Sustained attention and impulsivity in children with Tourette syndrome: comorbidity and confounds

We sought to determine whether Tourette syndrome (TS) was related to attentional disturbance independent of Attention Deficit Hyperactivity disorder (ADHD) and obsessive-compulsive symptoms (OCS), two comorbid conditions associated with attentional problems in other populations. Participants were 74 children [21 with uncomplicated TS (TS-Only), 14 with TS and ADHD (TS-ADHD), 21 with ADHD, and 18 controls]. Impaired sustained attention and impulsivity on a Continuous Performance Task were uncommon in the TS-Only group, but common in TS-ADHD and ADHD. The TS-ADHD group was less impulsive than the ADHD group, but had a higher rate of whole-body tics than the TS-Only group, raising questions about the diagnosis of ADHD in TS. OCS was not an independent risk factor for attention problems. However, the association of tic severity and impulsivity was consistent with the theory that TS involves dysfunction in cortical-subcortical circuits mediating behavioral inhibition.