Tourette syndrome (TS) is a childhood-onset neuropsychiatric disorder. In over half of cases tics improve or remit during adolescence. However, the most severe symptoms of TS are usually seen in adulthood. In this career development award we will conduct a longitudinal structural neuroimaging that follows children with TS to young adulthood. Our goal is to compare the brain development in persistent TS cases to remitted cases and unaffected controls. Michael H. Bloch, M.D., M.S., the candidate for this career development award, has spent the last 10 years researching and treating TS and related disorders at Yale first as a medical student and then in psychiatry residency. He will complete his child and adult psychiatry training in the Albert J., Solnit Integrated Training Program at the Yale Child Study Center in June 2010. The Albert J. Solnit Training Program is a novel combined six-year child and adult psychiatry residency program that combines clinical and research training. Based on his clinical expertise, he was appointed as Assistant Director of the Yale OCD Clinic after his third year of residency. He has also completed a graduate degree in chronic disease epidemiology from the Yale School of Public Health during his residency program. He has already published over 20 peer-reviewed publications in TS and related disorder during his residency training including first-authored publications in the American Journal of Psychiatry, Molecular Psychiatry, JAACAP, Neurology and Biological Psychiatry. The majority of these articles were published under the mentorship of James F. Leckman M.D. and Bradley S. Peterson, M.D., who are the proposed mentors for this K award. The candidate plans to become an independent investigator in developmental neuroimaging of TS and related disorders at the completion of his awards period. He plans to get training and mentorship in structural neuroimaging during the career development award period. We have followed a cohort of 46 children diagnosed with TS to young adulthood. Each of these children received a detailed clinical assessment, structural neuroimaging and focused neuropsychological testing prior to age 14 years. We have published several manuscripts on this demonstrated in this cohort that smaller childhood caudate volumes were associated with increased tic symptoms in young adulthood. Our goals are to (1) examine the association of childhood basal ganglia morphology and childhood cortical thickness measures and adulthood tic severity and (2) repeat structural neuroimaging scans on these subjects so that we can compare brain development between persistent TS cases, remitted TS cases and unaffected controls.

Public Health Relevance

Over half of children with Tourette syndrome (TS) improve or remit during adolescence. However, the most severe cases of TS are usually seen in adulthood. We will conduct a longitudinal structural neuroimaging that follows children with Tourette syndrome to young adulthood with the goal of comparing brain development between persistent TS cases to TS remitted cases and unaffected controls.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Mentored Patient-Oriented Research Career Development Award (K23)
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Application #
Study Section
Child Psychopathology and Developmental Disabilities Study Section (CPDD)
Program Officer
Sarampote, Christopher S
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Yale University
Schools of Medicine
New Haven
United States
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Taylor, Jerome H; Lebowitz, Eli R; Jakubovski, Ewgeni et al. (2018) Monotherapy Insufficient in Severe Anxiety? Predictors and Moderators in the Child/Adolescent Anxiety Multimodal Study. J Clin Child Adolesc Psychol 47:266-281
Taylor, Jerome H; Landeros-Weisenberger, Angeli; Coughlin, Catherine et al. (2018) Ketamine for Social Anxiety Disorder: A Randomized, Placebo-Controlled Crossover Trial. Neuropsychopharmacology 43:325-333
Kuang, Heide; Johnson, Jessica A; Mulqueen, Jilian M et al. (2017) The efficacy of benzodiazepines as acute anxiolytics in children: A meta-analysis. Depress Anxiety 34:888-896
Bloch, Michael H (2016) Editorial: Reducing adolescent suicide. J Child Psychol Psychiatry 57:773-4
Jakubovski, Ewgeni; Varigonda, Anjali L; Freemantle, Nicholas et al. (2016) Systematic Review and Meta-Analysis: Dose-Response Relationship of Selective Serotonin Reuptake Inhibitors in Major Depressive Disorder. Am J Psychiatry 173:174-83
Varigonda, Anjali L; Jakubovski, Ewgeni; Bloch, Michael H (2016) Systematic Review and Meta-Analysis: Early Treatment Responses of Selective Serotonin Reuptake Inhibitors and Clomipramine in Pediatric Obsessive-Compulsive Disorder. J Am Acad Child Adolesc Psychiatry 55:851-859.e2
Schumer, Maya C; Bartley, Christine A; Bloch, Michael H (2016) Systematic Review of Pharmacological and Behavioral Treatments for Skin Picking Disorder. J Clin Psychopharmacol 36:147-52
Bloch, Michael H; Panza, Kaitlyn E; Yaffa, Alisa et al. (2016) N-Acetylcysteine in the Treatment of Pediatric Tourette Syndrome: Randomized, Double-Blind, Placebo-Controlled Add-On Trial. J Child Adolesc Psychopharmacol 26:327-34
Lebowitz, Eli R; Panza, Kaitlyn E; Bloch, Michael H (2016) Family accommodation in obsessive-compulsive and anxiety disorders: a five-year update. Expert Rev Neurother 16:45-53
Jakubovski, Ewgeni; Carlson, Jon P; Bloch, Michael H (2015) Prognostic subgroups for remission, response, and treatment continuation in the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) trial. J Clin Psychiatry 76:1535-45

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