ELEVATED CEREBROSPINAL-FLUID CORTICOTROPIN-RELEASING FACTOR IN TOURETTES-SYNDROME - COMPARISON TO OBSESSIVE-COMPULSIVE DISORDER AND NORMAL CONTROLS

Stress- and anxiety-related fluctuations in tic severity are cardinal features of Tourette's syndrome (TS), and there is evidence for involv ement of noradrenergic mechanisms in the pathophysiology and treatment of-the disorder. To examine further the pathobiology of this enhanced vulnerability to stress and anxiety we measured central activity of c orticotropin-releasing factor (CRF) in patients with TS and the relate d condition, obsessive compulsive disorder (OCD), Lumbar cerebrospinal fluid (CSF) was obtained in a standardized fashion for measurement of CRF from 21 medication-free outpatients with TS, 20 with OCD, and 29 healthy controls. The TS patients had significantly higher levels of C SF CRF than both the normal controls and the OCD patients. However the re was no difference in CSF CRF between the OCD patients and the norma l controls. Group differences in CSF CRF were unrelated to current cli nical ratings of depression, anxiety, ties, and obsessive compulsive b ehaviors. Although the functional significance of this finding remains to be elucidated, these results are consistent with the hypothesis th at stress-related neurobiological mechanisms may play a role in the pa thobiology of TS.