Neurocognitive correlates of treatment response in children with Tourette's Disorder

• Type of Material: Article
• Authors: Susanna W. Chang, University of California Los Angeles; Joseph F. McGuire, University of California Los Angeles; John T. Walkup, Cornell University; Douglas W. Woods, Marquette University; Lawrence Scahill, Emory University; Sabine Wilhelm, Harvard Medical School; Alan L. Peterson, University of Texas San Antonio; James Dziura, Yale Child Study Center; John Piacentini, University of California Los Angeles
• Language: English
• Date: 2018-03-01
• Publisher: Elsevier: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2018 Elsevier B.V.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.psychres.2017.12.066
• Title of Journal or Parent Work: Psychiatry Research
• ISSN: 0165-1781
• Volume: 261
• Start Page: 464
• End Page: 472
• Grant/Funding Information: This research was supported by the National Institute of Mental Health (K23MH080914-01, PI: Chang; R01MH070802, PI: Piacentini; T32 MH073517; and Clinical Research Training Fellowship from the Tourette Association of America and the American Academy of Neurology PI: McGuire).
• Keywords: Life Sciences & Biomedicine; EXECUTIVE FUNCTION; SEVERITY-SCALE; CHRONIC TIC DISORDER; Tourette; OBSESSIVE-COMPULSIVE DISORDER; PARENT VERSIONS; DEVELOPMENTAL PSYCHOPATHOLOGY; RANDOMIZED CONTROLLED-TRIAL; COGNITIVE-BEHAVIORAL THERAPY; ADHD; Neurocognition; Behavior therapy; Youth; INTERVIEW SCHEDULE; Science & Technology; Psychiatry; Comorbidity; ATTENTION-DEFICIT/HYPERACTIVITY DISORDER
• Research Categories: Psychology, Cognitive; Psychology, Behavioral; Biology, Neuroscience

Abstract

This paper examined neurocognitive functioning and its relationship to behavior treatment response among youth with Tourette's Disorder (TD) in a large randomized controlled trial. Participants diagnosed with TD completed a brief neurocognitive battery assessing inhibitory functions, working memory, and habit learning pre- and post-treatment with behavior therapy (CBIT, Comprehensive Behavioral Intervention for Tics) or psychoeducation plus supportive therapy (PST). At baseline, youth with tics and Attention Deficit Hyperactivity Disorder (ADHD) exhibited some evidence of impaired working memory and simple motor inhibition relative to youth with tics without ADHD. Additionally, a small negative association was found between antipsychotic medications and youth's performance speed. Across treatment groups, greater baseline working memory and aspects of inhibitory functioning were associated with a positive treatment response; no between-group differences in neurocognitive functioning at post-treatment were identified. Within the behavior therapy group, pre-treatment neurocognitive status did not predict outcome, nor was behavior therapy associated significant change in neurocognitive functioning post-treatment. Findings suggest that co-occurring ADHD is associated with some impairments in neurocognitive functioning in youth with Tourette's Disorder. While neurocognitive predictors of behavior therapy were not found, participants who received behavior therapy exhibited significantly reduced tic severity without diminished cognitive functioning.