was Hope press, owned by Dr. Comings, a

geneticist at the City of Hope specializing in TS et al.

Theresa Mesa

Mesa Design House

http://mesadesignhouse.com

909-335-9710

Hours: By appointment only

On Dec 2, 2006, at 10:04 AM, bethany04us wrote:

>

> ADD medication and Medication for TS has to be balanced. Think of it

> like a see-saw. Add meds make the TS end go up, and TS meds make the

> ADD end go up. You have to get the right balance of both meds if it is

> going to help.

>

> Another thing is that when people think of TS they most of the time

> only consider the tics. In fact TS effects how the brain works.

> Especially memory and cognitive functioning. Just as ADD effects the

> brain in different areas and abilities. TS is finally getting more

> attention and they are finding new information in the past couple of

> years. Here are a couple of links I have found helpful.

>

> http://www.schoolbehavior.com/conditions_ts.htm

> http://www.ninds.nih.gov/disorders/tourette/detail_tourette.htm

>

> Take care,

> Beth

>

>

>

[Guest guest]

I guess just like the experts say that mercury has caused no cases of

autism yet they did find that the Hep B that was given to infants the

day they were born was linked to developmental delays. Just as the

drug companies do not wish to have a lawsuit for the mercury in

vaccines they also do not wish to have lawsuits for ritalin causing

TS to manifest in genetically sensative children.

However tossing all of that aside my 16 year old and countless others

have voiced as well as their parents to the effect the meds have if

not balanced. Many neurologists still agree with this from years of

experience and previous medical journals and choose to toss the new

finding.

As for TS " NOT " effecting cognitive functioning and memory unless

there is a comorbid disorder, which there almost always is a comorbid

disorder. However that is not the argument among researchers. The

argument is what disorder or disorders effect certain areas so that

they may be sure to treat each accordingly resulting in the best

outcome for the patient. If working memory is effected by both TS and

the comorbid ADD then what is the best method of treatment. This is

dealing with the relation between elevating and surpressing one or

more chemicals in the brain, dopamine and serotonin. Plus the ADD was

present first and the TS manifested later, so is the TS comorbid?

Personally I don't care, he has both and they both effect him so lets

do something about them both.

Of course I don't just go around reading medical journals and

claiming to be an expert. I research and discuss my findings with

several neurologist in hopes to have the best understanding so that

my son can get the best treatment and to get him the educational help

needed as well. After talking with the doctors I still draw my own

conclusion and don't just roll over because this doctor said this or

that. Unforunatly I have run into this very problem where his IEP was

taken away because the number of ADD kids is astronomical and

services on that disorder alone are very hard to obtain. Yet because

he controls his tics during school the special education " EXPERTS "

see no need for him to be on an IEP because they as well don't think

that TS effects his brain aside from tics alone.(I for one like the

teachers that take the childs needs over the last journal they read

and classify him according to the special education manual.) Of

course the consentration, effort and energy it takes for him to

surpress his tics is enormous and after they build up all day he has

to let them loose in the bathroom or once he gets home. Yet if he

lets them loose in school then not only does he get picked on but he

has trouble reading with all the blinking, head jerking, eye rolling

and facial shrugs and it disturbs others. They get distracted or

annoyed and have a right to their education. Heard it a million times

thus resulting in my research to beter help my son.

Here is one of many publications I have found that you may not have

edited:

Public release date: 5-Apr-2004

[ Print Article | E-mail Article | Close Window ]

Contact: Jim Dryden

jdryden@...

314-286-0110

Washington University School of Medicine

Brain activity, including memory-processing, changes in Tourette

syndrome

Dopamine drug normalizes some brain functions

St. Louis, April 5, 2004 -- Scientists have known for years that

abnormal activity involving a brain chemical called dopamine is

somehow connected to the movements and vocalizations, or tics,

associated with Tourette syndrome. Now neuroscience researchers at

Washington University School of Medicine in St. Louis have found

brain activity in these patients is abnormal during memory tasks, as

well.

The researchers also found that giving Tourette syndrome patients the

drug levodopa, which is used to treat abnormal dopamine activity in

conditions such as Parkinson's disease, normalized brain activity

during the memory tasks.

" We've observed in the living brain a dopamine-sensitive abnormality

in people with tics. That's been hypothesized for 40 years, but this

is the first time it's been demonstrated, " says principal

investigator J. Black, M.D., assistant professor of psychiatry,

neurology and radiology and staff physician at -Jewish

Hospital. " We actually have a direct demonstration of abnormal brain

activation in people with Tourette syndrome that is corrected when

they are given a dopamine-type medicine. "

The study is published online and will appear in the May issue of the

journal Biological Psychiatry.

Using functional magnetic resonance imaging (fMRI), the researchers

compared eight adults with Tourette syndrome to 10 age- and gender-

matched individuals without tics. Brain scans were taken while

participants performed a memory task that involved remembering and

identifying letters on a computer screen. The task measures working

memory, a type of short-term memory that involves concentration on

several things at once.

" We chose to look at the brain's response to a working memory task

because past research has shown that working memory could be affected

by dopamine levels in the brain, " says first author Tamara Hershey,

Ph.D., assistant professor of psychiatry and neurology at the School

of Medicine. " We also know dopamine is involved in tics, but if we

had studied a task that involved movement, for example, the fact that

some tics involve movement could have made it harder to interpret the

differences in brain activity. "

In terms of speed and accuracy during the memory task, there were no

differences between the two groups, but fMRI scans revealed that

several brain areas were more active in Tourette syndrome patients

than healthy participants.

The clearest differences were in a brain region called the parietal

cortex, located at the top of the brain roughly in between the front

and back of the head. Tourette syndrome patients also had increased

activity in the medial frontal gyrus and in the thalamus -- which

acts as the brain's relay station between the outer layer, or cortex

and the rest of the nervous system.

" People with tics performed this task just as well as people without,

so it's not something that involves a difference in output, " Black

says " Therefore, we believe any differences we saw in the fMRI scans

reflect changes in the way the brain is working. "

To determine whether the results were related to dopamine

abnormalities, Hershey, Black and colleagues gave all participants an

intravenous infusion of the drug levodopa.

When the two groups then repeated the original working memory task,

brain activity in healthy participants was unchanged. In TS patients,

however, the areas that had been abnormally overactive were

substantially less active after treatment.

" Levodopa seems to normalize the excess activity we had seen in the

parietal cortex in the group with tics, " Hershey says. " There were

changes in activity in the other structures, too, but the changes in

the parietal cortex were the most dramatic. "

Before decoding which brain scans belonged to which participants,

Black looked at the patients' medical histories and used a standard

method of rating the severity of their illness. He found that those

with the most severe history of Tourette syndrome had the largest

post-levodopa decreases in brain activity during the working memory

task.

Now that they know the brain functions differently in people with

Tourette syndrome, Black and Hershey plan to look at brain activity

during different tasks to see whether they can find more dopamine-

related differences.

Black also is finalizing a treatment study to determine if levodopa

helps control tics in Tourette syndrome patients. That study should

be completed later this year.

###

Hershey T, Black KJ, Hartlein JM, Barch DM, Braver TS, Carl JL,

Perlmutter JS. Cognitive-Pharmacologic Functional Magnetic Resonance

Imaging in Tourette Syndrome: A Pilot Study. Biological Psychiatry,

May 1, 2004.

This research was supported by a Young Investigator award from the

National Alliance for Research on Schizophrenia and Depression, by

the Greater St. Louis Chapter of the American Parkinson's Disease

Association (ADPA), the National Institutes of Health, the

Parkinson's Disease Foundation, the A. Dana Foundation and

the ADPA Advanced Center for Parkinson's Disease Research at

Washington University. The Tourette Syndrome Association provided

recruitment support.

The full-time and volunteer faculty of Washington University School

of Medicine are the physicians and surgeons of -Jewish and St.

Louis Children's hospitals. The School of Medicine is one of the

leading medical research, teaching and patient care institutions in

the nation, currently ranked second in the nation by U.S. News &

World Report. Through its affiliations with -Jewish and St.

Louis Children's hospitals, the School of Medicine is linked to BJC

HealthCare.

So there is one finding. Of course we all remember the doctors

and " experts " that had their works published on how autism is caused

by the mothers and such. I was told my AU son would never be in a

normal class, would always be communication impaired and one day we

would have to make a choice to have him live at home or be put in an

institution. I have been told that behavioral modification is cruel.

I learned a long time ago to listen to the " experts " get other

opinions, do my own research and come to my own conclusion as to what

is best for my children. My autistic son use to sit an rock for hours

if I let him. He could not say one word and his eyes were lost. Now

he is a straight A student and carries on conversations that are

remarkable. When I look at him now, he looks back. I thank God

everyday that I did not just listen to the experts. But researched,

challenged and pushed. Just as the info I share should be researched,

challenged and pushed and ultametly come to your own conclusion.

Beth

>

> Actually, a study in the last few years proved that ADD meds do

NOT

> make the tics of TS worse. Don't know that I believe it, though...

>

> OTOH, TS does NOT affect memory and cognitive functioning, unless

one

> has comorbid ADHD and/or learning disabilities.

>

> I used to edit lay medical books about TS, ADHD, autism, OCS, and

> learning disabilities written by medical doctors and therapists.

One

> of my biggest clients was Hope press, owned by Dr. Comings,

a

> geneticist at the City of Hope specializing in TS et al.

>

>

> Theresa Mesa

> Mesa Design House

> http://mesadesignhouse.com

> 909-335-9710

> Hours: By appointment only

>

>

[Guest guest]

My son's tics were just as bad off the psychostimulants as they were

on them, but the meds made my son rage, so he went off them. Even so,

my experience is anecdotal at best. ADHD meds don't " cause " TS, as

some believe. There have been studies that show that the meds could

lower the tic threshold in someone already genetically predisposed to

TS. I don't know that i believe that psychostimulants

I've known plenty of people with TS who only had the tics. Not

everyone has comorbid disorders. In people with TS AND ADHD, a

diagnosis of ADHD *usually* preceded the diagnosis of TS by about 2

years. Does everyone with TS have ADHD? No. In females with TS, their

disorder is often manifested as OCD behavior. Does that preclude

their having tics? No, but they are less likely to have them, or have

them as severely.

Consider that the brain doesn't have special compartments for these

disorders, that there is a TS compartment, and an autism compartment,

and another one for SID or OCD or learning disabilities. That's why

there is considerable overlap of symptoms across many of these

disorders. It's all neurotransmitters and synapses misfiring. That's

why the same med that treats schizophrenia can also treat the tics

and behaviors of TS and other disorders.

The groups giving out money for research - and I'm talking about TSA,

ASA, etc. - have a vested interest themselves in keeping their named

disorders separate, and will not countenance the idea that maybe

there aren't separate disorders but just a more-or-less single

neurological mishap going on in the brain. What if there isn't autism

and ADHD and TS and OCD and LD and SID, etc.? What if there is just

one thing that is happening slightly differently but similarly in

each person's brain? Why does one person have TS and Asperger's, and

another have TS and rages, and another person just has chronic vocal

tics? What was there so much consistency AND inconsistency in

symptomatology in our population? What was making one person have

coprolalia (language - one area of the brain), and another person a

hopping tic (motor - another area of the brain)?

When the Southern California chapter of the Tourette Syndrome

Association posited this idea to national, and even had some of our

area's doctors back us up, our parent organization was vehemently

against what we were saying, and basically told us to shut up or

they'd pull our charter. One of our chapter presidents at the time,

an R.N. with two children with TS, who was taking a lot of the

support calls and going out to the schools to do in-service training,

wrote a manual for a continuing education program on TS for

registered nurses that was adopted and used for CEU's. I edited the

manual. She went nose to nose with national, and they wouldn't budge.

We eventually seceded from the parent organization and got our own

medical advisory committee. How do I know this? I was on the

chapter's board of directors for several years.

My son's neurologist is considered a national expert on TS, but he

wasn't an expert on HFA, and told me when I asked about it that I

didn't know what I was talking about. Ritvo, M.D., an expert

at UCLA on classic Autism, told me my son had one of the worst cases

of ADHD he'd ever seen, but no autism. " But what about this behavior

and what about that behavior? " He basically told me it was just

" extra " and not to worry about it. Three years later, an expert on

HFA and Asperger's said definitely, autism - mild autism, which is

what I'd been saying all along. She wasn't even sure he had TS -

until she spent some time with him and saw him ticcing.

A study of 8 people is not definitive by any means. It's probably a

precursor to an even larger study. But before you believe the results

of any study, you have to look at how the study was created and

performed and at whom was financing the study. One of the things my

friend, the R.N., and the research doctors I dealt with taught me was

how to examine the study and see if it was set up properly and how

the results were arrived at.

I know some parents swear their child's immunizations were to blame

for their child's autism, and that there was a sea change in their

behavior the next day. The day I saw the change in my son's behavior,

he hadn't had immunizations in months. I was put on a Dexedrine for

my ADD. It didn't make my tics worse, but boy, could I concentrate!!!

I couldn't sleep, but I could concentrate. When I was put on Effexor

for depression, I took one pill and was in status tics within the

hour - alone, and trying to call 911. That was one interesting

conversation, considering how bad my vocal tics were. Others with TS

take Effexor without any problems.

My point is, no one knows. Each story that is outside the realm of a

controlled study of a large cohort is anecdotal or unreliable. I try

to keep an open mind though. The state of autism definition and

diagnosis is not where it was 10 or even 5 years ago.

Doctors say that teething doesn't cause a child to get a fever. My

mom, an R.N. herself, has 5 kids and a bunch of grandkids, and she

says every one of them has gotten a fever while teething. Both of my

kids got fevers. Who am I going to believe? My mom.

In other words, you and I are probably closer in philosophy than you

think.

Sorry if this sounds a little disjointed. I'm babysitting my cranky,

teething grandbaby and typing when I get a chance.

Theresa Mesa

Mesa Design House

http://mesadesignhouse.com

909-335-9710

Hours: By appointment only

On Dec 3, 2006, at 10:25 AM, bethany04us wrote:

> I guess just like the experts say that mercury has caused no cases of

> autism yet they did find that the Hep B that was given to infants the

> day they were born was linked to developmental delays. Just as the

> drug companies do not wish to have a lawsuit for the mercury in

> vaccines they also do not wish to have lawsuits for ritalin causing

> TS to manifest in genetically sensative children.

> However tossing all of that aside my 16 year old and countless others

> have voiced as well as their parents to the effect the meds have if

> not balanced. Many neurologists still agree with this from years of

> experience and previous medical journals and choose to toss the new

> finding.

>

> As for TS " NOT " effecting cognitive functioning and memory unless

> there is a comorbid disorder, which there almost always is a comorbid

> disorder. However that is not the argument among researchers. The

> argument is what disorder or disorders effect certain areas so that

> they may be sure to treat each accordingly resulting in the best

> outcome for the patient. If working memory is effected by both TS and

> the comorbid ADD then what is the best method of treatment. This is

> dealing with the relation between elevating and surpressing one or

> more chemicals in the brain, dopamine and serotonin. Plus the ADD was

> present first and the TS manifested later, so is the TS comorbid?

> Personally I don't care, he has both and they both effect him so lets

> do something about them both.

>

> Of course I don't just go around reading medical journals and

> claiming to be an expert. I research and discuss my findings with

> several neurologist in hopes to have the best understanding so that

> my son can get the best treatment and to get him the educational help

> needed as well. After talking with the doctors I still draw my own

> conclusion and don't just roll over because this doctor said this or

> that. Unforunatly I have run into this very problem where his IEP was

> taken away because the number of ADD kids is astronomical and

> services on that disorder alone are very hard to obtain. Yet because

> he controls his tics during school the special education " EXPERTS "

> see no need for him to be on an IEP because they as well don't think

> that TS effects his brain aside from tics alone.(I for one like the

> teachers that take the childs needs over the last journal they read

> and classify him according to the special education manual.) Of

> course the consentration, effort and energy it takes for him to

> surpress his tics is enormous and after they build up all day he has

> to let them loose in the bathroom or once he gets home. Yet if he

> lets them loose in school then not only does he get picked on but he

> has trouble reading with all the blinking, head jerking, eye rolling

> and facial shrugs and it disturbs others. They get distracted or

> annoyed and have a right to their education. Heard it a million times

> thus resulting in my research to beter help my son.

>

> Here is one of many publications I have found that you may not have

> edited:

>

> Public release date: 5-Apr-2004

> [ Print Article | E-mail Article | Close Window ]

>

> Contact: Jim Dryden

> jdryden@...

> 314-286-0110

> Washington University School of Medicine

>

> Brain activity, including memory-processing, changes in Tourette

> syndrome

> Dopamine drug normalizes some brain functions

> St. Louis, April 5, 2004 -- Scientists have known for years that

> abnormal activity involving a brain chemical called dopamine is

> somehow connected to the movements and vocalizations, or tics,

> associated with Tourette syndrome. Now neuroscience researchers at

> Washington University School of Medicine in St. Louis have found

> brain activity in these patients is abnormal during memory tasks, as

> well.

> The researchers also found that giving Tourette syndrome patients the

> drug levodopa, which is used to treat abnormal dopamine activity in

> conditions such as Parkinson's disease, normalized brain activity

> during the memory tasks.

>

> " We've observed in the living brain a dopamine-sensitive abnormality

> in people with tics. That's been hypothesized for 40 years, but this

> is the first time it's been demonstrated, " says principal

> investigator J. Black, M.D., assistant professor of psychiatry,

> neurology and radiology and staff physician at -Jewish

> Hospital. " We actually have a direct demonstration of abnormal brain

> activation in people with Tourette syndrome that is corrected when

> they are given a dopamine-type medicine. "

>

> The study is published online and will appear in the May issue of the

> journal Biological Psychiatry.

>

> Using functional magnetic resonance imaging (fMRI), the researchers

> compared eight adults with Tourette syndrome to 10 age- and gender-

> matched individuals without tics. Brain scans were taken while

> participants performed a memory task that involved remembering and

> identifying letters on a computer screen. The task measures working

> memory, a type of short-term memory that involves concentration on

> several things at once.

>

> " We chose to look at the brain's response to a working memory task

> because past research has shown that working memory could be affected

> by dopamine levels in the brain, " says first author Tamara Hershey,

> Ph.D., assistant professor of psychiatry and neurology at the School

> of Medicine. " We also know dopamine is involved in tics, but if we

> had studied a task that involved movement, for example, the fact that

> some tics involve movement could have made it harder to interpret the

> differences in brain activity. "

>

> In terms of speed and accuracy during the memory task, there were no

> differences between the two groups, but fMRI scans revealed that

> several brain areas were more active in Tourette syndrome patients

> than healthy participants.

>

> The clearest differences were in a brain region called the parietal

> cortex, located at the top of the brain roughly in between the front

> and back of the head. Tourette syndrome patients also had increased

> activity in the medial frontal gyrus and in the thalamus -- which

> acts as the brain's relay station between the outer layer, or cortex

> and the rest of the nervous system.

>

> " People with tics performed this task just as well as people without,

> so it's not something that involves a difference in output, " Black

> says " Therefore, we believe any differences we saw in the fMRI scans

> reflect changes in the way the brain is working. "

>

> To determine whether the results were related to dopamine

> abnormalities, Hershey, Black and colleagues gave all participants an

> intravenous infusion of the drug levodopa.

>

> When the two groups then repeated the original working memory task,

> brain activity in healthy participants was unchanged. In TS patients,

> however, the areas that had been abnormally overactive were

> substantially less active after treatment.

>

> " Levodopa seems to normalize the excess activity we had seen in the

> parietal cortex in the group with tics, " Hershey says. " There were

> changes in activity in the other structures, too, but the changes in

> the parietal cortex were the most dramatic. "

>

> Before decoding which brain scans belonged to which participants,

> Black looked at the patients' medical histories and used a standard

> method of rating the severity of their illness. He found that those

> with the most severe history of Tourette syndrome had the largest

> post-levodopa decreases in brain activity during the working memory

> task.

>

> Now that they know the brain functions differently in people with

> Tourette syndrome, Black and Hershey plan to look at brain activity

> during different tasks to see whether they can find more dopamine-

> related differences.

>

> Black also is finalizing a treatment study to determine if levodopa

> helps control tics in Tourette syndrome patients. That study should

> be completed later this year.

>

> ###

> Hershey T, Black KJ, Hartlein JM, Barch DM, Braver TS, Carl JL,

> Perlmutter JS. Cognitive-Pharmacologic Functional Magnetic Resonance

> Imaging in Tourette Syndrome: A Pilot Study. Biological Psychiatry,

> May 1, 2004.

>

> This research was supported by a Young Investigator award from the

> National Alliance for Research on Schizophrenia and Depression, by

> the Greater St. Louis Chapter of the American Parkinson's Disease

> Association (ADPA), the National Institutes of Health, the

> Parkinson's Disease Foundation, the A. Dana Foundation and

> the ADPA Advanced Center for Parkinson's Disease Research at

> Washington University. The Tourette Syndrome Association provided

> recruitment support.

>

> The full-time and volunteer faculty of Washington University School

> of Medicine are the physicians and surgeons of -Jewish and St.

> Louis Children's hospitals. The School of Medicine is one of the

> leading medical research, teaching and patient care institutions in

> the nation, currently ranked second in the nation by U.S. News &

> World Report. Through its affiliations with -Jewish and St.

> Louis Children's hospitals, the School of Medicine is linked to BJC

> HealthCare.

>

> So there is one finding. Of course we all remember the doctors

> and " experts " that had their works published on how autism is caused

> by the mothers and such. I was told my AU son would never be in a

> normal class, would always be communication impaired and one day we

> would have to make a choice to have him live at home or be put in an

> institution. I have been told that behavioral modification is cruel.

> I learned a long time ago to listen to the " experts " get other

> opinions, do my own research and come to my own conclusion as to what

> is best for my children. My autistic son use to sit an rock for hours

> if I let him. He could not say one word and his eyes were lost. Now

> he is a straight A student and carries on conversations that are

> remarkable. When I look at him now, he looks back. I thank God

> everyday that I did not just listen to the experts. But researched,

> challenged and pushed. Just as the info I share should be researched,

> challenged and pushed and ultametly come to your own conclusion.

> Beth

>

>

> >

> > Actually, a study in the last few years proved that ADD meds do

> NOT

> > make the tics of TS worse. Don't know that I believe it, though...

> >

> > OTOH, TS does NOT affect memory and cognitive functioning, unless

> one

> > has comorbid ADHD and/or learning disabilities.

> >

> > I used to edit lay medical books about TS, ADHD, autism, OCS, and

> > learning disabilities written by medical doctors and therapists.

> One

> > of my biggest clients was Hope press, owned by Dr. Comings,

> a

> > geneticist at the City of Hope specializing in TS et al.

> >

> >

> > Theresa Mesa

> > Mesa Design House

> > http://mesadesignhouse.com

> > 909-335-9710

> > Hours: By appointment only

> >

> >

>

>

>