Neurocognitive predictors of treatment response to randomized treatment in adults with tic disorders

• Authors: Amitai Abramovitch, Texas State University; Lauren S. Hallion, Massachusetts General Hospital; Hannah E. Reese, Massachusetts General Hospital; Douglas W. Woods, Marquette University; Alan Peterson, University of Texas Health Science Center, San Antonio; John T. Walkup, Weill Cornell Medical College; John Piacentini, University of California Los Angeles; Lawrence Scahill, Emory University; Thilo Deckersbach, Massachusetts General Hospital; Sabine Wilhelm, Massachusetts General Hospital
• Journal Title: Progress in Neuro-Psychopharmacology and Biological Psychiatry
• Volume: Volume 74
• Publisher: Elsevier: 12 months | 2017-03-06, Pages 9-14
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1016/j.pnpbp.2016.11.002
• Subjects: Health Sciences, Medicine and Surgery; Psychology, Behavioral; Biology, Neuroscience
• Keywords: Science & Technology; Life Sciences & Biomedicine; Clinical Neurology; Neurosciences; Pharmacology & Pharmacy; Psychiatry; Neurosciences & Neurology; Tourette's disorder; Response inhibition; Executive function; Treatment; Neuropsychology; OBSESSIVE-COMPULSIVE DISORDER; TOURETTE-SYNDROME; BEHAVIOR-THERAPY; CONTROLLED-TRIAL; INHIBITION; CHILDREN; METAANALYSIS; SEVERITY

Abstract

Tourette's disorder (TS) and chronic tic disorder (CTD) are neurodevelopmental disorders characterized by involuntary vocal and motor tics. Consequently, TS/CTD have been conceptualized as disorders of cognitive and motor inhibitory control. However, most neurocognitive studies have found comparable or superior inhibitory capacity among individuals with TS/CTD relative to healthy controls. These findings have led to the hypothesis that individuals with TS/CTD develop increased inhibitory control due to the constant need to inhibit tics. However, the role of cognitive control in TS/CTD is not yet understood, particularly in adults. To examine the role of inhibitory control in TS/CTD, the present study investigated this association by assessing the relationship between inhibitory control and treatment response in a large sample of adults with TS/CTD. As part of a large randomized trial comparing behavior therapy versus supportive psychotherapy for TS/CTD, a battery of tests, including tests of inhibitory control was administered to 122 adults with TS/CTD at baseline. We assessed the association between neuropsychological test performance and change in symptom severity, as well as compared the performance of treatment responders and non-responders as defined by the Clinical Global Impression Scale. Results indicated that change in symptoms, and treatment response were not associated with neuropsychological performance on tests of inhibitory control, intellectual ability, or motor function, regardless of type of treatment. The finding that significant change in symptom severity of TS/CTD patients is not associated with impairment or change in inhibitory control regardless of treatment type suggests that inhibitory control may not be a clinically relevant facet of these disorders in adults.