title: Neurobehavioral aspects, pathophysiology, and management of Tourette syndrome.
abstract: OBJECTIVE
  This update summarizes progress in understanding Tourette syndrome clinical characteristics, etiology, and treatment over the past year.
  
  
  RESULTS
  Premonitory sensory phenomena were found to have important impacts on Tourette syndrome quality of life. A rare genetic form of Tourette syndrome due to L-histidine-decarboxylase mutation, with similar features in human and rodent, has inspired new research on functional anatomy of Tourette syndrome. In response to new data, treatment guidelines have been revised to include behavioral therapy as first-line treatment. Novel dopamine receptor antagonists aripiprazole and ecopipam have shown potential efficacy - as well as tolerability concerns. Recent work has suggested efficacy and tolerability of topiramate and fluphenazine, but more rigorous studies are needed to further understand their role in Tourette syndrome management. Recent consensus guidelines explain when deep brain stimulation can be considered for severe refractory cases under a multidisciplinary team.
  
  
  CONCLUSIONS
  More research is needed to identify better tolerated treatments for, to understand pathophysiology or functional anatomy of, and to predict or influence longitudinal outcome of Tourette syndrome.
authors: aDepartment of Neurology bDepartment of Psychology, University of Utah, Salt Lake City, Utah, USA.
authors: David R
authors: DR
authors: Shprecher
authors: Lauren
authors: L
authors: Schrock
authors: Michael
authors: M
authors: Himle
mesh_terms: D000429:Alcohol Oxidoreductases / Q000235:genetics; D000068180:Aripiprazole; D001552:Benzazepines / Q000627:therapeutic use; D002529:Cerebellar Nuclei; D019468:Disease Management; D018492:Dopamine Antagonists / Q000627:therapeutic use; D006801:Humans; D001523:Mental Disorders / Q000209:etiology*; D009154:Mutation / Q000235:genetics; D010879:Piperazines / Q000627:therapeutic use; D015363:Quinolones / Q000627:therapeutic use; D005879:Tourette Syndrome / Q000150:complications* / Q000235:genetics / Q000473:pathology / Q000628:therapy*
chemical_list: D001552:Benzazepines; D018492:Dopamine Antagonists; D010879:Piperazines; D015363:Quinolones; C058081:ecopipam; D000068180:Aripiprazole; D000429:Alcohol Oxidoreductases; C021358:histidinol dehydrogenase