# The New Tics Study: A Novel Approach to Pathophysiology and Cause of Tic Disorders

> **NIH NIH R01** · WASHINGTON UNIVERSITY · 2021 · $626,493

## Abstract

Project Abstract
At least 20% of all children have tics at some time in their life, making tic disorders a subject of
substantial public health interest. However, only about 3% of all children have tics that last for a year
or more. Thus chronic tic disorders, including Tourette syndrome, can be conceptualized as a two-
step process: tics start, and then they fail to remit. By the numbers, the second part of this process is
the more unusual and perhaps more closely related to disease, yet surprisingly, almost no research
has examined this critical period after a first tic appears but before it is clear whether the child will go
on to have a chronic tic disorder. Therefore prior research that has identified abnormalities of brain
structure and function in children with TS generally does not clarify whether these abnormalities are
related to tic appearance or to the more important process of tic disappearance. Furthermore, tic
disappearance can be observed prospectively, allowing powerful within-subject analyses to test
whether features of brain structure or function shortly after tic onset predict remission of tics before
TS is diagnosable, and whether such features are state-related or more durable markers of
vulnerability to tics.
Colleagues in the TS field have agreed that such studies would be valuable, but have suspected that
recruitment would be extremely difficult. However, we have now demonstrated enrollment of subjects
with New Tics (defined as beginning within the previous 6 months, median 3.6 months) at a rate of 16
subjects per year when recruitment efforts were at their peak—though still on a shoestring budget
without full staffing or media advertisements. We have implemented subject preparation and quality
control methods that have allowed us to acquire structural and functional MRI data of high quality in
many subjects.
We now propose to enroll an additional 70 subjects with New Tics and characterize them carefully at
baseline and at the 1-year anniversary of tic onset (when TS can first be diagnosed). Both time points
will include clinical data, structural and functional MRI, and neuropsychological measures including
ability to suppress tics. We expect that complete data will be available for 55-70 subjects (including
those already collected), since MRI is sensitive to movement and we are selecting for subjects with tics
and additional difficulty holding still (about half of children with tics also have ADHD). We will
compare baseline data from this sample to matched tic-free control subjects, and to matched subjects
who already have TS or a chronic tic disorder (leveraging existing data in our laboratories to provide
some of the clinical and MRI data for these groups). Analyses will include tests of specific a priori
hypotheses as well as machine learning analyses of the complete dataset. These comparisons will
allow us to discover whether imaging differences in children with TS are present long before TS can be
diagnosed, whether...

## Key facts

- **NIH application ID:** 10198671
- **Project number:** 5R01MH104030-05
- **Recipient organization:** WASHINGTON UNIVERSITY
- **Principal Investigator:** KEVIN J BLACK
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $626,493
- **Award type:** 5
- **Project period:** 2017-06-09 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10198671

## Citation

> US National Institutes of Health, RePORTER application 10198671, The New Tics Study: A Novel Approach to Pathophysiology and Cause of Tic Disorders (5R01MH104030-05). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10198671. Licensed CC0.

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