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Nikolai is actually like everyone else and just as intelligent. But sometimes something in his brain doesn’t tick right – and suddenly his head twitches, his eye blinks, his face grimaces. Sometimes Nikolai screams – obscene words come out of his mouth without him having any influence over them. They have to get out – as if under duress.
He cannot suppress the tics. They come and go as they please. In medicine, this neuropsychiatric disorder is referred to as “Tourette’s syndrome”. The name comes from the French neurologist Dr. Georges Gilles De la Tourette, who first described this clinical picture in 1825.
What is Tourette’s syndrome?
Nicolai himself describes his tic disorder as follows: “You have to imagine that there is an ES inside you, so to speak. Pressure builds up in the body It becomes stronger and stronger until you have to release it at some point – through a scream, through convulsions, which is comparable to a hiccup. You realize how it comes, you can suppress it for a moment, but then it has to come out.”
Tourette syndrome (TS) is a neuropsychiatric disorder characterized by motor and vocal tics. Many – but not all – Tourette’s patients also suffer from compulsive behavior. Like Nikolai: if he has a thin glass in his hand, he has to crush it. He cannot defend himself against this compulsion – despite the risk of hurting himself.
These tics and compulsions vary from person to person. And they come at irregular intervals. The frequency and strength of the tics changes periodically. Sometimes they even disappear for a short time and then suddenly reappear. Only around one percent of Tourette’s patients are also affected by so-called “coprolalia”: the compulsion to utter obscene words.
Tourette syndrome usually occurs for the first time around the age of seven, intensifies during puberty and decreases again with increasing age. One in a thousand people is affected by this nerve disease. It is three times more common in men than in women. But nobody knows why.
The Harvard Brain Bank
The Harvard Brain Bank is the largest archive of human brains in the world. Over four thousand are stored here for scientific purposes. But the brains of Tourette’s patients are very rare. With a lot of luck, the Brain Bank will get one per year.
To find out more about the nerve disease, scientists freeze the core of the brain, the so-called basal ganglia, in dry ice. These terminal and diencephalic nuclei are switching stations of the nervous system – comparable to telephone exchanges and responsible for motor function. Neurologists suspect that the disease has its origins here.
They scraped off thin slices of 1/20 millimeter thickness from the frozen brain core one by one in order to be able to study the basal ganglia more closely. They place each slice in a special solution. This allows them to investigate which chemicals are contained in them and in what concentration.
The scientists are looking for chemicals which are neurotransmitters and are necessary for communication between nerve cells. One neurotransmitter of particular interest to them is dopamine. This messenger substance makes it possible to act out behaviors. But in the brains of Tourette’s patients, it seems to be released uncontrollably, causing the tics and involuntary movements.
In healthy people, dopamine is distributed evenly. In Tourette’s sufferers, on the other hand, the concentration in certain areas is extremely high. If scientists can find out how, where and why dopamine is so poorly distributed, they could develop new therapies and drugs that have fewer side effects than the preparations currently on the market.
High in the service of research
In a world where uncontrollable tics are unacceptable to society, some Tourette’s sufferers hide their symptoms with the help of medication. However, these so-called neuroleptics often have side effects. Nikolai has not yet found the right medication for him either. So far, he prefers the tics to the side effects.
In Germany, neurologists at the Hannover Medical School have tested a new form of therapy. It is based on a well-known but still controversial drug: the cannabis plant. Tourette’s patients reported having fewer tics or even none at all after using cannabis.
Marijuana is illegal in most countries. However, its active ingredient THC (tetrahydrocannabinol) is legal and available in the form of tablets or drops. How THC controls the symptoms is not yet entirely clear. It is possible that the substance acts on special nerve receptors in the brain.
Smoking weed for science
To find out more about how THC works in the brain, the Hannover Medical School conducted a placebo-controlled study with 24 test subjects in 2016, led by physician Dr. Kirsten Müller-Vahl. Nikolai was also one of the participants in this cannabis study.
So that the researchers to take a look inside his brain they injected Nikolai with a radioactive liquid. With the help of this so-called Spect study, the doctors were able to determine how many receptor sites there are for cannabis and where they are located.
It has been known for about ten years that such binding sites for cannabis and cannabis drugs exist in the brain. brain exist. Initially, corresponding tests were carried out on corpses and also on animals. The Hannover Medical School was the first in the world to develop and carry out a method on living humans that makes it possible to visualize these binding sites in the brain.
Over the next few years, the doctors want to use this technology to examine more people and patients in order to find out what significance this system has and whether there are specific diseases in which there is a disorder in this system.
