title: Set-Shifting Deficits: A Possible Neurocognitive Endophenotype for Tourette Syndrome Without ADHD.
abstract: OBJECTIVE
  Tourette syndrome (TS) can be associated with cognitive dysfunction. We assessed a range of cognitive abilities in adults with TS without comorbid disorders.
  
  
  METHODS
  Participants completed tests of sustained attention, verbal and non-verbal reasoning, comprehension, verbal fluency, working memory, inhibition, and set-shifting. We compared patients' task performance with that of healthy controls, and evaluated relationships between cognitive abilities and symptoms of obsessive-compulsive disorder (OCD), ADHD, impulse control problems, and mood disorders.
  
  
  RESULTS
  Patients with TS exhibited impairments on four measures assessing response inhibition, fine motor control, set-shifting, and sustained attention. The Wisconsin Card Sorting Test (WCST) discriminated best between patients and controls. Patients' deficits were not correlated with tic severity or symptoms related to OCD, ADHD, or mood disorders.
  
  
  CONCLUSIONS
  Deficits on the WCST could constitute a neurocognitive endophenotype for TS, reflecting dysfunction within neural networks involving basal ganglia, pre-supplementary motor area, and inferior prefrontal regions.
authors.affiliation: 1 Department of Neuropsychiatry, BSMHFT The Barberry, National Centre for Mental Health, Birmingham, UK.|2 University of Birmingham, UK.
authors.forename: Clare M
authors.initials: CM
authors.lastname: Eddy
authors.affiliation: 1 Department of Neuropsychiatry, BSMHFT The Barberry, National Centre for Mental Health, Birmingham, UK.|3 University College London, UK.|4 Aston University, UK.
authors.forename: Andrea E
authors.initials: AE
authors.lastname: Cavanna
mesh_terms: D000328:Adult; D001288:Attention / Q000502:physiology; D001289:Attention Deficit Disorder with Hyperactivity / Q000523:psychology*; D001479:Basal Ganglia / Q000502:physiology; D003072:Cognition Disorders / Q000523:psychology; D058068:Endophenotypes; D056344:Executive Function / Q000502:physiology; D005260:Female; D006801:Humans; D007266:Inhibition, Psychological; D008297:Male; D009415:Nerve Net / Q000502:physiology; D009483:Neuropsychological Tests; D009771:Obsessive-Compulsive Disorder / Q000523:psychology; D017397:Prefrontal Cortex / Q000502:physiology; D005879:Tourette Syndrome / Q000523:psychology*; D000073218:Wisconsin Card Sorting Test
keywords: Tourette syndrome; cognition; executive function; neuropsychological assessment; tics