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GTS  -  Gilles de la Tourette syndrome

Homo sapiens

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Disease relevance of GTS

  • Gilles de la Tourette syndrome (GTS) is a sporadic or inherited complex neuropsychiatric disorder characterized by involuntary motor and vocal tics [1].
  • Six had movement disorders related to non-tic conditions commonly associated with GTS: four patients had movements associated with OCD, one with ADHD and antisocial behavior, respectively [2].
  • Recently, evidence has accumulated supporting the role of autoimmune mechanisms in the aetiology of GTS, suggesting that it is within the paediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS) spectrum of childhood neurobehavioural disorders [3].
  • Chromosomal abnormalities have long been proposed to play a causative role in isolated cases of GTS spectrum phenomena, but confirmation of this hypothesis has yet to be forthcoming [4].
  • CONCLUSIONS: ADD, learning problems, stuttering, and speech problems by themselves are not variant forms of GTS [5].

Psychiatry related information on GTS


High impact information on GTS


Chemical compound and disease context of GTS


Biological context of GTS

  • We have investigated a GTS family with a complex chromosomal insertion/translocation involving chromosomes 2 and 7 [1].
  • We hypothesize that disruption or decreased expression of CNTNAP2 could lead to a disturbed distribution of the K(+) channels in the nervous system, thereby influencing conduction and/or repolarization of action potentials, causing unwanted actions or movements in GTS [1].
  • Our genome scan of sibling pair families with GTS found evidence suggestive of linkage to several chromosomal locations [16].
  • In this study, we investigate the association of three microsatellite polymorphisms (MOGa, MOGb, MOGc) in the gene for MOG with GTS in 197 family trios collected from southwest China. Linkage disequilibrium between these three markers was observed with the strongest between MOGa and MOGc (D' = 0.541, P = 0.000) [3].
  • Segregation analyses suggest that GTS and milder phenotypes are caused by a single dominant gene [17].

Anatomical context of GTS

  • These findings suggest that GTS subjects who lack normal basal ganglia structural asymmetries also lack normal functional asymmetries on related neuropsychological measures [18].
  • The glycine receptor gene responsible for hyperekplexia and the other neuroreceptor genes examined in this paper are not involved in the etiology of GTS in this large pedigree [19].
  • We studied 17 patients with GTS and eight normal controls using volumetric MRI techniques for measuring the caudate nucleus, amygdala, and corpus callosum [20].
  • BACKGROUND: Statistical characterization of tic behavior in Gilles de la Tourette syndrome (GTS) may provide insight into the dynamic functioning of the human central nervous system, as well as improve the quantitative assessment of tic symptom severity [21].
  • Erythrocyte measures of copper-zinc superoxide dismutase (CuZnSOD) were performed on 11 subjects with a clinical diagnosis of Gilles de la Tourette syndrome (GTS) and 6 healthy controls at specified intervals throughout the day [22].

Associations of GTS with chemical compounds

  • Some studies have implicated the D2 and D4 dopamine receptors as having a direct role in the etiology of GTS, but other studies have disputed those findings [23].
  • The adrenergic system has been suggested to play a role in GTS based on the reduction of symptoms with the adrenergic receptor agonists, clonidine and guanfacine [16].
  • We conducted an open-label trial of fluoxetine (20 to 40 mg/d) for 32 GTS patients with OCD [24].
  • The neurotransmitter systems most often thought to be involved in GTS include those involving adrenaline, noradrenaline, and dopamine [25].
  • Twenty-six GTS patients (10.5 +/- 2.6 years), experienced clinical response rates of 69% on 3.4 +/- 1.6 mg pimozide and 65% on 3.5 +/- 2.2 mg/day haloperidol [26].

Physical interactions of GTS

  • CONCLUSION: Patients with GTS show higher striatal binding of FP-CIT to the striatum in comparison with age- and gender-matched control subjects, indicating that dopamine transporter abnormalities are involved in the pathophysiology of GTS [27].

Other interactions of GTS


Analytical, diagnostic and therapeutic context of GTS

  • In community and epidemiological studies, depression in GTS individuals was evident in two of five investigations [8].
  • However, it is noted that sample sizes in most of these studies were small, and it is unclear at the present time as to why BAD may be overrepresented among GTS patients [8].
  • Depression in people with GTS has been shown to result in a lower quality of life, potentially leading to hospitalization and suicide [8].
  • Gilles de la Tourette Syndrome (GTS) has long been known to be familial, and evidence from twin studies indicates that it has a substantial genetic component [16].
  • To further characterize the distal breakpoint for a role in GTS, we performed Southern blot hybridization analysis and identified a 6.5-kb SacI junction fragment in the patient's genomic DNA [30].


  1. CNTNAP2 is disrupted in a family with Gilles de la Tourette syndrome and obsessive compulsive disorder. Verkerk, A.J., Mathews, C.A., Joosse, M., Eussen, B.H., Heutink, P., Oostra, B.A. Genomics (2003) [Pubmed]
  2. Hyperkinetic movement disorders misdiagnosed as tics in Gilles de la Tourette syndrome. Kompoliti, K., Goetz, C.G. Mov. Disord. (1998) [Pubmed]
  3. Linkage disequilibrium analysis of polymorphisms in the gene for myelin oligodendrocyte glycoprotein in Tourette's syndrome patients from a Chinese sample. Huang, Y., Li, T., Wang, Y., Ansar, J., Lanting, G., Liu, X., Zhao, J.H., Hu, X., Sham, P.C., Collier, D. Am. J. Med. Genet. B Neuropsychiatr. Genet. (2004) [Pubmed]
  4. Epigenetic abnormalities associated with a chromosome 18(q21-q22) inversion and a Gilles de la Tourette syndrome phenotype. State, M.W., Greally, J.M., Cuker, A., Bowers, P.N., Henegariu, O., Morgan, T.M., Gunel, M., DiLuna, M., King, R.A., Nelson, C., Donovan, A., Anderson, G.M., Leckman, J.F., Hawkins, T., Pauls, D.L., Lifton, R.P., Ward, D.C. Proc. Natl. Acad. Sci. U.S.A. (2003) [Pubmed]
  5. Familial relationship between Gilles de la Tourette's syndrome, attention deficit disorder, learning disabilities, speech disorders, and stuttering. Pauls, D.L., Leckman, J.F., Cohen, D.J. Journal of the American Academy of Child and Adolescent Psychiatry. (1993) [Pubmed]
  6. An epidemiologic study of Gilles de la Tourette's syndrome in Israel. Apter, A., Pauls, D.L., Bleich, A., Zohar, A.H., Kron, S., Ratzoni, G., Dycian, A., Kotler, M., Weizman, A., Gadot, N. Arch. Gen. Psychiatry (1993) [Pubmed]
  7. Cerebral imaging in paediatrics. Gordon, I. The quarterly journal of nuclear medicine : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR). (1998) [Pubmed]
  8. Mood disorders and Gilles de la Tourette's syndrome: an update on prevalence, etiology, comorbidity, clinical associations, and implications. Robertson, M.M. Journal of psychosomatic research. (2006) [Pubmed]
  9. A new gene for Tourette's syndrome: a window into causal mechanisms? Grados, M.A., Walkup, J.T. Trends Genet. (2006) [Pubmed]
  10. Indications of linkage and association of Gilles de la Tourette syndrome in two independent family samples: 17q25 is a putative susceptibility region. Paschou, P., Feng, Y., Pakstis, A.J., Speed, W.C., DeMille, M.M., Kidd, J.R., Jaghori, B., Kurlan, R., Pauls, D.L., Sandor, P., Barr, C.L., Kidd, K.K. Am. J. Hum. Genet. (2004) [Pubmed]
  11. Aripiprazole in patients with Tourette syndrome. Bubl, E., Perlov, E., Tebartz Van Elst, L. World J. Biol. Psychiatry (2006) [Pubmed]
  12. Clonidine and Gilles de la Tourette's syndrome: double-blind study using objective rating methods. Goetz, C.G., Tanner, C.M., Wilson, R.S., Carroll, V.S., Como, P.G., Shannon, K.M. Ann. Neurol. (1987) [Pubmed]
  13. Increased plasma kynurenine and its relationship to neopterin and tryptophan in Tourette's syndrome. Rickards, H., Dursun, S.M., Farrar, G., Betts, T., Corbett, J.A., Handley, S.L. Psychological medicine. (1996) [Pubmed]
  14. Dopamine agonist treatment of Tourette disorder in children: results of an open-label trial of pergolide. Lipinski, J.F., Sallee, F.R., Jackson, C., Sethuraman, G. Mov. Disord. (1997) [Pubmed]
  15. Psychopathology and personality characteristics in relation to blood serotonin in Tourette's syndrome and obsessive-compulsive disorder. Cath, D.C., Spinhoven, P., Landman, A.D., van Kempen, G.M. J. Psychopharmacol. (Oxford) (2001) [Pubmed]
  16. Evaluation of the genes for the adrenergic receptors alpha 2A and alpha 1C and Gilles de la Tourette Syndrome. Xu, C., Ozbay, F., Wigg, K., Shulman, R., Tahir, E., Yazgan, Y., Sandor, P., Barr, C.L. Am. J. Med. Genet. B Neuropsychiatr. Genet. (2003) [Pubmed]
  17. Linkage studies on Gilles de la Tourette syndrome: what is the strategy of choice? Heutink, P., van de Wetering, B.J., Pakstis, A.J., Kurlan, R., Sandor, P., Oostra, B.A., Sandkuijl, L.A. Am. J. Hum. Genet. (1995) [Pubmed]
  18. Behavioral laterality in individuals with Gilles de la Tourette's syndrome and basal ganglia alterations: a preliminary report. Yazgan, M.Y., Peterson, B., Wexler, B.E., Leckman, J.F. Biol. Psychiatry (1995) [Pubmed]
  19. Neuroreceptor subunit genes and the genetic susceptibility to Gilles de la Tourette syndrome. Brett, P.M., Curtis, D., Robertson, M.M., Gurling, H.M. Biol. Psychiatry (1997) [Pubmed]
  20. A volumetric MRI study of Gilles de la Tourette's syndrome. Moriarty, J., Varma, A.R., Stevens, J., Fish, M., Trimble, M.R., Robertson, M.M. Neurology (1997) [Pubmed]
  21. The temporal dynamics of tics in Gilles de la Tourette syndrome. Peterson, B.S., Leckman, J.F. Biol. Psychiatry (1998) [Pubmed]
  22. Postprandial changes in superoxide dismutase activity in subjects with Gilles de la Tourette syndrome and controls. Saghir, A.N., Rickards, H., Pall, H.S. Exp. Neurol. (1997) [Pubmed]
  23. Molecular approaches to child psychopathology. Alsobrook, J.P., Pauls, D.L. Hum. Biol. (1998) [Pubmed]
  24. An open-label trial of fluoxetine for obsessive-compulsive disorder in Gilles de la Tourette's syndrome. Como, P.G., Kurlan, R. Neurology (1991) [Pubmed]
  25. The genetic susceptibility to Gilles de la Tourette syndrome in a large multiple affected British kindred: linkage analysis excludes a role for the genes coding for dopamine D1, D2, D3, D4, D5 receptors, dopamine beta hydroxylase, tyrosinase, and tyrosine hydroxylase. Brett, P.M., Curtis, D., Robertson, M.M., Gurling, H.M. Biol. Psychiatry (1995) [Pubmed]
  26. Prolactin monitoring of haloperidol and pimozide treatment in children with Tourette's syndrome. Sallee, F.R., Dougherty, D., Sethuraman, G., Vrindavanam, N. Biol. Psychiatry (1996) [Pubmed]
  27. Dopamine transporter binding in Gilles de la Tourette syndrome: a [123I]FP-CIT/SPECT study. Serra-Mestres, J., Ring, H.A., Costa, D.C., Gacinovic, S., Walker, Z., Lees, A.J., Robertson, M.M., Trimble, M.R. Acta psychiatrica Scandinavica. (2004) [Pubmed]
  28. Neutralization of tumor necrosis factor activity shortly after the onset of dendritic cell hematopoiesis reveals a novel mechanism for the selective expansion of the CD14-dependent dendritic cell pathway. Santiago-Schwarz, F., McCarthy, M., Tucci, J., Carsons, S.E. Blood (1998) [Pubmed]
  29. Serotonin receptor genes HTR3A and HTR3B are not involved in Gilles de la Tourette syndrome. Niesler, B., Frank, B., Hebebrand, J., Rappold, G. Psychiatr. Genet. (2005) [Pubmed]
  30. Disruption of a novel gene (IMMP2L) by a breakpoint in 7q31 associated with Tourette syndrome. Petek, E., Windpassinger, C., Vincent, J.B., Cheung, J., Boright, A.P., Scherer, S.W., Kroisel, P.M., Wagner, K. Am. J. Hum. Genet. (2001) [Pubmed]
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