Tourette Syndrome Center of Excellence

Overview

Designated as a TS Center of Excellence by the Tourette Association of America, the Mass General Tourette Syndrome and Tic Disorders Clinic takes a team approach to treating Tourette syndrome and related disorders. Working closely with Mass General's world-class Department of Psychiatry enables us to treat all aspects of the patient's condition. When we encounter particularly challenging cases, we can consult with the other subspecialist physicians from the Movement Disorders Division, which is composed of four specialized clinics and cares for people with a variety of movement disorders.

In addition, our clinic includes the Mass General for Children Pediatric Tourette & Tic Disorders Clinic to care for pediatric patients. 

Treatment Tailored to Patient Needs

Our treatment approach depends on many factors, including the patient's:

• Age
• Severity of symptoms
• Co-occurring conditions
• Preference for pharmacological and/or behavioral treatments

Every plan begins with education on topics such as disease management and impact on school or work function.

For many patients, symptoms can be managed through education alone or with behavioral treatments. When medications are necessary, we maximize effectiveness and safety through carefully prescribing and monitoring practices.

Additionally, we tailor ongoing treatment to each patient's needs. Some patients visit us monthly, while others come once a year. Some patients rely on us for all treatment for Tourette syndrome; for others, we consult with their local pediatrician/primary care doctor, psychiatrist or neurologist. In all cases, our goal is to improve quality of life through successful symptom management.

What to Expect

If you are a new patient, you must receive a referral from your primary care physician, psychiatrist or neurologist before scheduling a consultation with our clinic. Prior to your first visit, we'll send you a packet of information to complete and return to us.

Please also send copies of all previous assessments (e.g. neurological, psychiatric, neuropsychological, psychoeducational). We need to review this information in advance to ensure we have time to address all of your specific issues during your one-hour consultation.

At your first visit, you'll undergo a thorough medical, developmental and family evaluation. Included is a comprehensive assessment of tic symptoms along with screening for common co-occurring conditions, such as obsessive-compulsive disorder (OCD) and attention-deficit/hyperactivity disorder (ADHD).

Usually, we can make a diagnosis and generate a comprehensive, multidisciplinary treatment plan on the first visit or soon thereafter. We often collaborate with Mass General psychiatrists, psychologists and/or neuropsychologists in this effort.

Interdisciplinary Care

We are one of the few dedicated Tourette syndrome clinics in New England, often seeing patients who are referred here due to the complexity of their cases.

People with Tourette syndrome and related disorders may experience symptoms ranging from mild, non-impairing motor and vocal tics to severe, complex tics and behaviors that markedly interfere with functioning and quality of life. We excel in managing care for patients no matter where they fall across this spectrum of symptom severity.

It's important to understand that Tourette syndrome lies in the border zone between neurology and psychiatry. As a result, patients often receive care from one specialty or the other—but not the coordinated care they need.

Our clinic bridges this gap by taking a comprehensive approach to diagnosing, treating and supporting patients. Clinic director Jeremiah Scharf, MD, PhD, received fellowship training in behavioral neurology and neuropsychiatry along with subspecialty training in Tourette syndrome. We also work closely with our colleagues in the Department of Psychiatry and MassGeneral for Children to coordinate all aspects of care for patients of all ages.

Our interdisciplinary partnerships for adults include:

• Mass General Center for OCD and Related Disorders
• Adult Psychology Assessment Center

• Pediatric Psychiatry OCD and Tic Disorders Program
• Child CBT Program
• Learning and Emotional Assessment Program (LEAP)

Pioneering Research Efforts

Our clinic's research focuses on uncovering the underlying causes of Tourette syndrome and tic spectrum disorders, as well as developing the next generation of treatments and interventions.

The Scharf Lab within the Mass General Center for Genomic Medicine co-directs the Tourette Association of America International Consortium for Genetics, which is working to identify the genes that may be responsible for Tourette syndrome. If you are a patient with Tourette syndrome or other tic disorders and would like information about participating in this important study, please contact Clinical Research Coordinator Evan Realbuto.

You can find more research participation opportunities at the Scharf lab's list of current studies and Mass General Brigham's Rally platform.