Cognitive and Brain Development in Adolescents With Gilles de la Tourette Syndrome

Study Overview
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Brief Summary
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In children with neurodevelopmental disorders, adolescence is usually associated with a reshaping of the clinical picture and symptomatology. Tourette syndrome (TS) is a paradigmal neurodevelopmental syndrome characterised by involuntary paroxysmal movements (motor tics) and vocalisation (vocal tics) often associated with various psychiatric disorders. The neuronal and cognitive mechanisms associated with TS symptoms improvement during adolescence, or the persistence in adulthood remains unknown, and this is what we aim to address in this study.

Detailed Description
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Thus, the aims of the present project is threefold: Aim 1: To evaluate the maturation of cognitive functions in adolescents with TS compared to typically developing adolescents. To achieve this aim, three distinct cognitive dimensions will be assessed in all subjects (patients and controls): (i) reward sensitivity and habit formation; (ii) cognitive impulsivity and action control and (iii) self-agency. Aim 2: To identify neuronal correlates of cognitive function and brain development in health and disease. To achieve this aim, we will use a combined behavioural (as described in Aim 1), (i) neuroimaging and (ii) TMS approaches. Aim 3: To predict clinical outcome . In this part of the project we aim to identify behavioural, imaging or neurophysiological markers of clinical outcome in patients with TS.

Official Title
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Développement Cognitif et cérébral Chez Les Adolescents Souffrants d'un Syndrome de Gilles de la Tourette

Conditions
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Tourette Syndrome in Adolescence

Intervention / Treatment
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* Behavioral: Behavioral testing on cognitive computerized tasks
* Other: brain MRI
* Other: TMS


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Tourette syndrome Ages 13 - 18 Acceptance to perform the Brain MRI Acceptance to perform the cognitive testing Acceptance to perform the TMS measures Exclusion Criteria: Learning disability Incompatibility with MRI procedure (metal body implants, pregnancy)

Ages Eligible for Study
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Minimum Age: 13 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Between group comparison
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Tourette syndrome<br>Patients with Tourette syndrome aged 13 - 18 y.o. Interventions : Brain scans, cognitive testing, TMS measures | Behavioral: Behavioral testing on cognitive computerized tasks<br>* Testing on cognitive computerized tasks<br>Other: brain MRI<br>* Brain MRI scans<br>Other: TMS<br>* Measure of the cortical inhibitory capacity using TMS measures<br>|
| Other: Controls<br>Controls matched to Tourette syndrome group nterventions : Brain scans, cognitive testing, TMS measures | Behavioral: Behavioral testing on cognitive computerized tasks<br>* Testing on cognitive computerized tasks<br>Other: brain MRI<br>* Brain MRI scans<br>Other: TMS<br>* Measure of the cortical inhibitory capacity using TMS measures<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Behavioral test main outcome measures [1] | reaction times | from 16 to 20 months | 
| Behavioral test main outcome measures [2] | discounting factor | from 16 to 20 months | 
| Behavioral test main outcome measures [3] | number of premature responses | from 16 to 20 months | 
| Behavioral test main outcome measures [4] | agency composite scores | from 16 to 20 months | 
| Brain MRI scan measures | whole brain structural connectivity, whole brain functional connectivity, brain cortical and subcortical structures volumes and morphology | from 16 to 20 months | 
| Transcranial magnetic stimulation | intracortical inhibition (SICI) scores | from 16 to 20 months |