Graduated doses of d- and l-isomers of amphetamine were administered on several occasions in double blind fashion to a patient with symptoms of both Gilles de la Tourettes disease and minimal brain dysfunction. d-Amphetamine markedly increased the frequency of ticking while l-amphetamine did not alter the tics. By contrast both isomers decreased the patient's hyperactivity to a similar extent. Based on the known differential influence of amphetamine isomers upon brain norepinephrine and dopamine, these findings suggest that aggravation of the tics is mediated by brain norepinephrine, while brain dopamine plays a major role in the alleviation of the symptoms of minimal brain dysfunction.
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