Dietary Neurotransmitters: A Narrative Review on Current Knowledge

Foods are natural sources of substances that may exert crucial effects on the nervous system in humans. Some of these substances are the neurotransmitters (NTs) acetylcholine (ACh), the modified amino acids glutamate and γ-aminobutyric acid (GABA), and the biogenic amines dopamine, serotonin (5-HT), and histamine. In neuropsychiatry, progressive integration of dietary approaches in clinical routine made it necessary to discern the more about some of these dietary NTs. Relevant books and literature from PubMed and Scopus databases were searched for data on food sources of Ach, glutamate, GABA, dopamine, 5-HT, and histamine. Different animal foods, fruits, edible plants, roots, and botanicals were reported to contain NTs. These substances can either be naturally present, as part of essential metabolic processes and ecological interactions, or derive from controlled/uncontrolled food technology processes. Ripening time, methods of preservation and cooking, and microbial activity further contributes to NTs. Moreover, gut microbiota are considerable sources of NTs. However, the significance of dietary NTs intake needs to be further investigated as there are no significant data on their bioavailability, neuronal/non neuronal effects, or clinical implications. Evidence-based interventions studies should be encouraged

Obsessive Compulsive Tic Disorder: appropriate diagnosis and treatment as key elements to improve health and rationalize use of resources

Background: Obsessive Compulsive Tic Disorder (OCTD) has been described recently as an early onset and highly disabling endophenotype of Tic Disorder and Obsessive Compulsive Disorder. OCTD has a relevant but largely unknown clinical, social and economic burden for patients and their families. Our paper aimed to explore relevant aspects of the burden of OCTD. Methods: we conducted a literature review and a pilot study using retrospective demographic, clinical and economic data of patients with OCTD accessing the Galeazzi Hospital in Milan. Results: the literature review shows the absence of information on OCTD. From the pilot study we analysed data of 30 patients (80.0% male, 36.7% aged from 7 to 13 years, 63.3% aged from 15 to 48 years), 83.0% declared that obsessions and/or compulsions were the most important factors determining their social impairment. Adult patients refractory to drug treatment underwent Deep Brain Stimulation plus drugs. The mean clinical scores at the time of diagnosis indicated a severe condition for both tics and obsessive compulsive components. The mean time elapsed from symptoms onset to diagnosis of OCTD was 5.6 years, reaching up to 11 years in one case. Before reaching the correct diagnosis, different specialists visited the patients several times, 93.3% underwent diagnostic examinations and 86.7% took 2 or 3 different drugs. Ten patients were hospitalised and 8 had received psychotherapy. Discussion: Albeit preliminary, these results show that attention is mandatory for establishing correct diagnosis and treatment guidelines to improve health and rationally spend resources for OCTD

Creativity Assessment in Subjects with Tourette Syndrome vs. Patients with Parkinson’s Disease: A Preliminary Study

(1) Background: Literature suggests that high levels of dopamine are associated with creative thoughts. Tourette Syndrome (TS) patients have high dopamine levels, while Parkinson’s Disease (PD) subjects have low dopamine levels. Consequently, TS individuals are supposed to have a major and PD patients less creative output. Moreover, dopamine medications may alter the level of creativity, and therefore Quality of Life, in both pathologies. (2) Methods: The aim of the study was to verify the hypothesis of TS patients having higher creative scores than PD patients. The assessment consisted of the administration of the Creative Thinking ASK Test. There were 54 participants—36 males and 18 females—i.e., 27 TS patients and 27 PD subjects. Age of the sample was 35 to 57 years old, high school certificate was required. (3) Results: TS sample (103.11 ASK average score) was more creative than PD sample (94.11 ASK average score). (4) Conclusions: The results supported the aforementioned hypothesis: TS sample resulted in having higher creative scores than PD sample. Dopamine and other neurotransmitters of TS and PS appear to affect subject’s creativity. Further studies with creative assessments in TS and PD patients are needed to support the preliminary results of our study

Handwriting Tics in Tourette’s Syndrome: A Single Center Study

Tourette’s syndrome (TS) is a neurodevelopmental disorder typically defined by multiple motor tics and at least one sound tic (1), beginning in childhood or in adolescence. More recently, Tourette’s syndrome has been acknowledged as a broad spectrum syndrome (2), including different comorbidities and coexisting symptoms. When beginning in early childhood TS mainly presents with attention deficit and hyperactivity disorder (ADHD) and tics, when beginning in adolescence instead tics and obsessive-compulsive behavior or disorder (OCB/OCD) are predominant. OCB/OCD trait is present in 60-80% of patients (3), and they are considered as thought tics (4). In many cases motor and sound tics resolve spontaneously in adulthood, though OCB/OCD generally remain. Tics often interfere with subject’s daily activities (5) affecting Quality of Life and causing Social Impairment, particularly in schooling and working. Handwriting is one of the most impaired school activity for TS patients because of the tics presence that hamper learning processes.In our clinical experience handwriting tics (HT) could severely affect and condition TS subjects, but they are not often pointed out in the Literature. For this reason there are not precise data regarding the incidence of HT neither in Tourette’s syndrome patients nor in healthy population

Music-dance-imaging training for young adults with Tourette Syndrome

Tourette Syndrome (TS) is a childhood-onset neurobehavioral disorder, which is characterized by motor and sound tics. Current studies have identified some specific factors that lead to tic reduction, such as relaxation, concentration, musical activities, and the execution of voluntary and finalistic movements. Patients with TS show a higher level of creativity than other people, which can be channeled, together with their excessive motor energy, into various functional activities that favor the reduction of tics. Moreover, in the last decades, music has been used as a rehabilitative tool, since it has shown to induce a positive effect on TS patients\u2019 mood and to facilitate the performance of fluid and rhythmic voluntary movements. The present study refers to \u201cImagine, Tourette!\u201d, a motor imagery, music-based intervention aimed at reducing the manifestation of motor and sound tics in adult TS patients. To test the specific effect of such a kind of training, 8 TS patients were exposed to one of two interventions: the experimental group performed motor tasks based on music whereas the control group performed motor tasks without the accompaniment of music. The hypothesis tested was that performing motor tasks accompanied by music could reduce the severity of tics and have an effect on patients\u2019 mood more than simply performing motor tasks alone. The results supported the hypothesis: music played a specific effect on the manifestation of tics and on the patients\u2019 mood, confirming its potentially positive role in motor interventions addressed to TS

Food Bioactive Compounds and Their Interference in Drug Pharmacokinetic/Pharmacodynamic Profiles

Preclinical and clinical studies suggest that many food molecules could interact with drug transporters and metabolizing enzymes through different mechanisms, which are predictive of what would be observed clinically. Given the recent incorporation of dietary modifications or supplements in traditional medicine, an increase in potential food-drug interactions has also appeared. The objective of this article is to review data regarding the influence of food on drug efficacy. Data from Google Scholar, PubMed, and Scopus databases was reviewed for publications on pharmaceutical, pharmacokinetic, and pharmacodynamic mechanisms. The following online resources were used to integrate functional and bioinformatic results: FooDB, Phenol-Explorer, Dr. Duke's Phytochemical and Ethnobotanical Databases, DrugBank, UniProt, and IUPHAR/BPS Guide to Pharmacology. A wide range of food compounds were shown to interact with proteins involved in drug pharmacokinetic/pharmacodynamic profiles, starting from drug oral bioavailability to enteric/hepatic transport and metabolism, blood transport, and systemic transport/metabolism. Knowledge of any food components that may interfere with drug efficacy is essential, and would provide a link for obtaining a holistic view for cancer, cardiovascular, musculoskeletal, or neurological therapies. However, preclinical interaction may be irrelevant to clinical interaction, and health professionals should be aware of the limitations if they intend to optimize the therapeutic effects of drugs

Creative Thinking in Tourette's Syndrome: An Uncharted Topic

This opinion article discusses the literature about creativity in patients with Tourette Syndrome (TS) and provides some suggestions about how this topic might be further exploited. TS is a neurodevelopmental disorder, with an onset occurring before the age of 18 (Robertson, 2011). The main symptom is the presence of tics, of which one or multiple sound tics and multiple motor tics (American Psychiatric Association, 2013). TS is associated with other potential impairments, such as cognitive anomalies, physical pain, impairment in daily activities, emotional and behavioral problems (Cavanna et al., 2013; Morand-Beaulieu et al., 2017). Despite these problems, high levels of creativity have been reported in TS patients. Examples of eminent individuals, e.g., W. A. Mozart (Ashoori and Jankovic, 2007), allegedly affected by TS, have been described (Szejko et al., 2019). On these premises, researchers studied more recent cases of TS patients showing creative aptitudes and measured the average levels of creative skills in samples of TS patients, to speculate about the reasons why these patients excel in creativity