Wilford Hall to evaluate Tourette syndrome program Published Dec. 5, 2005 By Sue Campbell 59th Medical Wing Public Affairs LACKLAND AIR FORCE BASE, Texas (AFPN) -- Wilford Hall Medical Center received a $3 million multi-site National Institutes of Health grant to evaluate a behavior therapy program to help control tics in adults who suffer Tourette syndrome. Tourette syndrome is a neurological disorder characterized by enduring motor and vocal tics. “A growing body of evidence suggests that behavioral treatments may work just as well as the current medications, without the drug side effects,” said Dr. Alan Peterson of the University of Texas Health Science Center at San Antonio “Behavior therapy alone, or in conjunction with medication, may help to reduce tics in individuals who are not sufficiently helped with currently available treatments,” said Dr. Peterson, a professor in the center’s psychiatry department. The university will also take part in the evaluation. The syndrome’s motor tics are usually rapid and darting movements of face, head, neck and shoulders. However, the tics in TS may also involve the extremities and more complex movements that are purposeful in appearance. Vocal tics are usually simple sounds such as throat clearing, snorting or grunting or more complex sounds including the repetition of words or short phrases. The tics of TS fluctuate over time with a peak severity between the ages 10 and 12 years in most cases. For some patients, however, the tics persist into adulthood and may be associated with considerable distress or social and occupational impairment. The current standard treatment for tic suppression is medication, particularly drugs that block dopamine in the brain. However, the medications often produce a dose-related range of adverse effects that may threaten compliance and result in premature termination of treatment, according to researchers. But currently available medications rarely eliminate all tics. Given these limitations, adults with TS are often faced with a partial response to medication. Others choose not to use medication due to unacceptable side effects, so research is exploring non-pharmacological interventions. The study will evaluate the effectiveness of habit reversal, a behavior therapy treatment approach that Dr. Peterson helped develop almost 20 years ago. The program will involve 10 sessions of behavioral treatments with follow-up assessments at three- and six-month intervals. One hundred twenty adults with TS will be randomly assigned to receive habit reversal or supportive psychotherapy. The study will be conducted at UTHSCSA, but military beneficiaries will also be eligible to participate. There are a number of active duty military members and their family members who suffer from TS with mild to severe tics. Dr. Peterson, a retired Air Force psychologist, will head the study at the university center. "My new research position will allow me to foster and expand the collaborative relationship between Wilford Hall and UTHSCSA,” Dr. Peterson said. "Most of my other research -- on tobacco cessation, weight management, chronic pain management and post traumatic stress disorder -- will continue at Wilford Hall.” The doctor said research is one of the joint programs between Wilford Hall and the university. “We have an outstanding relationship that involves graduate medical education, not only in psychiatry, but also in general surgery, nephrology and nuclear medicine,” he said. Yale and Harvard universities will also participate in the evaluation.