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Cholinergic mechanisms in Tourette syndrome

Department of Neurological Sciences, Rush-Presbyterian-St. Lukes Medical Center, Chicago, IL.

To examine the role of the cholinergic system in Tourette syndrome, we administered intramuscular physostigmine and scopolamine hydrobromide to 10 patients, evaluating both motor tics and involuntary vocalizations. Patients showed a consistent abatement of motor tics and exacerbation of vocal tics after scopolamine injection. The scopolamine effect was reversed by physostigmine. These data suggest that the cholinergic system plays a role in the pharmacologic patho-physiology of Tourette syndrome. The pharmacology of vocal and motor tics may differ, and cholinergic manipulation may benefit some patients.

Address correspondence and reprint requests to Dr. Tanner, Department of Neurological Sciences, Rush-Presbyterian-St. Lukes Medical Center, 1725 West Harrison, Chicago, IL 60612.

This work was supported in part by the United Parkinson Foundation and the Boothroyd Foundation. Dr. Goetz is the recipient of a NINCDS Teacher Investigator Award.

These data were presented in part at the thirty-second annual meeting of the American Academy of Neurology, April 1980.

Accepted for publication March 8, 1982.

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