Featured Publications
Comparative efficacy, tolerability, and acceptability of pharmacological interventions for the treatment of children, adolescents, and young adults with Tourette's syndrome: a systematic review and network meta-analysis
Farhat L, Behling E, Landeros-Weisenberger A, Levine J, Macul Ferreira de Barros P, Wang Z, Bloch M. Comparative efficacy, tolerability, and acceptability of pharmacological interventions for the treatment of children, adolescents, and young adults with Tourette's syndrome: a systematic review and network meta-analysis. The Lancet Child & Adolescent Health 2022, 7: 112-126. PMID: 36528030, DOI: 10.1016/s2352-4642(22)00316-9.Peer-Reviewed Original ResearchConceptsSecond-generation antipsychotic drugsMedication categoriesAntipsychotic drugsModerate certaintyIndividual medicationsTourette syndromePharmacological interventionsLow certaintyWHO International Clinical Trials Registry PlatformInternational Clinical Trials Registry PlatformSystematic reviewClinical Trials Registry PlatformChoice of medicationCochrane Central RegisterNetwork meta-analysis frameworkTrials Registry PlatformRandom-effects networkTerms of tolerabilityCertainty of evidenceClinical practice guidelinesComorbid attention deficit hyperactivity disorderStandardised mean differenceTreatment of childrenAttention deficit hyperactivity disorderWeb of ScienceMeta-Analysis: Treatment of Attention-Deficit/Hyperactivity Disorder in Children With Comorbid Tic Disorders
Bloch MH, Panza KE, Landeros-Weisenberger A, Leckman JF. Meta-Analysis: Treatment of Attention-Deficit/Hyperactivity Disorder in Children With Comorbid Tic Disorders. Journal Of The American Academy Of Child & Adolescent Psychiatry 2009, 48: 884-893. PMID: 19625978, PMCID: PMC3943246, DOI: 10.1097/chi.0b013e3181b26e9f.Peer-Reviewed Original ResearchMeSH KeywordsAdrenergic alpha-AgonistsAtomoxetine HydrochlorideAttention Deficit Disorder with HyperactivityChildComorbidityContraindicationsDose-Response Relationship, DrugDouble-Blind MethodHumansMethylphenidatePropylaminesPsychotropic DrugsRandomized Controlled Trials as TopicTic DisordersTourette SyndromeConceptsAlpha-2 agonistsAttention-deficit/hyperactivity disorderTic symptomsComorbid ticsSupratherapeutic dosesTic disordersADHD symptomsTreatment of ADHDHyperactivity disorderPlacebo-controlled trialEfficacy of medicationsStandardized mean differenceEvidence-based treatmentsHalf of childrenComorbid tic disordersPrimary outcomeDifferent medicationsPsychostimulant medicationPubMed searchTic severityTourette syndromePackage insertsDrug AdministrationAtomoxetineSymptoms
2024
The Effects of Shaoma Zhijing Granules and its Main Components on Tourette Syndrome
Zhao Q, Hu Y, Yan Y, Song X, Yu J, Wang W, Zhou S, Su X, Bloch M, Leckman J, Chen Y, Sun H. The Effects of Shaoma Zhijing Granules and its Main Components on Tourette Syndrome. Phytomedicine 2024, 129: 155686. PMID: 38759346, DOI: 10.1016/j.phymed.2024.155686.Peer-Reviewed Original ResearchTourette syndromeChina National Knowledge Infrastructure (CNKI) databasesNerve damageRepair of nerve damageClinical trialsEffective treatmentImprove sleep disordersNeurotransmitter imbalanceSleep disordersReducing neuroinflammationSyndromeComprehensive searchClinical applicationChinese medicine compoundObsessive-compulsive disorder
2023
Protocol description for a randomized controlled trial of fMRI neurofeedback for tics in adolescents with Tourette Syndrome
Awasthi J, Harris-Starling C, Kalvin C, Pittman B, Park H, Bloch M, Fernandez T, Sukhodolsky D, Hampson M. Protocol description for a randomized controlled trial of fMRI neurofeedback for tics in adolescents with Tourette Syndrome. Psychiatry Research Neuroimaging 2023, 336: 111692. PMID: 37673711, PMCID: PMC10722977, DOI: 10.1016/j.pscychresns.2023.111692.Peer-Reviewed Original ResearchConceptsTourette syndromeFunctional magnetic resonance imagingStudy protocolChronic tic disorderSupplementary motor areaLower functional connectivityMagnetic resonance imagingResearch study protocolLarge trialsClinical trialsTic disordersMotor areaBrain areasControl groupResonance imagingBrain regionsNew trialsFunctional connectivityNeurofeedback interventionFMRI neurofeedbackNF protocolTrialsNF studiesSyndromeIntervention
2022
Mispatterning and interneuron deficit in Tourette Syndrome basal ganglia organoids
Brady M, Mariani J, Koca Y, Szekely A, King R, Bloch M, Landeros-Weisenberger A, Leckman J, Vaccarino F. Mispatterning and interneuron deficit in Tourette Syndrome basal ganglia organoids. Molecular Psychiatry 2022, 27: 5007-5019. PMID: 36447010, PMCID: PMC9949887, DOI: 10.1038/s41380-022-01880-5.Peer-Reviewed Original ResearchConceptsTourette syndromeInterneuron deficitsGABAergic interneuronsHealthy controlsNeurodevelopmental underpinningsNeuropathological deficitsBG circuitryNeuropsychiatric disordersDecreased differentiationT patientsInterneuronsAltered expressionPotential mechanismsCilia disruptionSonic hedgehogOrganoidsStem cellsTS individualsPluripotent stem cellsGli transcription factorsDeficitsOrganoid differentiationEarly stagesCholinergicPatientsPhenomenology of Tics and Sensory Urges
Leckman J, Bloch M, Sukhodolsky D, Artukoğlu B, Scahill L, King R. Phenomenology of Tics and Sensory Urges. 2022, 6-25. DOI: 10.1093/med/9780197543214.003.0002.Peer-Reviewed Original ResearchMeta‐Analysis: Efficacy and Tolerability of Vesicular Monoamine Transporter Type 2 Inhibitors in the Treatment of Tic Disorders
Behling E, Farhat LC, Landeros‐Weisenberger A, Bloch MH. Meta‐Analysis: Efficacy and Tolerability of Vesicular Monoamine Transporter Type 2 Inhibitors in the Treatment of Tic Disorders. Movement Disorders 2022, 37: 684-693. PMID: 35191552, DOI: 10.1002/mds.28957.Peer-Reviewed Original ResearchConceptsChronic tic disorderTourette syndromeVMAT2 inhibitorsTic disordersVesicular monoamine transporter type 2 inhibitorsYale Global Tic Severity ScaleMean differenceRate of discontinuationTic Severity ScaleType 2 inhibitorsShort-term treatmentTic symptomsBlinded RCTEffective therapySeverity ScaleSystematic reviewTolerabilityAvailable evidenceAdverse effectsInverse varianceEfficacyRCTsInhibitorsNonsignificant effectTrials
2021
A Phase-2 Pilot Study of a Therapeutic Combination of Δ9-Tetrahydracannabinol and Palmitoylethanolamide for Adults With Tourette’s Syndrome
Bloch MH, Landeros-Weisenberger A, Johnson JA, Leckman JF. A Phase-2 Pilot Study of a Therapeutic Combination of Δ9-Tetrahydracannabinol and Palmitoylethanolamide for Adults With Tourette’s Syndrome. Journal Of Neuropsychiatry 2021, 33: 328-336. PMID: 34340527, DOI: 10.1176/appi.neuropsych.19080178.Peer-Reviewed Original ResearchConceptsTourette syndromeTic symptomsUncontrolled trialsYale Global Tic Severity Scale-Total Tic ScoreDouble-blind placebo-controlled trialAvailable evidence-based treatmentsPhase 2 pilot studyExtension phasePlacebo-controlled trialRefractory Tourette syndromeTotal tic scoreEffective pharmacological treatmentCannabis-derived compoundsEvidence-based treatmentsTHC dosingSecondary outcomesPrimary outcomeComorbid conditionsPharmacological treatmentTic scoreYGTSS scoresTherapeutic combinationsSide effectsTrial designSyndrome
2020
Chapter 40 Tourette syndrome
Fasching L, Brady M, Bloch M, Lombroso P, Vaccarino F. Chapter 40 Tourette syndrome. 2020, 675-686. DOI: 10.1016/b978-0-12-813866-3.00040-0.ChaptersTourette syndromeThalamic-cortical circuitryHuman postmortem brain tissueThalamo-cortical circuitryAdult TS patientsStriatal volume lossPostmortem brain tissueEnvironmental risk factorsStriatal interneuronsDopaminergic receptorsRecurrence rateAmeliorate symptomsBasal gangliaRisk factorsFamilial recurrence ratePharmacological strategiesVocal ticsTS patientsAnimal modelsMetabolic hypofunctionComplex neuropsychiatric disorderBrain tissueMolecular abnormalitiesNeuropsychiatric disordersGenetic alterations
2019
Randomized, Sham-Controlled Trial of Real-Time Functional Magnetic Resonance Imaging Neurofeedback for Tics in Adolescents With Tourette Syndrome
Sukhodolsky DG, Walsh C, Koller WN, Eilbott J, Rance M, Fulbright RK, Zhao Z, Bloch MH, King R, Leckman JF, Scheinost D, Pittman B, Hampson M. Randomized, Sham-Controlled Trial of Real-Time Functional Magnetic Resonance Imaging Neurofeedback for Tics in Adolescents With Tourette Syndrome. Biological Psychiatry 2019, 87: 1063-1070. PMID: 31668476, PMCID: PMC7015800, DOI: 10.1016/j.biopsych.2019.07.035.Peer-Reviewed Original ResearchConceptsSupplementary motor areaYale Global Tic Severity ScaleFunctional magnetic resonanceTic Severity ScaleReal-time functional magnetic resonanceTourette syndromeSeverity ScaleYale Global Tic Severity Scale-Total Tic ScoreTotal tic scorePrimary outcome measureSham control conditionReduction of ticsMagnetic resonanceSecondary outcomesSessions of neurofeedbackCrossover studyTic symptomsTic scoreOutcome measuresMotor areaSecondary measuresTic severityReal neurofeedbackEnd pointNeurofeedback interventionMeta-analysis: Adulthood prevalence of Tourette syndrome
Levine JLS, Szejko N, Bloch MH. Meta-analysis: Adulthood prevalence of Tourette syndrome. Progress In Neuro-Psychopharmacology And Biological Psychiatry 2019, 95: 109675. PMID: 31220521, DOI: 10.1016/j.pnpbp.2019.109675.Peer-Reviewed Original ResearchConceptsPrevalence of TSTourette syndromeRisk ratioCases of TSPrevalence estimatesLogit event rateAccurate prevalence estimatesTS prevalenceRemission criteriaTic symptomsFemale ratioPublic health decisionsOverall prevalencePsychiatric conditionsPublication biasCase identificationEvent ratesPrevalenceHealth decisionsLongitudinal studyAdultsSignificant differencesSyndromeTS casesTwo-thirdsThe Potential of Cannabinoid-Based Treatments in Tourette Syndrome
Artukoglu BB, Bloch MH. The Potential of Cannabinoid-Based Treatments in Tourette Syndrome. CNS Drugs 2019, 33: 417-430. PMID: 30977108, DOI: 10.1007/s40263-019-00627-1.Peer-Reviewed Original ResearchConceptsTourette syndromeCannabinoid systemAdult populationPositive urine drug screenBiological rationaleCannabinoid-based treatmentsPotential of cannabinoidsTourette syndrome populationsPlacebo-controlled trialTreatment of ticsUrine drug screensNovel pharmacological treatmentsCannabis-derived compoundsStrong biological rationaleCurrent evidence baseComprehensive literature searchDevelopmental adverse effectsRefractory patientsSafety profilePharmacological treatmentClinical trialsTic disordersUncertain efficacyFurther trialsSyndrome population
2016
N-Acetylcysteine in the Treatment of Pediatric Tourette Syndrome: Randomized, Double-Blind, Placebo-Controlled Add-On Trial
Bloch MH, Panza KE, Yaffa A, Alvarenga PG, Jakubovski E, Mulqueen JM, Landeros-Weisenberger A, Leckman JF. N-Acetylcysteine in the Treatment of Pediatric Tourette Syndrome: Randomized, Double-Blind, Placebo-Controlled Add-On Trial. Journal Of Child And Adolescent Psychopharmacology 2016, 26: 327-334. PMID: 27027204, PMCID: PMC6445198, DOI: 10.1089/cap.2015.0109.Peer-Reviewed Original ResearchConceptsBenefit of NACEfficacy of NACYale Global Tic Severity ScaleAttention-deficit/hyperactivity disorderObsessive-compulsive disorderTourette syndromeN-acetylcysteineObsessive-compulsive spectrum disordersSide effectsRecent placebo-controlled trialPediatric Tourette syndromePlacebo-controlled trialCurrent pharmacological treatmentsTreatment of ticsTotal tic scoreSeverity of ticsSubstantial side effectsTic Severity ScaleYears of ageMinimal side effectsPediatric TSPrimary outcomeSecondary outcomesGlutamatergic systemPharmacological treatment
2015
Tic disorders
Leckman J, Bloch M. Tic disorders. 2015, 757-773. DOI: 10.1002/9781118381953.ch56.Peer-Reviewed Original ResearchPsychological processesCognitive-behavioral treatmentTourette syndromeEmotional processingCourse of developmentNeural mechanismsInhibitory controlBehavioral treatmentFirst-line interventionPathogenesis of TSEnvironmental influencesPathways of careTic disordersDelivery of careMotor regulationSensorimotor gatingTherapeutic algorithmClinical presentationDisordersRelated disordersTreatment trialsClinical expressionOrphan disorderExperienced cliniciansPathogenesisChapter 107 Tourette Syndrome
Lennington J, Bloch M, Scahill L, Szuhay G, Lombroso P, Vaccarino F. Chapter 107 Tourette Syndrome. 2015, 1311-1320. DOI: 10.1016/b978-0-12-410529-4.00107-8.ChaptersTourette syndromeThalamic-cortical circuitryChildhood-onset neuropsychiatric disorderBasal ganglia circuitryStriatal interneuronsAmeliorate symptomsBasal gangliaPharmacological strategiesVocal ticsAnimal modelsPostmortem tissueNeuropsychiatric disordersSyndromeContemporary treatmentHeterogeneous disorderLarge genome-wide association studiesRecent screeningDysfunctionPotential target sitesStereotypic behaviorDisordersGenome-wide association studiesAssociation studiesChemical disruptionDopaminergic
2014
Clinical features of Tourette syndrome and tic disorders
Leckman JF, King RA, Bloch MH. Clinical features of Tourette syndrome and tic disorders. Journal Of Obsessive-Compulsive And Related Disorders 2014, 3: 372-379. PMID: 30197854, PMCID: PMC6124690, DOI: 10.1016/j.jocrd.2014.03.004.Peer-Reviewed Original ResearchTourette syndromeTic disordersLong-term clinical courseLong-term outcomesAge 10 yearsAttention deficit hyperactivity disorderCo-occurring conditionsClinical courseClinical featuresObsessive-compulsive disorderTic symptomsVisual-motor integrationVocal ticsPsychosocial stressMost childrenCourse of monthsLiterature searchRelevant articlesMotor integrationStereotyped movementsHyperactivity disorderEarly adulthoodDisordersNeurodevelopmental disordersSensory stimuliHistidine Decarboxylase Deficiency Causes Tourette Syndrome: Parallel Findings in Humans and Mice
Baldan LC, Williams KA, Gallezot JD, Pogorelov V, Rapanelli M, Crowley M, Anderson GM, Loring E, Gorczyca R, Billingslea E, Wasylink S, Panza KE, Ercan-Sencicek AG, Krusong K, Leventhal BL, Ohtsu H, Bloch MH, Hughes ZA, Krystal JH, Mayes L, de Araujo I, Ding YS, State MW, Pittenger C. Histidine Decarboxylase Deficiency Causes Tourette Syndrome: Parallel Findings in Humans and Mice. Neuron 2014, 81: 77-90. PMID: 24411733, PMCID: PMC3894588, DOI: 10.1016/j.neuron.2013.10.052.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAmphetamineAnimalsBrainChildDopamine AgonistsDopamine AntagonistsExploratory BehaviorFemaleHistidine DecarboxylaseHumansMaleMaze LearningMiceMice, KnockoutMiddle AgedMutationOxazinesRacloprideRadionuclide ImagingStereotyped BehaviorTime FactorsTourette SyndromeTryptophanYoung AdultConceptsTourette syndromeHA infusionKnockout miceD2/D3 receptor bindingDecarboxylase deficiencyDopamine D2 antagonist haloperidolCortico-basal ganglia circuitsStriatal DA levelsHDC knockout miceD3 receptor bindingImmediate early gene FosD2 antagonist haloperidolRare genetic causeBiosynthesis of histamineStriatal DARare causeBasal gangliaDA levelsAntagonist haloperidolGanglia circuitsPrepulse inhibitionMiceReceptor bindingGenetic causeHistidine decarboxylase
2013
Brain mechanisms for prepulse inhibition in adults with Tourette syndrome: Initial findings
Zebardast N, Crowley MJ, Bloch MH, Mayes LC, Wyk BV, Leckman JF, Pelphrey KA, Swain JE. Brain mechanisms for prepulse inhibition in adults with Tourette syndrome: Initial findings. Psychiatry Research 2013, 214: 33-41. PMID: 23916249, PMCID: PMC3932431, DOI: 10.1016/j.pscychresns.2013.05.009.Peer-Reviewed Original ResearchConceptsTourette syndromeFunctional magnetic resonance imagingHealthy subjectsTic severityWhole-brain functional magnetic resonance imagingYale Global Tic Severity ScaleTactile startle responseCase-control study designTic Severity ScaleCortical-striatal circuitsBrain activityMagnetic resonance imagingMultiple brain regionsLeft middle frontal gyrusMiddle frontal gyrusDegree of PPIPulse-alone stimuliBlock-design fMRI paradigmTic symptomsNeuropathological dataHealthy controlsPrepulse inhibitionDevelopmental neuropsychiatric disordersSensorimotor gatingLeft caudatePhenomenology of Tics and Sensory Urges: The Self Under Siege
Leckman J, Bloch M, Sukhodolsky D, Scahill L, King R. Phenomenology of Tics and Sensory Urges: The Self Under Siege. 2013, 3-25. DOI: 10.1093/med/9780199796267.003.0001.Peer-Reviewed Original ResearchAcademic outcomesComorbid behavioral problemsNovel behavioral interventionKey phenomenological featuresCognitive domainsIrrelevant informationBehavioral problemsBehavioral interventionsPhenomenology of ticsTourette syndromeLong-term outcomesPhenomenological featuresTic expressionTic disordersEnvironmental contextReduced abilitySensory urgeOutside worldRelated disordersEducational objectivesPhenomenological spectrumTourette Syndrome and Tic Disorders
Williams K, Bloch M, State M, Pittenger C. Tourette Syndrome and Tic Disorders. 2013, 1048-1060. DOI: 10.1093/med/9780199934959.003.0079.Peer-Reviewed Original ResearchTourette syndromeTic disordersCortico-basal ganglia circuitryImmune-brain interactionPost-mortem findingsSubset of casesFunctional imaging studiesAttention deficit disorderObsessive-compulsive disorderVocal ticsDisorder pathophysiologySevere endImaging studiesDeficit disorderSpecific populationsDisordersSyndromeSensory phenomenaRecent findingsHeterogeneous genetic architecturePathophysiologyInterneuronsEtiologyAbnormalitiesFindings