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Current time:0:00Total duration:8:19

Video transcript

so you may have heard of Tourette's or Tourette's syndrome before and it's possible that when you think about Tourette's you might picture what's been kind of popularized in TV shows and movies which is that people with Tourette's have these kind of verbal outbursts and while this is possible in someone with Tourette's this popularized image of Tourette's is actually not all that common so if this isn't exactly what Tourette's is always like then what is Tourette's well Tourette's is a disorder that causes the person to make sudden really brief unwanted movements and sounds and just before these unwanted movements or sounds occur the person actually feels this urge to make them kind of like that feeling you get when you have an itch that you really want to scratch or like that feeling we get just before we're about to sneeze and just like itching and sneezing right after doing these things the person feels a sense of relief so an example of an unusual unwanted movement could be something like unnecessary blinking or facial expressions or maybe shrugging the shoulders or kicking and an unusual unwanted sound could be something like grunting or repeating words or maybe swearing and there's actually a word to describe these movements and sounds they're called tics so Tourette's is actually a particular type of tic disorders there are a few different types of take disorders and what makes Tourette's different from the other types is that someone with Tourette's has both of these types of tics so the movements and the sounds they might not occur together at exactly the same time but the person does occasionally have both movement and sound tics and something that's really unique to Tourette's and help set it apart from other movement disorders is that many people are able to find ways to suppress their tics so in other words with effort they're able to kind of push away that urge to engage in a tic behavior but often they'll need to release the urge in another way maybe by performing a different movement or sound that is more appropriate while they're in public maybe like blinking or shrugging the shoulders or maybe they'll need to release the urge later on by actually engaging in the tick but this time in privacy so you might have been able to guess from the examples that we put down here these examples of possible takes the Tourette's can look pretty different between different people and that's definitely the case Tourette's is actually a spectrum disorder which means that someone with Tourette's can fall anywhere along a spectrum that ranges from mild to severe where mild would mean that the person's tics the unwanted movements and sounds that they make aren't really noticeable and don't really impact their life so maybe every so often they blink unnecessarily or clear their throat something that you might not even notice and on the severe end of the spectrum the tics that the person has would be really debilitating so maybe their tics involve really noticeable head jerking or saying obscene words these sorts of tics could really impact the person's day-to-day life especially if they occur frequently so Tourette's is a disorder that crops up in childhood usually around the age of about 6 to 7 years old and while we haven't completely figured out what causes Tourette's we do have some clues about the cause so for example we know that a lot of people with Tourette's have parents who also have Tourette's and we also know that boys are about three times more likely to be affected than girls so both of these things suggest that there's probably a genetic cause involved something going on in the genes that are being passed down from the parents to their kids and we also have a clue but where in the brain we think things might be going awry so we know that in the brains of people with Tourette's there's a particular neural circuit that doesn't quite function properly so bear with me here this is a bit of a complex name but we'll go through it in a sec so the quartic Oh striatal thalamic cortical so quartic oh here stands for the cortex of the brain and striatal stands for a striatum which is part of the basal ganglia here and the lamech stands for thalamus so these structures normally chat to each other to coordinate our movements so when someone with Tourette's where this circuit isn't able to function properly well that might explain why movements can't really be prevented like they normally would be and the person ends up with tics so even though we think we I know what's going on in the brains of people with Tourette's we don't currently have a way to actually see this we don't have a brain scan or a blood test to look for undiagnosed Tourette's so instead Tourette's is diagnosed by looking for the movement and vocal tics in children that we suspect might have the disorder now once we determine that someone does indeed have Tourette's what do we do to treat it well it turns out that for a lot of people with Tourette's the disorder is on the mild end of the spectrum here and the tics actually often disappear or at least improve significantly once the child reaches adulthood so for these people we don't usually really need any medications to manage their Tourette's and instead one of the main things that we usually do is something called habit reversal therapy so remember how we mentioned that people with Tourette's can often find a way to suppress their tics so with habit reversal training the idea here is to help the child learn to recognize those urges that happen just before a tick is about to occur and then try to help them find a new habit that they can use to help relieve that urge without performing the tick so maybe their tick is kicking and when they start to feel that urge that would normally be relieved by kicking we get them to itch their nose instead and try to relieve the urge through this movement so even though we're kind of trading one example of a tick for another itching the nose is much more subtle and something that the person can probably do in public to relieve the urge they feel before a tick comes on now for some people they're on the far end of the spectrum so their Tourette's is more severe and it does impact their daily living so when this is the case we might need something more than habit reversal training to manage the tics now when someone has an involuntary sound that they make or maybe a movement that just happens to be in a really specific part of the body one way that we might be able to deal with this is by going directly to the problematic body part so maybe if it's a movement let's say that it's a hand jerk well we could try to stop that from occurring by preventing the messages that neurons send to that particular muscle to tell it to move and funny enough we can actually do this with Botox so when we inject Botox into the hand here that jerks during a tick well that blocks some of the signals coming from the neurons that send messages to the hand to make it active so after the injection of Botox the hand can't really be as active anymore for a few months until the Botox wears off so the tick won't really be as noticeable or may not even occur now sometimes the ticks might not be so localized they might be more widespread so we might need something that acts in a little bit more of a widespread way than Botox does so when this is the case rather than going to the muscles involved in the tics we might need to head back up to the source the brain and try something that will reduce these movements in a more global way and it turns out that we have these particular medications called anti dopaminergic medications that we can use so dopaminergic here is referring to dopamine a chemical that neurons can use to initiate movements in muscles so these anti dopaminergic medications they prevent dopamine in the brain from activating the muscles so much so all these extra movements don't really get initiated and the person's tics hopefully get decreased or go away and it turns out that quite a few kids with Tourette's also have other disorders that co-occur with their Tourette's disorders like attention deficit hyperactivity disorder are also known as ADHD and obsessive-compulsive disorder also known as OCD so for kids with Tourette's that also have one of these other disorders they may need to go on a medication or have some sort of therapy to help them manage these disorders as well as their Tourette's