The purpose of this study is to determine the areas of the brain responsible for motor tics in patients with tic disorders including Tourette's Syndrome and Chronic Motor or Vocal Tic Disorder. Previous studies have been done looking at brain activity during tics using electroencephalography (EEG) and positron emission tomography (PET). 16 adult patients with DSM-IV-TR (American Psychiatric Association 2000) diagnosis of a tic disorder and frequent tics will be studied. We will utilize blood oxygenation level dependent functional magnetic resonance imaging (BOLD fMRI) on patients with tics while they are experiencing spontaneous tics and while they are voluntarily imitating those tics. The differential activation between the tics and the voluntary movements may shed light on the regions of the brain responsible for generation of tics.
INCLUSION CRITERIA Patients will have a clinically documented tic disorder as defined by DSM-IV-TR and evaluation of tics severity using Yale Tic Sale. This criterion will be established by the preliminary screening in the NINDS Movement Disorders Outpatient Clinic. Patients will be in age range 14 to 65. Patients may be male or female. Patients will be asked to stop any medications that can influence central nervous system for at least 24 hours prior to exam also they will be asked to abstain from alcohol for 24 hours before the study. 10 normal controls will be included; controls will be screened in the NINDS Movement Disorders Outpatient Clinic, and will have neurological and physical examination. Controls with chronic illnesses, taking any medication that affects the CNS will be excluded. Controls will be asked to abstain from alcohol for 24 hours before the study. All subjects participating in MR studies should have a valid Clinical Center Medical Record Number. EXCLUSION CRITERIA Patients younger than 14 years old will be excluded from the study. Patients with MRI findings consistent with brain tumors, strokes, trauma or AVMs will be excluded. Patients with progressive neurological disorders other than a tic disorder will be excluded. Patients with a history of significant medical disorders, or requiring chronic treatment with other drugs, which cannot be stopped, will be excluded. Patients with cancer will be excluded. Pregnant women will be excluded. Patients not capable of giving informed consent will be excluded.