Kevin John Black

Washington University in St. Louis | WUSTL , Wash U · Department of Psychiatry

Objective: We developed a novel method to map behavioral effects of deep brain stimulation (DBS) across a 3D brain region and to assign statistical significance after stringent Type I error correction. This method was applied to behavioral changes in Parkinson disease (PD) induced by subthalamic nucleus (STN) DBS to determine whether these response...

Pharmacological challenge imaging has mapped, but rarely quantified, the sensitivity of a biological system to a given drug. We describe a novel method called rapid quantitative pharmacodynamic imaging. This method combines pharmacokinetic-pharmacodynamic modeling, repeated small doses of a challenge drug over a short time scale, and functional ima...

Adenosine A(2a) receptor antagonists reduce symptom severity in Parkinson disease (PD) and animal models. Rodent studies support the hypothesis that A(2a) antagonists produce this benefit by reducing the inhibitory output of the basal ganglia indirect pathway. One way to test this hypothesis in humans is to quantify regional pharmacodynamic respons...

Dopamine can induce fascinating, complex human behavioral states, including disinhibition, euphoria, or elaborate stereotypies, whereas dopamine deficiency can cause anxiety or sadness. Limited data suggest that these phenomena may involve dysfunction of orbital frontal cortex, cingulate cortex, or ventral striatum. The dopamine D3 receptor (D3R) h...

Dopamine agonists and antagonists can reduce abnormal movements and vocalizations (tics) in Tourette syndrome (TS); however, dopamine-responsive abnormal function in specific brain regions has not been directly demonstrated in TS. We sought to identify dopamine-modulated brain regions that function abnormally in TS by combining functional magnetic...

Objective This study examined children at the onset of tic disorder (tics for less than 9 months: NT group), a population on which little research exists. Here, we investigate relationships between the baseline shape and volume of subcortical nuclei, diagnosis, and tic symptom outcomes. Methods 187 children were assessed at baseline and a 12-month...

In this, the tenth annual update for the F1000Research Tics collection, we summarize research reports from 2023 on Gilles de la Tourette syndrome and other tic disorders. The authors welcome article suggestions and thoughtful feedback from readers.

In this, the tenth annual update for the F1000Research Tics collection, we summarize research reports from 2023 on Gilles de la Tourette syndrome and other tic disorders. The authors welcome article suggestions and thoughtful feedback from readers.

Transcranial magnetic stimulation (TMS) and deep brain stimulation (DBS) can treat some neuropsychiatric disorders, but there is no consensus approach for identifying new targets. We localized causal circuit-based targets for anxiety that converged across multiple natural experiments. Lesions (n=451) and TMS sites (n=111) that modify anxiety mapped...

This is the ninth yearly article in the Tourette Syndrome Research Highlights series, summarizing selected research reports from 2022 relevant to Tourette syndrome. The authors briefly summarize reports they consider most important or interesting.

Introduction Eight members of the International Parkinson’s Disease and Movement Disorders Society Tic and Tourette Syndrome Study Group formed a subcommittee to discuss further barriers to practice guideline implementation. Based on expert opinion and literature review, the consensus was that practice variations continue to be quite broad and that...

This is the ninth yearly article in the Tourette Syndrome Research Highlights series, summarizing selected research reports from 2022 relevant to Tourette syndrome. The authors briefly summarize reports they consider most important or interesting.

Background: Many children with tic disorders outgrow their tics, but little is known about the proportion of individuals who will continue to require specialist services in adulthood and which variables are associated with tic persistence. Objectives: The aims were to estimate the proportion of individuals first diagnosed with tic disorders in c...

Background: Recent years have seen a dramatic increase in new “tic” cases in teens and young adults. These individuals often present with fulminant onset of symptoms not commonly seen in Tourette syndrome (TS) and are often diagnosed with Functional Neurological Symptom Disorder (FND-tic). However, some authors have questioned whether this illness...

Median nerve stimulation (MNS) at 10–12 Hz was recently proposed as a treatment for Tourette syndrome and other chronic tic disorders (TS/CTD). We report on 31 participants ages 15–64 with TS/CTD in an open-label, comparative (within-group, several time points) study of MNS (ClinicalTrials.gov registration number NCT05016765). Participants were rec...

A prior study showed that rhythmic, but not arrhythmic, 12 Hz stimulation of the median nerve (MNS) entrained the sensorimotor cortex EEG signal and found that 10 Hz MNS improved tics in Tourette syndrome (TS). However, no control condition was tested, and stimulation blocks lasted only 1 min. We set out to replicate the TS results and to test whet...

A prior study showed that rhythmic, but not arrhythmic, 12 Hz stimulation of the median nerve (MNS) entrained EEG power, and found that 10 Hz MNS improved tics in Tourette syndrome (TS). However, no control condition was tested and stimulation blocks lasted only 1 minute. We set out to replicate the TS results and to test whether tic improvement oc...

Tic disorders are the most common movement disorders in a pediatric practice. Moreover, tic disorders are frequently associated with comorbid neuropsychiatric symptoms. Therefore, understanding tic disorders is vital for general practitioners who are likely to encounter these conditions in their practice. However, misunderstanding and misconception...

Background: Recent years have seen a dramatic increase in new “tic” cases in teens and young adults. These individuals often present with fulminant onset of symptoms not commonly seen in Tourette syndrome (TS) and are often diagnosed with Functional Neurological Symptom Disorder (FND-tic). However, some authors have questioned whether this illness...

Introduction: Estimates of tic prevalence in community samples of children vary significantly. It is important to know the true prevalence of tics, as it aids in clinicians’ ability to counsel patients and families on the typical course of tics in those presenting for treatment. In this study, we directly observe elementary school children in the c...

Over the past 3 years, a global phenomenon has emerged characterized by the sudden onset and frequently rapid escalation of tics and tic-like movements and phonations. These symptoms have occurred not only in youth known to have tics or Tourette syndrome (TS), but also, and more notably, in youth with no prior history of tics. The Tourette Associat...

We summarize selected research reports from 2021 relevant to Tourette syndrome that the authors consider most important or interesting. The authors welcome article suggestions and thoughtful feedback from readers.

Tourette’s Disorder or Tourette Syndrome (TS) is a highly heritable neuropsychiatric disorder affecting about 0.5% of the population worldwide. Study and clinical samples have been heavily Caucasian, and the sparse existing data on TS prevalence in African or African American samples are highly discordant. This door-to-door and health-fair-based st...

Much of the research regarding Tourette’s syndrome (TS) has focused on why certain individuals develop tics while others do not. However, a separate line of research focuses on the momentary influences that cause tics to increase or decrease in patients who are already known to have TS or another chronic tic disorder (CTD). Environmental and intern...

Recent years have seen a dramatic increase in new “tic” cases in teens and young adults. These individuals often present with fulminant onset of distinct symptoms not commonly seen in Tourette syndrome (TS), and are often diagnosed with Functional Neurological Disorder (FND-tic). Some have questioned whether this illness truly differs from typical...

Median nerve stimulation (MNS) at 10-12 Hz was recently proposed as a potential treatment for tics in Tourette syndrome and other chronic tic disorders (TS/CTD). Here we report on 31 people ages 15-64 with TS/CTD who participated in a 4-week open label study of MNS, 27 of whom completed the final survey. They reported tic frequency and intensity ea...

Perceptions of Tourette Syndrome (TS) and tic disorders are often driven by social media. During the COVID-19 pandemic, social media consumption greatly increased, particularly in the adolescent population. In parallel with increased social media consumption, there has also been an increase in tic severity and functional tic-like behavior (FTLB). G...

Much of the research regarding Tourette’s syndrome (TS) has focused on why certain individuals develop tics while others do not. However, a separate line of research focuses on the momentary influences that cause tics to increase or decrease in patients with a who are already known to have TS or another chronic tic disorder (CTD). Environmental and...

Tourette syndrome (TS) is characterized by multiple motor and vocal tics, and high-comorbidity rates with other neuropsychiatric disorders. Obsessive compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), autism spectrum disorders (ASDs), major depressive disorder (MDD), and anxiety disorders (AXDs) are among the most prevalent...

Reddy and Reddy (2014) discuss the optimal timing for lithium levels in patients taking once-daily extended-release lithium formulations. They argue for blood sampling 24 h after the previous dose rather than the standard 12 h. I interpret the data quite differently. The authors start with the assumption that the clinician wants a trough level. I d...

We summarize selected research reports from 2021 relevant to Tourette syndrome that the authors consider most important or interesting. The authors welcome article suggestions and thoughtful feedback from readers.

We present here research from 2020 relevant to Tourette syndrome (TS). The authors briefly summarize a few reports they consider most important or interesting.

Tourette syndrome (TS) is now recognized as a common neurodevelopmental disorder affecting children and adults. It has gained increasingly public awareness and scientific interest worldwide. Knowledge of its clinical presentation and available treatment approaches has increased dramatically over the last two decades. Tourette Syndrome offers a uniq...

Tics manifest as brief, purposeless and unintentional movements or noises that, for many individuals, can be suppressed temporarily with effort. Previous work has hypothesized that the chaotic temporal nature of tics could possess an inherent fractality, that is, have neighbour-to-neighbour correlation at all levels of timescale. However, demonstra...

We present here research from 2020 relevant to Tourette syndrome (TS). The authors briefly summarize a few reports they consider most important or interesting.

Perceptions of Tourette syndrome (TS) and tic disorders are often driven by social media. During the COVID-19 pandemic, social media consumption greatly increased, particularly in the adolescent population. In parallel with increased social media consumption, there has also been an increase in tic severity and functional tic-like behavior (FTLB). G...

The ongoing NewTics study examines children who have had tics for less than 9 months (NT group) - a population on which little research exists. Here, we further investigate relationships between subcortical shape and tic symptom outcomes. 138 children were assessed at baseline and a 12-month follow-up: 79 with NT, 27 tic-free healthy controls (HC),...

Background The experimental therapeutics approach that combines a placebo-controlled clinical trial with translational neuroscience methods can provide a better understanding of both the clinical and physiological effects of pharmacotherapy. We aimed to test the efficacy and tolerability of low-dose augmentation with buprenorphine (BPN) for treatme...

Tic disorders and Tourette syndrome are the most common movement disorders in children and are characterized by movements or vocalizations. Clinically, Tourette syndrome is frequently associated with comorbid psychiatric symptoms. Although dysfunction of cortical-striatal-thalamic-cortical circuits with aberrant neurotransmitter function has been c...

Tics manifest as brief, purposeless, and involuntary movements or noises that can be suppressed temporarily with effort. In 1998, Peterson and Leckman (P&L) hypothesized that the chaotic temporal nature of tics could possess an inherent fractality, that is, have neighbor-to-neighbor correlation at all levels of time scale. However, demonstrating th...

Tics are characterized by sudden, rapid, recurrent, nonrhythmic movement or vocalization, and are the most common movement disorders in children. Their onset is usually in childhood and tics often will diminish within one year. However, some of the tics can persist and cause various problems such as social embarrassment, physical discomfort, or emo...

Purpose of Review Tic disorders are common in the pediatric population and are differentiated from other movement disorders by tic suppressibility. Understanding the mechanism of tic suppression may provide new insights to the pathophysiology of tic disorders. This article highlights clinical phenomenology and neuronal correlates of tic suppressibi...

Purpose of Review To summarize and update information on the course of tic disorders from childhood through later life. Recent Findings Tics tend to improve substantially over the first year after they appear. However, contrary to widespread opinion, tics usually last longer than 1 year, though usually at minimal severity. Tics often wane to clini...

Woods and Himle developed a standardized tic suppression paradigm (TSP) for the experimental setting, to quantify the effects of intentional tic suppression in Tourette syndrome. We previously provided a computer program to facilitate recording tic occurrence and to automate reward delivery during the several experimental conditions of the TSP. The...

Tic disorders are the most common movement disorders in a pediatric practice. Moreover, tic disorders are frequently associated with comorbid neuropsychiatric symptoms. Therefore, understanding tic disorders is vital for general practitioners to deliver appropriate care to patients with tics. However, misunderstanding and misconceptions of tic diso...

This is the sixth yearly article in the Tourette Syndrome Research Highlights series, summarizing research from 2019 relevant to Tourette syndrome and other tic disorders. The highlights from 2020 is being drafted on the Authorea online authoring platform; readers are encouraged to add references or give feedback on our selections comments feature...

Purpose of review: To summarize and update information on the course of tic disorders from childhood through later life. Recent findings: Tics tend to improve substantially over the first year after they appear. However, contrary to widespread opinion, tics usually last longer than one year, though usually at minimal severity. Tics often wane to cl...

This is the sixth yearly article in the Tourette Syndrome Research Highlights series, summarizing research from 2019 relevant to Tourette syndrome and other tic disorders. The highlights from 2020 is being drafted on the Authorea online authoring platform; readers are encouraged to add references or give feedback on our selections comments feature...

In this published article, members of ‘The Tourette Association of America Neuroimaging Consortium’ were not cited in PubMed. These consortium members are listed in the associated correction.

Woods and Himle developed a standardized tic suppression paradigm (TSP) for the experimental setting, to quantify the effects of intentional tic suppression in Tourette syndrome. We previously provided a computer program to facilitate recording tic occurrence and to automate reward delivery during the several experimental conditions of the TSP. The...

Purpose of review: Tic disorders are common in the pediatric population and are differentiated from other movement disorders by tic suppressibility. Understanding the mechanism of tic suppression may provide new insights to the pathophysiology of tic disorders. This article highlights clinical phenomenology and neuronal correlates of tic suppressib...

Objective: Recent introduction of a commercial electronic medical record (EMR) system at the authors' institution raised a number of questions about documenting visits for presymptomatic testing for Huntington's disease (HD). Specifically, adoption of the EMR potentially compromised patient confidentiality and the personal delivery of test results...

Previous studies have investigated differences in the volumes of subcortical structures (e.g., caudate nucleus, putamen, thalamus, amygdala, and hippocampus) between individuals with and without Tourette syndrome (TS), as well as the relationships between these volumes and tic symptom severity. These volumes may also predict clinical outcome in Pro...

A boy with multiple phonic tics, one lifetime motor tic, and no impairment or marked distress does not meet criteria for any DSM-5 tic disorder diagnosis. The next version of the Diagnostic and Statistical Manual should adjust the criteria for Tourette's Disorder and/or for "other specified tic disorder" and "unspecified tic disorder."

We report on the ongoing project "The New Tics Study: A Novel Approach to Pathophysiology and Cause of Tic Disorders," describing the work completed to date, ongoing studies and long-term goals. The overall goals of this research are to study the pathophysiology of Provisional Tic Disorder, and to study tic remission (or improvement) in a prospecti...

We propose a novel pharmacological fMRI (phMRI) method for objectively quantifying disease severity in Parkinson disease (PD). It is based on the clinical observation that the benefit from a dose of levodopa wears off more quickly as PD progresses. Biologically this has been thought to represent decreased buffering capacity for dopamine as nigrostr...

Tourette syndrome (TS) is a neurodevelopmental disorder characterized by motor and vocal tics. TS is complex, with symptoms that involve sensory, motor, and top-down control processes and that fluctuate over the course of development. While many have studied atypical brain structure and function associated with TS, the neural substrates supporting...

Objective: This study determined whether striatal dopamine (DA) release is affected by food ingestion and whether the DA response to high-calorie food images is greater in the fasted than in the fed state in people with obesity. Methods: Striatal DA release was evaluated in 10 people with obesity and prediabetes after consuming a meal to satiati...

Background: Previous studies have investigated the relationships between the volumes of subcortical structures (e.g. caudate, putamen, thalamus, amygdala, hippocampus) and present tic symptom severity or future tic outcome in individuals with Tourette syndrome (TS). The largest such study found increased hippocampal volume in children with TS, but...

We propose a novel brain imaging method for objectively quantifying disease severity in Parkinson disease (PD). Levodopa pharmacological fMRI (phMRI) hysteresis mapping is based on the clinical observation that the benefit from a dose of levodopa wears off more quickly as PD progresses. Biologically this has been thought to represent decreased buff...

Functional neuroimaging studies have attempted to explore brain activity that occurs with tic occurrence in subjects with Tourette syndrome (TS). However, they are limited by the difficulty of disambiguating brain activity required to perform a tic, or activity caused by the tic, from brain activity that generates a tic. Inhibiting ticcing followin...

Objective: Limited evidence is available to guide treatment of depression for persons with epilepsy. We evaluated comparative effectiveness of sertraline and cognitive behavior therapy (CBT) for depression, quality of life, seizures, and adverse treatment effects. Methods: We randomly assigned 140 adult outpatients with epilepsy and current majo...

This is the fifth yearly article in the Tourette Syndrome Research Highlights series, summarizing research from 2018 relevant to Tourette syndrome and other tic disorders. The authors briefly summarize reports they consider most important or interesting. The highlights from 2019 article is being drafted on the Authorea online authoring platform, an...

Background: Tourette syndrome (TS) is a neuropsychiatric disorder with symptomatology that typically changes over development. Whether and how brain function in TS also differs across development has been largely understudied. Here, we used functional connectivity magnetic resonance imaging to examine whole-brain functional networks in children an...

Successful voluntary tic suppression is a key component of the behavioral interventions that are used to treat tic disorders. This study aimed to examine tic suppression in children with recent-onset tics and determine whether the capacity to suppress tics predicts future tic severity. We tested 45 children (30 male, mean age 7.74 years) with recen...