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Tourette Syndrome Neuroimaging Consortium Pilot

Principal Investigator:
Stewart
Mostofsky

Important research on Tourette Syndrome (TS) is proceeding along several fronts, from gene-hunting to controlled trials of new treatments. The Tourette Syndrome Association (TSA) has fostered collaborative research in these areas among several centers of excellence. 
By laying the groundwork for a successful collaboration, TSA produced two of the largest tic treatment studies ever completed, and did so at remarkable speed. Similar success may result from bringing multicenter collaborative TS research to neuroimaging. Neuroimaging studies have contributed to our understanding of TS pathophysiology, but essentially all of these research studies were performed in isolation, each at a single site. 

There are scientific obstacles that may have driven that isolation. Methods for brain imaging are complex and in some cases equivalent scans simply cannot be performed on magnets from different MRI manufacturers. Additional complications include subtle but consistent inter-site differences in image acquisition and reconstruction, subject placement, noise volume, brightness of visual stimulus presentation, and so on. However, recent developments have allowed successful multicenter collaborative brain imaging studies in Alzheimer’s disease and schizophrenia. 

This raises the question, what important questions about TS could best be answered by a multicenter imaging study? 

Questions such as:

Can we predict which children with recent-onset tics will go on to develop a chronic tic disorder, compared to the majority whose tics will disappear forever after a few months?
Why do some children with chronic tic disorders, but not others, outgrow them in adulthood?
What is the developmental course of the delayed and aberrant functional connectivity recently demonstrated in TS adolescents [4]?
What clinical features are most closely associated with these findings? 

Together, the PIs and collaborators have expertise in these areas, and these are studies whose completion could be substantially speeded with a multi-site design. However, the first step is to demonstrate that we can collect and analyze data of high quality across several sites. 
Therefore we propose to develop a TS neuroimaging consortium at a few carefully selected sites, demonstrate that we can achieve adequate quality control so that our results are reliable whether done at one center or another, and show that including more than one site boosts the overall recruitment rate. We will also develop procedures that will allow other sites to qualify to join the consortium.

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