Impulsivity in Tourette Syndrome : Behavioral and Neuroimaging Study (COGIT)

Institut National de la Santé Et de la Recherche Médicale, France

Status: Completed

Conditions: Tourette Syndrome

Treatments: Other: IRM and comportemental tasks

Study type: Interventional

Funder types: Other

Identifiers

NCT02960698

2016-A00936-45 (Registry Identifier)

C16-07

Details and patient eligibility

About

Tourette syndrome (TS) is characterized by the presence of multiple vocal and motor tics. Behavioral disorders associated with TS are common, particularly impulsivity, anti-sociality and socially inappropriate behavior. Specifically, cognitive impulsivity could be the source of these troubles. Its anatomical substrates is based on connections between frontal and striatal areas.

Initially, a battery of behavioral tests measuring different types of impulsivity (motor, cognitive and decision) will be administered on three groups of subjects: TS: 80 patients (40 patients treated and 40 untreated) and 40 healthy volunteers.

Then, investigators will study the fronto-striatal connections in the TS group of 80 patients (40 patients treated and 40 untreated) compared to 40 healthy volunteers using neuroimaging techniques (3T MRI). The techniques used will be functional connectivity study of "resting state" MRI (RS-fMRI) combined with a reconstruction of white matter fibers by diffusion tensor imaging (DTI). Behavioral performance will be correlated with the correlation imaging data to highlight the functional anatomical substrates of impulsivity in patients with TS.

Finally, investigators will look specifically using functional MRI activation, the anatomical and functional substrates of the three types of impulsivity (motor, cognitive and decision-making).

Through this study, investigators hope to elucidate the anatomical and functional bases of cognitive impulsivity in patients with TS and thus lay the basis for more targeted treatments.

Enrollment: 98 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

For all subjects:

• ≥ about 18 and 65 years old
• About receiving Social Security or universal health coverage or any equivalent plan
• About who signed the informed consent

For TS patients treated :

• TS principal diagnosis, based on the DSM-5 criteria
• Stable pharmacological treatment at least 4 weeks prior to study entry;
• Possibility of controlling the majority tics of the upper part of the body lying down for at least 10 minutes (frequency tics on YGTSS <3).

For TS patients untreated:

• TS principal diagnosis, based on the DSM-5 criteria
• No psychotropic treatments (neuroleptics, antidepressants or anxiolytics) mentioned at the time of inclusion.
• Possibility of controlling the majority tics of the upper part of the body lying down for at least 10 minutes (frequency tics on YGTSS <3).

In healthy volunteers:

• Normal neurological examination (evaluation MINI).
• No regular pharmacological treatment with the exception of birth control pills for women

Exclusion criteria

For all patients TS:

• Age <18 years.
• Presence One of the following diagnoses Axis I DSM-5: schizophrenic disorders or current psychotic episode or in the past, bipolar disorder, current major depressive disorder autism spectrum.
• Abus Psychotropic substance dependency or a psychotropic substance, including alcohol (except nicotine).
• Support Regular / chronic drugs and other xenobiotics tropic psychotropic.
• Support Treatment with benzodiazepines in the 4 months prior to study entry. -Patient Subject to a measure of legal protection (guardianship, curatorship or safeguard justice). -No private freedom by administrative decision or justice.
• No Unable to consent and are not subject to a protection measure.
• Participation In other biomedical research or subjected to an exclusion period for another search.
• Problems General understanding.
• Weight Of more than 150 kg.
• Inability To maintain an upper portion of movement of the body lying down for at least 10 minutes (frequency tics on YGTSS> 3).

In healthy volunteers (HV):

• psychiatric disorders, cognitive impairment assessed by the MINI scale.
• About not being able to understand the tasks
• age <18 years.
• No Subject to a measure of legal protection (guardianship, curatorship or safeguard justice).
• Participation In other biomedical research or subjected to an exclusion period for another search.
• Not Unable to consent and are not subject to a protection measure.
• Not private freedom by administrative decision or court

For TS patients (treated and untreated) and HV

• relative to MRI 3Tesla : pacemaker, cardiac cell or neural stimulator ferromagnetic surgical clips body intraocular or intracranial metallic foreign cochlear implant artificial heart valve or arterial metal surgical equipment metallic material that could concentrate the radio frequency pulses pregnant women, women in labor or lactating aneurism Standing up the eyelids vascular malformation of the brain
• Topic not wishing to be informed of a clinically significant abnormality discovered during the realization of MRI

Trial design

Primary purpose: Other

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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98 participants in 3 patient groups, including a placebo group

TREATED PATIENT WITH TOURETTE SYNDROME

Active Comparator group

Description:

comportemental tasks included impulsivity tests will performed at V1 Resting state IRM will be performed at V2 40 patients

Treatment:

Other: IRM and comportemental tasks

UNTREATED PATIENT WITH TOURETTE SYNDROME

Active Comparator group

Description:

comportemental tasks included impulsivity tests will performed at V1 Resting state IRM will be performed at V2 40 patients

Treatment:

Other: IRM and comportemental tasks

Healthy volunteers

Placebo Comparator group

Description:

comportemental tasks included impulsivity tests will performed at V1 Resting state IRM will be performed at V2 80 subjects

Treatment:

Other: IRM and comportemental tasks