A New Treatment For Tourette's Syndrome

Tourette syndrome (TS) is a morecomplex type of tic disorder (TD). In addition to motor tics (such as blinking,nodding, nose shrugging, shoulder rotation, limb stretching, etc.) and vocaltics (such as blowing, coughing, sniffing, speech repetition, etc.), TSpatients often have Attention-deficit/hyperactivity disorder,obsessive-compulsive symptoms, mood disorders, and other comorbidities, add alot of trouble to the patient's life and study. The pathogenesis is stillunclear, genetic factors may be the cause, and it is believed to be related tothe following factors:

1. Excessive dopamine (DA)conduction or DA receptor (DR) hypersensitivity in the striatal systemApplication of DR antagonists can effectively control tic symptoms, whereas theapplication of amphetamine can significantly worsen tic symptoms.

2. The content of DA metabolitehomovanillic acid (HVA) was significantly reduced and the degree of reductionwas related to the severity of symptoms. The level of plasma tryptophan and thecontent of 5-HT metabolite 5-hydroxytryptophan (5-HTP) in cerebrospinal fluidwere significantly decreased, and the degree of tics was related to changes inthe concentration of 5-HT metabolite 5-hydroxyindoleacetic acid (5-HIAA). It issuggested that there is abnormal 5-HT metabolism in TS. It has been reportedthat the concentration of cAMP in the cerebral cortex is decreased in the brainautopsy of patients, suggesting that neurological disorders may occur secondaryto affecting the transmission of nerve signals.

3. Hypertrophic effect In the earlystage of brain development, due to the excessive nutritional effect ofexcitatory amino acids and sex hormones, excitatory neurons continue todepolarize. The abnormal increase of neurons in some parts and the excessivederivation of neuronal synapses result in a series of clinical symptoms. Mostof TS occurs before puberty, more men than women, suggesting that it is mainlyrelated to the role of androgens.

Commonly used tic symptoms controldrugs include typical and atypical antipsychotics, antiepileptic drugs andcentral α2 adrenergic receptor agonists. The commonly used traditional drugs(such as haloperidol, tiapride, etc.) have good therapeutic effects, but manypatients cannot tolerate their side effects. Therefore, medical scientists havedeveloped a new treatment for Tourette's syndrome, which has better treatmenteffect on TS and fewer adverse reactions. Let's introduce the new treatment forTourette's syndrome-risperidone combined psychotherapy.

The onset of TS in patients is inchildhood, and the symptoms of motor or vocal tics bring serious harm to thepatient. In addition, TS is more common in children aged 10 to 12 years, andthis age group is about to enter the rebellious stage of adolescence. Patientsare often accompanied by negative psychology such as tension, fear, loneliness,low self-esteem, impatience, irritability, anxiety, depression, rebellion,hatred, etc. It has a huge impact on patients and their families. Therefore, itis also very important to carry out scientific and effective psychologicalintervention after treatment and control of tic symptoms.

At present, the main target of thenew treatment for tourette's syndrome is to control the symptoms of tics, and thetreatment plan is mainly based on drugs. Risperidone is an atypicalantipsychotic drug, which has a blocking effect on serotonin receptors anddopamine D2 receptors. It can achieve the effect of treating TS by regulatingthe balance of neurotransmitters. Less reaction and high safety. Some scholarsbelieve that the occurrence of TS may be related to striatal DA hyperactivityor postsynaptic DA receptor hypersensitivity, and may also be related to 5-TH,norepinephrine (NE) and other transmitters. The efficacy of the psychiatricdrug risperidone in the treatment of TS is similar to that of haloperidol, andthe adverse reactions are milder than those of haloperidol. In psychotherapy, anew "bio-psycho-social" treatment model is used to intervene,focusing on children, taking into account family members and teachers, buildinga harmonious doctor-patient relationship, and positively guiding children toactively face tic symptoms. Health education can obtain social support andprovide children with a good social atmosphere, thereby helping to improvenegative emotions. Results of a study showed that the YGTSS score of the twogroups of patients after drug combined with psychological intervention wassignificantly lower than before, and the YGTSS score of the observation groupwas lower than that of the control group. There was no statistical significancein the comparison of adverse reactions between the two groups, indicating thatrisperidone combined with psychological treatment of Tourette's syndrome hasgood effect and high safety.

To sum up, this new treatment forTourette's syndrome, that is, psychological combined with risperidone treatmenthas a better effect, which can help children with TS and their families tocorrectly understand the disease, and is beneficial to eliminate or alleviatethe negative psychology of children with small side effects, which is worthy ofclinical application.