title: Elevated cerebrospinal fluid corticotropin-releasing factor in Tourette's syndrome: comparison to obsessive compulsive disorder and normal controls.
abstract: Stress- and anxiety-related fluctuations in tic severity are cardinal features of Tourette's syndrome (TS), and there is evidence for involvement of noradrenergic mechanisms in the pathophysiology and treatment of the disorder. To examine further the pathobiology of this enhanced vulnerability to stress and anxiety, we measured central activity of corticotropin-releasing factor (CRF) in patients with TS and the related condition, obsessive compulsive disorder (OCD). Lumbar cerebrospinal fluid (CSF) was obtained in a standardized fashion for measurement of CRF from 21 medication-free outpatients with TS, 20 with OCD, and 29 healthy controls. The TS patients had significantly higher levels of CSF CRF than both the normal controls and the OCD patients. However, there was no difference in CSF CRF between the OCD patients and the normal controls. Group differences in CSF CRF were unrelated to current clinical ratings of depression, anxiety, tics, and obsessive compulsive behaviors. Although the functional significance of this finding remains to be elucidated, these results are consistent with the hypothesis that stress-related neurobiological mechanisms may play a role in the pathobiology of TS.
authors.affiliation: Child Study Center, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: P
authors.initials: P
authors.lastname: Chappell
authors.forename: J
authors.initials: J
authors.lastname: Leckman
authors.forename: W
authors.initials: W
authors.lastname: Goodman
authors.forename: G
authors.initials: G
authors.lastname: Bissette
authors.forename: D
authors.initials: D
authors.lastname: Pauls
authors.forename: G
authors.initials: G
authors.lastname: Anderson
authors.forename: M
authors.initials: M
authors.lastname: Riddle
authors.forename: L
authors.initials: L
authors.lastname: Scahill
authors.forename: C
authors.initials: C
authors.lastname: McDougle
authors.forename: D
authors.initials: D
authors.lastname: Cohen
mesh_terms: D000293:Adolescent; D000328:Adult; D001143:Arousal / Q000502:physiology; D015897:Comorbidity; D003346:Corticotropin-Releasing Hormone / Q000134:cerebrospinal fluid*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000502:physiology; D009771:Obsessive-Compulsive Disorder / Q000134:cerebrospinal fluid* / Q000175:diagnosis / Q000523:psychology; D010552:Personality Assessment; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D012016:Reference Values; D005879:Tourette Syndrome / Q000134:cerebrospinal fluid* / Q000175:diagnosis / Q000523:psychology
chemical_list: D003346:Corticotropin-Releasing Hormone; D009638:Norepinephrine