This document discusses Tourette Syndrome, a neurobiological disorder that the author's younger sister has. It begins by describing her sister's symptoms from childhood tics to inappropriate words as she grew older. It then explains the mechanisms in the brain involved, focusing on dysfunction in the thalamus, basal ganglia and frontal cortex. Circuits connecting these areas are implicated in causing involuntary movements. The document concludes by noting there are no diagnostic tests, and treatment typically involves medications to suppress tics, though these can have side effects.

1. COURSERA
SUNLATA THAPAR
Peer graded assignment : Final project
Understanding the Brain :The Neurobiologyof Everyday Life
INTRODUCTION
My young sister has Tourette Syndrome which is a very
common neurobiologicaldisorder . Her disorder started in the
childhooditself. When she was young we could only observe
tics such as blinking,sniffing, facial movements etc. But later it
became sure that it wasn’t something normal. These type of
symptoms usuallyare not noticed by any observer but a person
who lives with a person with this syndrome finds it really odd.
As she grew up this syndrome flared up as in she began to use
words which were inappropriate.Thistype of disease do not
affect intelligencemuch so she was good at studies. As there is
no cure to Tourette’s and no such medicines are also not
available. So , the only thing which was possible was to take
her to specialty clinics or psychiatrist or therapist . By telling
and discussing about her conditionreally made her feel better.

2. Fig: Symptoms of Tourette Syndrome

3. Fig : Role of ANS in Tourette Syndrome
MECHANISM
Tics are thought to be caused by dysfunction in the thalamus,
basal ganglia, and frontal cortex, which are cortical and

4. subcortical brain regions. Neuroanatomicmodels suggest
failures in circuits connecting the cortex and subcortex imaging
techniques implicatethe frontal cortex and basal ganglia .
The brain sends signals to the basal ganglia via cortico-striato-
thalamo-cortical(CSTC) circuits, or neural pathways. These
circuits link the basal ganglia to other parts of the brain,
allowinginformation to be transferred that affects movement
planningand control, behaviour,decision-making, and learning.
Cross-connections that "enable the integrationof information"
from these circuits influencebehaviour. Impairments in various
CSTC circuits, such as the sensorimotor, limbic, language,and
decision-makingpathways, can cause involuntarymovements.
Tics and premonitory desires may be caused by abnormalities
in these circuits.
The caudatenuclei may be smaller in tics patientsthan in non-
tics patients, supporting the theory of CSTC circuit dysfunction
in Tourette's. Brain circuits that "regulate response inhibition
and cognitive control of motor behaviour"are required to
suppress tics. A larger prefrontal cortex has been discovered in
children with TS, which could be the result of an adaptationto
help regulate tics. Tics are likelyto decrease as the frontal
cortex's capacityincreases with age. Circuits in the cortico-
basal ganglia (CBG) may also be affected, contributing to
"sensory, limbic, and executive" characteristics.

5. CONCLUSION
There are no specific diagnostic or screening tests that can be
used to identify Tourette's the diagnosisis usuallymade after
ruling out secondary causes of tic disorders and observation of
the individual'ssymptoms and family history. Tourettism is a
term for tics that resemble those of Tourette's but are caused
by illnesses other than Tourette's. Most of these ailments, such
as dystonias, choreas, and other hereditary conditions,are less
common than tic disorders, and a thorough history and
examinationmay be sufficient to rule them out without the
need of medical or screening tests.
Typicaland atypical neuroleptics,which have been shown to be
effective in treating tics, can have long-term and short-term
side effects. Tics are often treated with antihypertensivedrugs,
which have a milder adverse effect profile than neuroleptics
but have varied success. Risperidoneand aripiprazoleare
neurolepticsthat are used when antihypertensives are
ineffective and are usuallyattempted first in adults.
Haloperidolis the most effective treatment for tics, but it
comes with a higher risk of side effects.
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