1) Streptococcal infections and neuropsychiatric disorders

On 23 October a meeting was held in London convened by Professor Gavin Giovannoni and funded by the European Science Foundation. There were 28 participants from around Europe and the discussion was around a proposed study into the link between streptococcus infection and neuropsychiatric disorders which we hope will go ahead on a Europe-wide basis in due course.

There has also been a couple of new papers- one for and one against this elusive link:

This paper shows that, in 45 cases, streptococcal infection predicted an increase in tic and obsessional symptoms and, interestingly, increased the effect of social stress which is also very important. It was concluded that a minority of children with TS are indeed sensitive to Strep.

This is a study by Dr. Harvey Singer, who has been more sceptical about the link with streptococcus. In this study his group found that there was no difference in antibodies found in TS and non-TS cases. This is the kind of study where different groups can spend a long time debating the different methods used and whether one lab's result can be replicated at another lab or not- it is still very difficult to define the underlying science here.

2) Deep Brain Stimulation

TA members will already have heard of this study on deep brain stimulation via the TA newsletter.

This is a follow up study of Italian patients who had DBS surgery two years ago. After the two years the treatment appeared to maintain its effectiveness for tics and neuropsychiatric symptoms.

In the UK a study at Birmingham and London is starting. I have certainly met patients with very severe TS who nonetheless don't like the idea of surgery. It may be that the option when available is less popular than was expected.

You may like to take a look at this accompanying article which is written for patients.

3) Cognitive function and self-perception in a children with Tourette Syndrome in Sweden

This Swedish paper is worth mentioning as Dr. Khalifa has been conducting excellent population-based work in which TS cases are found ("ascertained") in schools rather than in clinics, removing the bias of a sample that has come to see a doctor.

This is a study of 25 children with TS. One third had cognitive problems and negative self-perceptions and this was not related to the severity of their tics. This is an important indicator of the significance of the 1% frequency of TS in children- it may be important even in "mild" cases where the tics are not bad enough to go to a specialist.