Objective: The authors present a model of the developmental psychopathology and neurobiology of Tourette's syndrome that provides a framework for ongoing research and treatment.
Method: The model is based on clinical experience and a selective review of relevant scientific literature.
Results: During the past decade, Tourette's syndrome and related conditions have emerged as model disorders to study the interplay of genetic, neurobiological, psychological, and environmental factors during development. Although prevention and treatment are paramount, the effectiveness of these interventions depends on the quality and extent of our knowledge. Programmatic research combined with sustained clinical care has led to advances in our knowledge of the natural history of these disorders over the course of development and glimpses of the pathophysiologic and psychopathological mechanisms that mediate their expression in vulnerable persons.
Conclusions: In the future, we expect that our understanding will extend from the molecular level of how specific genes and epigenetic factors confer and mediate vulnerability to an understanding of why certain symptoms emerge when they do in the course of central nervous system development.