Introdução: O Transtorno Obsessivo-Compulsivo (TOC) é reconhecido como um transtorno heterogêneo. Esta heterogeneidade dificulta a interpretação dos resultados dos estudos. A descrição de grupos de pacientes mais homogêneos pode facilitar a identificação desta busca, já que pode identificar fenótipos que sejam hereditários e válidos do ponto de vista genético. A abordagem categorial e dimensional são estratégias reconhecidas para a identificação de subgrupos mais homogêneos de pacientes. Dentro da abordagem categorial, o subgrupo de pacientes com início precoce dos sintomas obsessivo-compulsivo (SOC), e o subgrupo de TOC associado a transtorno de tiques apresentam características clínicas semelhantes, com evidências de sobreposição destas características entre os dois grupos. Os objetivos deste estudo foram: investigar características demográficas e clínicas dos pacientes com TOC de início precoce (GP) e TOC de início tardio (GT); e pesquisar características demográficas e clínicas dos pacientes com TOC de início precoce (GP) com tiques e pacientes com TOC de início precoce (GP) sem tiques. Metodologia: Trezentos e trinta pacientes com diagnóstico de TOC de acordo com o DSM-IV foram avaliados diretamente com os seguintes instrumentos: Entrevista Clínica Estruturada para o DSM-IV - Transtornos do Eixo I; Escala Yale-Brown de Sintomas Obsessivo-Compulsivos - Y-BOCS; Escala Dimensional para Avaliação de Presença e Gravidade de Sintomas Obsessivo-Compulsivos DY-BOCS; Escala de Avaliação Global de Tiques desenvolvida pelo Yale Child Study Center - YGTSS. Foi considerado TOC de início precoce se os sintomas dos pacientes tiveram início até os 10 anos de idade (160 pacientes). Os pacientes com início de sintomas entre 11 e 17 anos (95 pacientes) foram denominados grupo intermediário, enquanto aqueles após os 17 anos foram chamados grupo de início tardio (75 pacientes). Resultados: os pacientes do GP se diferenciaram dos pacientes do GT por apresentar maior freqüência do sexo masculino; maior freqüência de história familiar de SOC em familiares de primeiro grau; maiores escores da escala Y-BOCS para compulsões e Y-BOCS total; maior chance de ter obsessões de contaminação; maior chance de ter compulsões de repetição, colecionismo, diversas e compulsões do tipo tic-like; menor chance de ter compulsões de contagem; maior chance de apresentar sintomas da dimensão de \"colecionismo\"; maior gravidade nas dimensões de \"agressão/violência\", \"diversas\" e escore global da escala DY-BOCS; maior número médio de comorbidades; maior probabilidade de ocorrência de transtorno de ansiedade de separação, fobia social, transtorno dismórfico corporal e transtorno de tiques; menor chance de apresentar transtorno de estress pós-traumático; e maior chance de ter redução de 35% dos sintomas na escala Y-BOCS. O GP com tiques se diferenciou do GP sem tiques por apresentar maior prevalência de fenômenos sensoriais; menor chance e menor gravidade de ter a dimensão de \"contaminação/limpeza\" e menor gravidade no escore global da escala DY-BOCS; menor chance de apresentar transtorno de humor, transtorno unipolar, transtornos ansiosos, fobia social e skin picking, e maior a chance de apresentar diminuição de 35% dos sintomas na escala Y-BOCS. Os resultados sugeriram que as diferenças encontradas entre os grupos precoce, intermediário e tardio foram devidas à própria idade de início, e outras diferenças foram devidas à presença de tiques. / Introduction: Obsessive-compulsive disorder (OCD) is recognized as a heterogeneous condition. This heterogeneity obscures the interpretation of the results of the studies. The description of more homogeneous groups of patients can facilitate the identification of this search, since it can identify phenotypes that are hereditary and valid to the genetic point of view. Categorical and dimensional approaches are recognized strategies for the identification of more homogeneous subgroups of patients. Regarding the categorical approach, the subgroup of patients with early age at onset of the obsessive-compulsive symptoms (OCS), and the tic-related-OCD subgroup present similar clinical characteristics, with evidences of an overlap of these characteristics between the two groups. The aims of this study were: to investigate clinical and demographic characteristics of the early age at onset subgroup (EO), compared to the late onset subgroup (LO); and to investigate demographic and clinical characteristics of early age at onset OCD patients, with and without comorbid tic disorders. Methodology: Three hundred and thirty patients with the diagnosis of OCD according to the DSM-IV were directly assessed with the following instruments: Structured Clinical Interview for DSM-IV Axis I Disorders-patient edition - SCID-I/P; Yale-Brown Obsessive-Compulsive Scale - Y-BOCS; Dimensional Yale-Brown Obsessive-Compulsive Scale - DY-BOCS and Yale Global Tics Severity Scale - YGTSS. We considered early age at onset when OCS began before the age of 10 (160 patients). Patients with age at onset between 11 and 17 years old were termed intermediate group (95 patients), whereas those with age at onset after 17 years old were designated as late onset OCD (75 patients). Results: EO patients differed from LO patients in terms of presenting higher frequency of the male gender; higher frequency of a family history of OCS; higher Y-BOCS for compulsions and total Y-BOCS scores; higher chance of presenting contamination obsessions, repeating, hoarding, miscellaneous and tic-like compulsions; lower chance of having counting compulsions; higher probability of presenting symptoms of \"hoarding\" dimension; higher severity in \"aggression/violence\" and \"miscellaneous\" dimensions and global DY-BOCS scale score; higher mean number of comorbidities; higher probability of presenting separation anxiety disorder, social phobia, body dysmorphic disorder and tic disorders; lower chance of presenting posttraumatic stress disorder; and a higher chance of having a 35% reduction on the Y-BOCS scale. The EO subgroup with tic disorders differed from the EO without tics for presenting higher chance of having sensory phenomena, somatic obsessions; lower chance and lower score in the DY-BOCS scale; lower chance of presenting mood disorder, depressive disorder, anxiety disorders, social phobia and skin picking; higher chance of having a 35% reduction on the Y-BOCS scale. Results suggested that the differences found among early, intermediated and late onset groups with early onset were secondary to the own age at onset, and other differences were secondary to the presence of tics.

Increasing numbers of children being referred for mental health services are exhibiting problematic behaviors that can be subsumed under the category of Disruptive Behavior Disorders. This study with its foundations in a post-positivist approach was designed to explore treatment effectiveness of cognitive behavioral intervention applied to adolescents at Oak Grove Institute, a residential treatment facility. This study hypothesized that Wexler's PRISM Model, with its integration of affect, would be instrumental in modifying disruptive behavior as measured at Oak Grove Institute. Although the small sample size precluded statistically significant findings, there were interesting results with respect to two dependant variables. Findings approached significance on measures of impulsivity and verbal aggression. That is, impulsivity and verbal aggression scores were lowered.

Ce qui caractérise principalement le syndrome de Gilles de la Tourette (SGT), c’est la présence de tics moteurs et vocaux chez les individus qui en sont atteints. Toutefois, les tics ne sont que la pointe de l’iceberg pour plusieurs patients. Le SGT s’accompagne souvent de troubles concomitants. Les plus fréquents sont le trouble obsessionnel-compulsif et le trouble du déficit de l’attention avec ou sans hyperactivité. De plus, certaines études neuropsychologiques ont rapporté que les patients atteints du SGT présentaient des capacités d’inhibition réduites, ce qui seraient directement associées à la difficulté de contrôler les tics. Toutefois, plusieurs résultats contradictoires ont été publiés à ce sujet. Aussi, plusieurs hypothèses ont été avancées pour expliquer la génération des tics. Parmi celles-ci, on retrouve notamment certaines études qui ont identifié une suractivité des régions motrices du cerveau. Encore ici, il n’existe pas de conclusion définitive au sein de la littérature. On ne peut guérir du SGT, mais il existe plusieurs traitements qui permettent de diminuer la sévérité des symptômes. La pharmacothérapie est généralement efficace, mais s’accompagne souvent d’effets secondaires indésirables. La thérapie cognitive-comportementale s’avère est une avenue de traitement intéressante, car elle n’entraîne pas d’effets secondaires sur le plan physique. Bien que son efficacité ait été maintes fois démontrée, on ne connaît toujours pas les mécanismes neuronaux impliqués dans son fonctionnement. L’objectif général de cette thèse était de mieux comprendre le fonctionnement cognitif des patients atteints du SGT et d’identifier les substrats neurobiologiques qui sous-tendent ces fonctions. Nous souhaitions observer comment ces fonctions évoluent suite à une thérapie cognitive-comportementale permettant de diminuer les tics. Cet objectif général a été divisé en trois volets. Le premier volet visait à mieux comprendre et à quantifier les déficits d’inhibition retrouvés au sein du SGT, ainsi que les facteurs qui les modulent. Nous voulions également identifier les corrélats électrophysiologiques des capacités d’inhibition. Le deuxième volet concernait les processus de préparation et d’exécution des mouvements et leur lien avec la symptomatologie du SGT. Dans le troisième volet, nous avons investigué l’impact d’une thérapie cognitive-comportementale sur le fonctionnement cérébral des patients atteints du SGT. Nous avons tenté également d’identifier des prédicteurs du succès thérapeutique. Pour répondre à ces objectifs, nous avons d’abord réalisé une méta-analyse pour déterminer si les patients atteints du SGT présentaient des déficits d’inhibition et pour comprendre quels facteurs influençaient les capacités d’inhibition. À l’aide des potentiels évoqués, nous avons aussi évalué les corrélats électrophysiologiques des capacités d’inhibition (P300 No-Go) à l’aide d’une tâche de compatibilité stimulus-réponse qui incluait une composante No-Go. Nous avons aussi évalué les corrélats électrophysiologiques des processus de préparation et d’exécution motrice (sLRP et rLRP) durant cette même tâche. Finalement, nous avons investigué comment une thérapie cognitive-comportementale pouvait modifier l’activité du cerveau, à la fois durant la tâche de compatibilité stimulus-réponse (sLRP et rLRP) et durant une tâche oddball (P300; onde positive apparaissant environ 300 ms après la présentation d’un stimulus et associée à l’évaluation et à la catégorisation des stimuli). Nos résultats ont d’abord démontré que les patients atteints du SGT présentaient des déficits d’inhibition durant les tâches de Stroop, de complétion de phrases, de tracement de cercles, et la Continuous Performance Task. Toutefois, la performance durant les tâches de compatibilité stimulus-réponse et Go/No-Go était quant à elle normale. La présence d’un TDAH ainsi que des tics plus sévères étaient associés à des déficits d’inhibition plus importants. Notre étude électrophysiologique a révélé une P300 No-Go plus ample au niveau frontal chez les patients atteints du SGT, en comparaison avec des sujets sains. Ensuite, dans les conditions compatibles et incompatibles, les patients atteints du SGT ont présenté un délai relatif à l’amorce du sLRP ainsi qu’une plus grande amplitude du rLRP, suggérant ainsi un délai quant à la préparation des mouvements, ainsi qu’une plus grande activité des aires motrices du cerveau lors de l’exécution des mouvements. Cette activité s’est toutefois normalisée suite à la thérapie. La latence de l’amorce du sLRP incompatible combinée à l’amplitude de la N200 (onde négative apparaissant environ 200 ms après la présentation d’un stimulus et associée au contrôle cognitif) incompatible ont permis de prédire 43% de la variance associée à la diminution des tics après le traitement. Finalement, nous avons aussi observé que la thérapie permettait une normalisation de la P300 dans une tâche oddball, ce qui suggère que davantage de ressources cognitives sont désormais mobilisées dans les processus de mémoire de travail. Cette normalisation était localisée au niveau du cortex pariétal. Toutefois, l’activité cérébrale mesurée durant cette tâche ne permettait pas de prédire le succès thérapeutique. Nous avons donc démontré que les patients atteints du SGT présentaient un patron d’activité corticale différent de celui des participants contrôles, en lien avec les fonctions motrices et l’inhibition. Les changements relatifs à la symptomatologie du SGT induits par la thérapie cognitive-comportementale se reflètent aussi au niveau du fonctionnement cérébral des patients, où certaines modifications spécifiques peuvent être vues. / Tourette syndrome (TS) is mainly characterized by the presence of motor and vocal tics. However, tics are just the tip of the iceberg for many patients. TS often comes with concomitant disorders, such as obsessive-compulsive disorder and attention deficit hyperactivity disorder. In addition, some neuropsychological studies have reported that TS patients show diminished inhibitory functions, which could be reflected in an incapacity to inhibit tics. However, no consensus has been reached on the matter of inhibitory functions in TS. Also, several hypotheses have been advanced to explain the generation of tics. Some studies that have identified overactivity of motor regions of the brain as a cause of tic generation. Here again, there is no definitive conclusion in the literature. While TS cannot be fully cured, several treatment options exist. These treatments have been shown to reduce tic severity. Pharmacotherapy is usually effective in most patients but is often accompanied by unwanted side effects. Cognitive-behavioral therapy was found to be an interesting treatment avenue since it does not cause physical side effects. Although its effectiveness has been demonstrated many times, its neural mechanisms are still poorly understood. The objective of this thesis was to give a better understanding of the cognitive functioning of TS patients and to investigate the neurofunctional substrates underlying these functions. We also wanted to evaluate the impact of a cognitive-behavioral therapy on these functions. This general objective was divided into three specific objectives. The first objective was to better understand inhibitory deficits found in TS. We also wanted to identify the electrophysiological correlates of inhibitory functions. The second objectives concerned movement preparation and execution processes, as well as the link between these processes and the symptomatology of TS. For the third objective, we investigated the impact of a cognitive-behavioral therapy on the brain function of TS patients and tried to identify predictors of treatment outcome. To this end, we first performed a meta-analysis of inhibitory functions in TS patients. This meta-analysis first aimed to determine if TS patients truly exhibited inhibitory deficits, and then to understand the factors influencing such deficits. Using event-related potentials, we also evaluated the electrophysiological correlates of inhibitory function (P300 No-Go) using a stimulus-response compatibility task that included a No-Go component. We also evaluated the electrophysiological correlates of motor preparation and execution processes (sLRP and rLRP) during the same task. Finally, we investigated how cognitive-behavioral therapy could alter brain activity, both during the stimulus-response compatibility task (sLRP and rLRP) and during an oddball task (P300; a positive wave peaking approximately 300 ms after stimuls onset and associated to stimulus evaluation and categorization). Our results first showed that TS patients had inhibitory deficits during the Stroop task, sentence completion paradigm, circle tracing task, and the Continuous Performance Task. The performance during the stimulus-response compatibility and Go/No-Go compatibility tasks was however normal. The concomitant presence of ADHD as well as more severe tics were associated with greater inhibitory deficits. Our electrophysiological study revealed a larger frontal No-Go P300 in TS patients. Then, in compatible and incompatible conditions, TS patients presented a delayed sLRP onset, as well as a larger rLRP peak. This suggests a delay in movement preparation, as well as an overactivation of motor areas during movement execution. These measures were however normalized following cognitive-behavioral therapy. The latency of the incompatible sLRP onset and the incompatible N200 (a negative wave peaking approximately 200 ms after stimuls onset and associated to cognitive control) amplitude predicted 43% of the variance associated with the decrease in tic severity after treatment. Finally, we also observed that the therapy allowed a normalization of the P300 in an oddball task, which suggests that more cognitive resources are now mobilized by working memory processes. This normalization was localized to the parietal cortex. However, brain activity measured during this task was not predictive of treatment outcome. With regards to motor function and inhibition, TS patients display a pattern of cortical activity that differs from that of control participants. Changes in the symptomatology of TS induced by cognitive-behavioral therapy are also reflected in the cerebral functioning of patients, where specific normalization in brain activity can be found.

M.A. (Counselling Psychology) / The treatment of learning- and associated socio-emotional problems as found in ADHD has long been researched and practiced. The treatment still doesn't seem 100% effective since it helps in some cases but worsens effects in others. The literature aroused the possibility that other disorders could occur under the same behavioural symptoms as displayed in ADHD. One of these is Tourette's disorder ...

L'objectif de cette thèse est d'identifier et caractériser les boucles anatomiques et fonctionnelles cortico-sous-corticales chez l'Homme, à partir de données d'imagerie par résonance magnétique fonctionnelle (IRMf) au repos et de diffusion. Une boucle est un ensemble de régions corticales, sous-corticales et cérébelleuses, qui interagissent afin d'effectuer ou de préparer une tâche.Le premier axe de ce travail vise à identifier les réseaux fonctionnels cortico-sous-corticaux en IRMf au repos. Nous proposons une méthode statistique robuste séparant l'analyse corticale de l'analyse sous-corticale. Une analyse en composantes indépendantes spatiales est d'abord réalisée individuellement sur les régions corticales, et suivie d'une classification hiérarchique. Les régions sous-corticales associées sont ensuite extraites par un modèle linéaire général dont les régresseurs comportent la dynamique des régions corticales, suivi d'une analyse de groupe à effets aléatoires. La méthode est validée sur deux jeux de données différents. Un atlas immunohistochimique des structures sous-corticales permet ensuite de déterminer la fonction sensorimotrice, associative ou limbique des réseaux obtenus. Nous montrons enfin que l'anatomie est un support pour la fonction chez des sujets sains.Le dernier axe étudie le syndrome de Gilles de la Tourette, qu'on pense être dû à un dysfonctionnement des boucles cortico-sous-corticales. Nous caractérisons d'abord les boucles cortico-sous-corticales fonctionnelles grâce à des métriques d'intégration et de théorie des graphes, et des différences en termes de connectivité sont mises en évidence entre patients adultes et volontaires sains. Nous montrons également que les boucles cortico-sous-corticales fonctionnelles chez les patients sont soutenues par l'anatomie sous-jacente. / The objective of this thesis is to identify and characterize human anatomical and functional cortico-subcortical loops, using data from resting-state functional magnetic resonance imaging (fMRI) and diffusion MRI. A loop is a set of cortical, subcortical and cerebellar regions that interact to perform or prepare for a task.We first aim to identify cortico-subcortical functional networks from resting-state fMRI data. We propose a robust statistical method that separates the analysis of cortical regions from that of subcortical structures. A spatial independent component analysis is first performed on individual cortical regions, followed by a hierarchical classification. The associated subcortical regions are then extracted by using a general linear model, the regressors of which contain the dynamics of the cortical regions, followed by a random-effect group analysis. The proposed approach is assessed on two different data sets. An immunohistochemical subcortical atlas is then used to determine the sensorimotor, associative or limbic function of the resulting networks. We finally demonstrate that anatomy is a support for function in healthy subjects.The last part is devoted to the study of the Gilles de la Tourette syndrome, thought to be due to adysfunction of cortico-subcortical loops. Firstly, cortico-subcortical functional loops are characterized using metrics such as integration and graph theory measures, showing differences in terms of connectivity between adult patients and healthy volunteers. Secondly, we show that the cortico-subcortical functional loops in patients are supported by the underlying anatomy.

Este estudo avaliou 106 crianças e adolescents com TOC e 44 probandos controle. Estes probandos e seus 465 familiares de primeiro grau foram avaliados por entrevistadores treinados, usando entrevistas semi-estruturadas. Diagnósticos foram determinados pelo DSM-IV, pelo processo de estimativa de diagnóstico. Comparados aos "familiares controle", "familiares caso" tiveram risco significativamente aumentado para TOC (22.7% vs. 0.9%) e tiques (11.6% vs. 1.7%). Houve uma correlação significativa entre as idades de início do TOC nos probandos e seus familiares. Estes dados sugerem que o TOC de início precoce é um transtorno altamente familiar. / The current study examined 106 children and adolescents with OCD and 44 control probands. These probands and their 465 first-degree relatives were assessed by trained interviewers, using standardized semi-structured interviews. Diagnoses were assigned according to DSM-IV criteria, through the best-estimate process. Compared to control relatives, case relatives had higher age-corrected recurrence risks of OCD (22.7% vs. 0.9%) and tics (11.6% vs. 1.7%). There was a significant correlation between the ages of onset of OCD in probands and their affected relatives. These data suggest that childhood onset OCD is a highly familial disorder.

Les troubles des tics, comme le syndrome de Gilles de la Tourette et le trouble de tics chroniques, sont des conditions neuropsychiatriques impliquant des tics moteurs et/ou phoniques. En plus de nombreuses comorbidités, les patients qui en sont atteints ont aussi des difficultés neuropsychologiques, notamment au niveau de l’inhibition et des fonctions motrices. La thérapie cognitivo-comportementale permet d’améliorer les tics et la condition générale de ces patients. Nous avons donc enregistré, durant une tâche de compatibilité stimulus-réponse, les potentiels évoqués cognitifs et les potentiels de latéralisation motrice (lateralized readiness potential; LRP) chez 20 patients atteints de trouble des tic avant et après une thérapie cognitivo-comportementale, et chez 20 participants contrôles. Chez les patients atteints de trouble des tics, nos résultats ont révélé une apparition plus tardive de l’amorce du LRP moyenné par rapport au stimulus, une amplitude plus élevée du LRP moyenné par rapport à la réponse, et une suractivation frontale liée aux processus d’inhibition. Suite à la thérapie, le retard au niveau de la latence de l’amorce du LRP moyenné par rapport à la réponse est comblé et l’amplitude du LRP moyenné par rapport à la réponse est normalisée, mais pas la suractivation frontale liée à l’inhibition. Cela suggère donc que la thérapie induit une modification des processus prémoteurs de sélection et de préparation de la réponse, ainsi que des processus d’exécution motrice, mais n’altère pas la suractivation frontale reliée aux fonctions inhibitrices. Étant donnés ces résultats, nous suggérons que la thérapie cognitivo-comportementale induit une modification du fonctionnement des aires motrices du cerveau. / Gilles de la Tourette syndrome and chronic tic disorder are two neuropsychiatric condition involving motor and/or phonic tics. In the DSM, these two conditions are characterized as “tic disorders”. Patients with such diagnoses face numerous comorbidities, and also show multiple neuropsychological impairments, especially concerning inhibition and motor processing. Tic symptoms, as well as general condition, can be improved with a cognitive-behavioural therapy (CBT). To this end, we recorded, during a stimulus-response compatibility task, event-related potentials and lateralized readiness potentials in 20 patients with tic disorder and 20 healthy controls. Patients and controls were paired on age, sex and hand dominance. Our result revealed a delay in stimulus-locked lateralized readiness potential (LRP) onset latency, higher response-locked LRP peak amplitude and a frontal overactivation related to stimulus inhibition in GTS and CTD patients. Following CBT, stimulus-locked LRP onset latency and response-locked LRP peak amplitude were normalized, but the frontal overactivation related to inhibition processing remained unchanged. These results suggest that CBT induces a modification of pre-motor processes such as response selection and preparation, as well as motor processes like response execution, but does not affect cortical activation related to stimulus inhibition. Since we found a reduction in tic symptoms, as well as a normalization of stimulus-locked LRP onset latency and response-locked LRP peak amplitude, and because LRPs are partly generated by the supplementary motor area, we suggest that CBT leads to a modification of this structure’s functioning.

Les tics affectent 1% des individus et sont associés avec une diminution de la qualité de vie. L’importante hétérogénéité phénoménologique retrouvée chez ceux-ci représente un obstacle majeur pour l’évaluation et le traitement de ces symptômes, et explique potentiellement la présence de données neurobiologiques contradictoires. Certaines variables rarement contrôlées, comme la complexité des tics et la demande motrice des tâches pourraient expliquer l’hétérogénéité de ces résultats. Une meilleure compréhension des processus cognitifs affectés pourrait être atteinte par l’étude de la chronométrie des événements cérébraux. Ainsi, notre objectif était d’évaluer l’impact de la complexité des tics et du type de réponse sur les potentiels électrocorticaux liés à l’inhibition, à l’attention et à la mémoire de patients tics. Nous avons comparé 12 patients présentant des tics simples avec 12 patients atteints de tics complexes, qui furent appariés à 15 participants contrôles sains. Deux tâches oddball furent accomplies, dont l’une exigeait une réponse motrice et l’autre une réponse non-motrice (compter le nombre de stimuli). Durant ces tâches, nous avons enregistré des composantes électrocorticales indexant des processus d’attention (P200), d’inhibition (N200) et de mémoire (P300). Pour la tâche non-motrice, nos résultats révélèrent une N200 plus ample chez les deux groupes de patients tics et une P300 réduite seulement chez ceux avec des tics simples. Quant à la tâche motrice, les deux groupes de patients tics présentaient une P300 réduite. Selon nos résultats, la complexité des tics et la demande motrice des tâches peuvent affecter les mécanismes neuronaux sous-tendant les différentes étapes du traitement de l’information. / Tic disorders affect up to 1% of individuals worldwide and are associated with social stigma. A major obstacle to these disorders’ evaluation and treatment is the large heterogeneity of phenotypes, which could explain the important number of conflicting neurobiological data. Certain variables, like tic complexity and tasks’ cognitive demand, could explain these heterogeneous results. We propose that a better understanding of cognitive impairments often seen in tic disorders could be obtained by studying the chronometry of electrocortical activity underlying inhibition, attention, memory and motor processes. Our aim was to evaluate the impact of tic complexity as well as task response demand on tic patients’ electrocortical profiles. Thus, we compared 12 patients exhibiting simple tics to 12 patients showing complex tics, and matched them to 15 healthy control participants. All participants performed two Oddball tasks in which one required a motor response (button press) and the other a non-motor response (counting). During both tasks, electrophysiological components were recorded, serving as indices of processes underlying attention (P200), inhibition (N200) and memory (P300). Our results revealed that for the non-motor task, both groups of tics patients had an enhanced N200, while only those with simple tics showed a reduced P300. For the motor task, both groups of tics patients exhibited a decreased P300. According to our results, both tic complexity and motor demand can affect neural mechanisms of the processing stream. Conflicting results found in previous studies might have been confounded by tic complexity as well as task motor requirements.

Este estudo avaliou 106 crianças e adolescents com TOC e 44 probandos controle. Estes probandos e seus 465 familiares de primeiro grau foram avaliados por entrevistadores treinados, usando entrevistas semi-estruturadas. Diagnósticos foram determinados pelo DSM-IV, pelo processo de estimativa de diagnóstico. Comparados aos "familiares controle", "familiares caso" tiveram risco significativamente aumentado para TOC (22.7% vs. 0.9%) e tiques (11.6% vs. 1.7%). Houve uma correlação significativa entre as idades de início do TOC nos probandos e seus familiares. Estes dados sugerem que o TOC de início precoce é um transtorno altamente familiar. / The current study examined 106 children and adolescents with OCD and 44 control probands. These probands and their 465 first-degree relatives were assessed by trained interviewers, using standardized semi-structured interviews. Diagnoses were assigned according to DSM-IV criteria, through the best-estimate process. Compared to control relatives, case relatives had higher age-corrected recurrence risks of OCD (22.7% vs. 0.9%) and tics (11.6% vs. 1.7%). There was a significant correlation between the ages of onset of OCD in probands and their affected relatives. These data suggest that childhood onset OCD is a highly familial disorder.

No description available.