Sat. Jun 4, 2022 1:00 PM - 2:30 PM Room 2 (Main Hall A)

Chair: Yoshiko Nomura(Yoshiko Nomura Neurological Clinic for Children),Lillian Lee(Philippine Children's Medical Center)

【企画・趣旨のねらい】
Tourette syndrome（TS）is a frequently observed developmental neuropsychiatric disorder occurring in children. Tics are an involuntary movement, and consist of motor tics and phonic tics. TS is one of the tic disorders and defined as the multiple motor tics associated with phonic tics lasting more than one year. It is associated with other behavior disorders such as attention deficit hyperactivity disorder（ADHD）, obsessive compulsive disorder（OCD）, and others.
The onset of tics and behavioral symptoms show the characteristic age dependency. The natural course takes also age related changes, i.e. starting in the early childhood, waxing and waning through the mid to late childhood, and subsiding by the late teens. There are some cases whose symptoms continue to the adulthood, and a few cases even exacerbate in adulthood.
There is gender difference involving male more than female. The familial occurrences of tic disorders are well known. Tics also fluctuate under the various environments.
Thus, the pathophysiology of TS involves both genetic and environmental factors.
The effects of haloperidol reported by Seignot in 1961 suggested the role of nigrostriatal dopamine（NS—DA）system as an essential part of the pathophysiology.
The hypothesis of the pathophysiology include the followings.
The activity of tyrosine hydroxylase（TH）which convert tyrosine to dopa takes age dependent changes at striatum, the terminal of NS—DA system. The activity is high in the early childhood, decreases rapidly till around 10 years of age, moderately till mid—teens, and reaches to low adult level. The hypothesis based on the data from sleep components analysis suggested the age dependent decrease of DA activity at the striatum is accelerated, and causes the DA receptor super—sensitivity.
Associated behavior abnormalities such as OCD, anxiety and depressive mood imply the possible involvement of serotonergic system.
The roles of basal ganglia—thalamo—cortical pathway are also discussed for the motor tics, and the non—motor circuits are thought to be involved in other behavior disorders and complex tics. There are three non—motor circuits, which are dorsolateral prefrontal circuit, lateral orbitofrontal and anterior cingulate circuit. Among these, lateral orbitofrontal and anterior cingulate circuit are involved in the pathophysiology of TS.
This symposium, titled as“Tourette Syndrome in Asia”, covers the following subjects, and aims to share and to discuss about TS and associated behavior problems in Asia.
1）‘Clinical features and Treatments'is presented by Huei—Shyong Wang, Taiwan
2）‘Tourette syndrome in different cultures and environments；
Tics and Tourette syndrome at the Philippine Children's Medical Center：
A Single Center Experience'is presented by Marilyn Ortiz and Lillian Lee, The Philippines.
3）‘Tourette syndrome；The Histories and Neurosciences'is presented by Yoshiko Nomura, Japan.