Brad Cohen shares his experiences with Tourette Syndrome: tinyurl.com/5tsojox

Children with Tourette Syndrome are frequently denied the additional resources at school that are freely available to children with dyslexia/dyspraxia, yet they may have many similar learning difficulties and may even be more disadvantaged. Children with dyslexia are often permitted free laptops, untimed exams, support & adjustments at school. Those with Tourette Syndrome often receive no resources at all.

Some well-known people of achievement with Tourette Syndrome: Tim Howard (footballer), Jim Eisenreich (baseball player), Nick van Bloss (concert pianist), Brad Cohen (award-winning schoolteacher/motivational speaker), Michael Wolff (jazz pianist), Tobias Picker (composer of classical music and opera), Rick Fowler (blues guitarist), Dr Evan Trost (family physician), Dr Orrin Palmer (psychiatrist) and Dr Peter Hollenbeck (neuro-scientist)

The neuro-developmental condition, Tourette Syndrome was described as a specific disorder in a seminal paper in 1885 by the neurologist Gilles de la Tourette in which the disorder is described as "maladie des tics" and was based on a study of 9 patients. Later Charcot, the famous French neurologist established the eponymous name, Gilles de la Tourette Syndrome.

The basal ganglia and dopamine

One of the pathophysiological causes of some symptoms of Tourette Syndrome appears to be a higher than normal 'level' of dopaminergic neuron activity in the basal ganglia area of the brain. This is thought to involve increased concentrations of dopamine (a chemical neuro-transmitter substance) and, possibly, increased numbers of dopamine receptors. This is the basis for treating TS by administering drugs, such as the neuroleptics, which antagonise or inhibit the effects of dopamine. The basal ganglia are thought to play an important role in determining action selection, inhibitory and voluntary motor control, behaviour switching and procedural learning of routine behaviours. Dysfunction here is implicated in the symptoms of tic, obsessive and compulsive behaviours (see: serotonin). Activity in the basal ganglia is influenced by and in turn influences many other parts of the brain. Basal ganglia structure

Low Latent Sensory Inhibition LLSI

Many people with Tourette Syndrome have 'low latent sensory inhibition' and consequently experience sensory input, such as vision and hearing (and other senses including touch) in excessive detail and in consequence have difficulty in focusing on specific and important selective aspects of their environment.

British schools & universities regularly discriminate against students with developmental disorders such as autism & Tourette Syndrome despite the legal obligations of the Disability Discrimination Act and The Equalities Act 2010 which require fairness, accommodations, reasonable adjustments and the removal of specific disadvantages inherent in disabilities that affect academic progress.

Individuals mostly do not want to be defined by Tourette Syndrome, all they ask for is acceptance & the opportunity to live a normal life!

There is a very strong link between Tourette Syndrome and creative skills - there are many accomplished musicians, artists & writers with TS

The serotonin system

Serotonin (5-hydroxytryptamine [5-HT]) is a neurotransmitter found in the gut and central nervous system (CNS). It is thought to influence the regulation of mood, sleep, appetite and influence memory and learning. Serotonin is commonly thought of as being responsible for feelings of 'happiness'. In Tourette Syndrome, concentrations of serotonin (and nor-epinephrine), in the brain/CNS, appear to be lower than normal and are thought to play an important role, along with dopamine which is strongly involved in controlling motor activity, in reducing regulation and selective inhibition of neural activity responsible for some complex tic behaviours, obsessive and compulsive behaviours, anxiety and sleep disturbance. Selective serotonin re-uptake inhibitors (SSRIs) are a class of drug often prescribed in TS to help increase CNS serotonin concentration. SSRIs may be beneficial in ameliorating some symptoms common in TS, including obsessive thoughts, attention deficit, sensory hypersensitivity, sleep disturbance and emotional hyper-responsiveness and rage. Both fluoxetine (Prozac) and sertraline (Zoloft) are commonly used. Paroxetine (Seroxat) has some effectiveness in improving 'rage' problems in adults with TS (but is unsuitable for children). All SSRIs have some side-effects. Venlafaxine (Efexor), is a serotonin-norepinephrine re-uptake inhibitor (SNRI) and is a drug sometimes used when symptoms, such as obsessive and compulsive behaviours and anxiety are unresponsive to SSRIs. Although conventional OCD tends to respond to SSRI therapy, evidence suggests that 'Tourettic' obsessive compulsive behaviours (OCB) are not very responsive to SSRIs/SNRIs. OCB in TS appears to be more 'wired-in' (neurological) and differs, markedly, to OCD without Tourette symptoms [<R>] [<R>].


Low concentrations of serotonin or serotonergic activity (and nor-adrenaline) are thought to be a cause of depression. Low mood is frequently a problem in TS and evidence suggests that SSRIs can be of benefit, however the role of serotonin deficiency as a primary cause in 'classic' clinical depression is, increasingly, being questioned [<R>]. Patients with TS sometimes report a rapid response to SSRI administration which contrasts with the long delay (up to 6 weeks) that is usual for MMD (major depressive disorder) patients without TS. Clearly, the pathopysiological mechanisms involved and the clinical responses to serotonin-increasing drugs, are complex and a full understanding of the serotonin system and it's role in TS will require considerably more research.