Apathy in Tourette Syndrome and Changes in Quality of Life

Tourette syndrome(TS) is a complex neuropsychological disorder with both motor and vocal
tics associated with multiple psychological co-morbidities. The most common co-morbidities
include obsessive compulsive disorder (OCD), attention deficit and hyperactivity disorder
(ADHD) and depression. Apathy has not been extensively studied in the Tourette syndrome
population. Apathy is currently defined as reduced motivation, with symptoms in at least two
of three domains of reduced initiative, reduced interest and/or reduced emotional
responsiveness. A study assessed the prevalence of apathy in multiple movement disorders and
reported that apathy is much more common in disorders associated with slowed movements like
Parkinson disease while less common in disorders with increased movements like Huntington
disease and Tourette syndrome in adults. However, no apathy studies in adolescent patients
with Tourette syndrome are published. Disengagement from treatment may affect health
outcomes in other disease states. Apathy has significant effects on the quality of life and
health outcomes in many patients. Apathy can be a direct manifestation of the
neuropsychological process (intrinsic to the disease) or can be secondary to medication side
effects most notably anti-dopaminergic agents and some reports of selective serotonin
receptor inhibitors (SSRI). Further attention to the prevalence and impact of apathy in the
adolescent Tourette syndrome population is needed to explore if this may be a factor
influencing TS management and ultimately Quality of life (QOL). Multiple psychotropic
medications are used in the management of tics as well as the psychological co-morbidities.
How these medications affect apathy prevalence in Tourette syndrome patients is not known.

Inclusion Criteria:

- Diagnosis: Tourette syndrome

- Age: 12-16 years

- Followed at the CMDNR

Exclusion Criteria:

- History of cerebral palsy or traumatic brain injury