Social disinhibition is a heritable subphenotype of tics in Tourette syndrome

Hirschtritt, M. E., Darrow, S. M., Illmann, C., Osiecki, L., Grados, M., Sandor, P., Dion, Y., King, R. A., Pauls, D. L., Budman, C. L., Cath, D. C., Greenberg, E., Lyon, G. J., Yu, D., McGrath, L. M., McMahon, W. M., Lee, P. C., Delucchi, K. L., Scharf, J. M., Mathews, C. A. (August 2016) Social disinhibition is a heritable subphenotype of tics in Tourette syndrome. Neurology, 87 (5). pp. 497-504. ISSN 0028-3878

DOI: 10.1212/wnl.0000000000002910


OBJECTIVE: To identify heritable symptom-based subtypes of Tourette syndrome (TS). METHODS: Forty-nine motor and phonic tics were examined in 3,494 individuals (1,191 TS probands and 2,303 first-degree relatives). Item-level exploratory factor and latent class analyses (LCA) were used to identify tic-based subtypes. Heritabilities of the subtypes were estimated, and associations with clinical characteristics were examined. RESULTS: A 6-factor exploratory factor analysis model provided the best fit, which paralleled the somatotopic representation of the basal ganglia, distinguished simple from complex tics, and separated out socially disinhibited and compulsive tics. The 5-class LCA model best distinguished among the following groups: unaffected, simple tics, intermediate tics without social disinhibition, intermediate with social disinhibition, and high rates of all tic types. Across models, a phenotype characterized by high rates of social disinhibition emerged. This phenotype was associated with increased odds of comorbid psychiatric disorders, in particular, obsessive-compulsive disorder and attention-deficit/hyperactivity disorder, earlier age at TS onset, and increased tic severity. The heritability estimate for this phenotype based on the LCA was 0.53 (SE 0.08, p 1.7 x 10-18). CONCLUSIONS: Expanding on previous modeling approaches, a series of TS-related phenotypes, including one characterized by high rates of social disinhibition, were identified. These phenotypes were highly heritable and may reflect underlying biological networks more accurately than traditional diagnoses, thus potentially aiding future genetic, imaging, and treatment studies.

Item Type: Paper
Subjects: diseases & disorders > mental disorders
diseases & disorders > mental disorders > Tourette Syndrome
CSHL Authors:
Communities: CSHL labs > Lyon lab
Depositing User: Matt Covey
Date: 2 August 2016
Date Deposited: 06 Jul 2016 19:51
Last Modified: 30 Aug 2016 19:56
PMCID: PMC4970665
Related URLs:

Actions (login required)

Administrator's edit/view item Administrator's edit/view item
CSHL HomeAbout CSHLResearchEducationNews & FeaturesCampus & Public EventsCareersGiving