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Movement Disorders : Official Journal... Dec 2021
Topics: Humans; Tic Disorders; Tics; Tourette Syndrome
PubMed: 34921458
DOI: 10.1002/mds.28853 -
The Cochrane Database of Systematic... Jan 2018Gilles de la Tourette syndrome, or Tourette's syndrome, is defined as the presence of both motor and vocal (phonic) tics for more than 12 months, that manifest before... (Review)
Review
BACKGROUND
Gilles de la Tourette syndrome, or Tourette's syndrome, is defined as the presence of both motor and vocal (phonic) tics for more than 12 months, that manifest before the age of 18 years, in the absence of secondary causes. Treatment of motor and phonic tics is difficult and challenging.
OBJECTIVES
To determine the safety and effectiveness of botulinum toxin in treating motor and phonic tics in people with Tourette's syndrome, and to analyse the effect of botulinum toxin on premonitory urge and sensory tics.
SEARCH METHODS
We searched the Cochrane Movement Disorders Group Trials Register, CENTRAL, MEDLINE, and two trials registers to 25 October 2017. We reviewed reference lists of relevant articles for additional trials.
SELECTION CRITERIA
We considered all randomised, controlled, double-blind studies comparing botulinum toxin to placebo or other medications for the treatment of motor and phonic tics in Tourette's syndrome for this review. We sought both parallel group and cross-over studies of children or adults, at any dose, and for any duration.
DATA COLLECTION AND ANALYSIS
We followed standard Cochrane methods to select studies, assess risk of bias, extract and analyse data. All authors independently abstracted data onto standardized forms; disagreements were resolved by mutual discussion.
MAIN RESULTS
Only one randomised placebo-controlled, double-blind cross-over study met our selection criteria. In this study, 20 participants with motor tics were enrolled over a three-year recruitment period; 18 (14 of whom had a diagnosis of Tourette's syndrome) completed the study; in total, 21 focal motor tics were treated. Although we considered most bias domains to be at low risk of bias, the study recruited a small number of participants with relatively mild tics and provided limited data for our key outcomes. The effects of botulinum toxin injections on tic frequency, measured by videotape or rated subjectively, and on premonitory urge, are uncertain (very low-quality evidence). The quality of evidence for adverse events following botulinum toxin was very low. Nine people had muscle weakness following the injection, which could have led to unblinding of treatment group assignment. No data were available to evaluate whether botulinum injections led to immunoresistance to botulinum.
AUTHORS' CONCLUSIONS
We are uncertain about botulinum toxin effects in the treatment of focal motor and phonic tics in select cases, as we assessed the quality of the evidence as very low. Additional randomised controlled studies are needed to demonstrate the benefits and harms of botulinum toxin therapy for the treatment of motor and phonic tics in patients with Tourette's syndrome.
Topics: Botulinum Toxins, Type A; Humans; Neuromuscular Agents; Tics; Time Factors; Tourette Syndrome
PubMed: 29304272
DOI: 10.1002/14651858.CD012285.pub2 -
Healthcare (Basel, Switzerland) May 2024During the COVID-19 pandemic, there have been multiple reports about an unforeseen surge in adolescents and young adults exhibiting sudden onset functional tic-like... (Review)
Review
During the COVID-19 pandemic, there have been multiple reports about an unforeseen surge in adolescents and young adults exhibiting sudden onset functional tic-like behaviors. This phenomenon has been mainly associated with the female gender and occasionally after exposure to social media content featuring similar patterns of functional tic-like behaviors. A significant portion of these individuals have been directed to specialist clinics for movement disorders with initial misdiagnoses of late-onset refractory Tourette syndrome. Distinguishing between rapid onset functional tic-like behaviors and neurodevelopmental tics as part of Tourette syndrome can be challenging; however, the differential diagnosis is facilitated by focusing on specific clinical and demographic factors, which we have explored in a systematic literature review. Compared to neurodevelopmental tics, functional tic-like behaviors typically present with a more abrupt and intense manifestation of symptoms, onset at a later age, higher prevalence among females, inability to suppress tics, coexisting anxiety and depression, and sometimes a history of exposure to social media content portraying tic-like behaviors of a similar nature. This novel manifestation of a functional neurological disorder may thus be viewed as an emerging neuropsychiatric condition potentially triggered/exacerbated by the psychosocial repercussions of the COVID-19 crisis.
PubMed: 38891181
DOI: 10.3390/healthcare12111106 -
Biomedical Journal Apr 2022This issue of Biomedical Journal provides the reader with articles concerning the latest understanding of Tourette syndrome (TS), the relation to genetic predisposition,...
This issue of Biomedical Journal provides the reader with articles concerning the latest understanding of Tourette syndrome (TS), the relation to genetic predisposition, defects in the dopaminergic system, and related comorbidities which further complications like sleep disruption. Treatment approaches for TS, attention deficit hyperactivity disorder and developmental coordination disorder are discussed. The second section of this issue offers insights into inside out integrin activation and its link to T cell activation, demonstrates how polarity in immune cells allows adoption to specialized functions, and describes the endosomal signaling of internalized T cell receptors (TCRs). The link between mutations in TCR signaling and immunodeficiencies is elucidated, as well as the interactions of thymocyte-expressed molecule involved in selection in T cell development. Additionally, we learn about a potential biomarker for colorectal cancer, screening tools for determining frailty in older adults, surgical approaches in spinal metastases, the influence of autophagy on mating behavior, and the effect of nitrite administration on SNARE proteins associated with insulin secretion. Finally, parameters for surgery in breast cancer are discussed, as well as gender and age dependent pain perception in a lysosomal storage disease, and the use of laser meridian massage in opioid use disorder. Three letters complement this issue, one concerning neuroimaging in pediatric COVID-19 patients, and two discussing the role of cancer antigen-125 and renal impairment in ovarian cancer patients.
Topics: Aged; COVID-19; Child; Humans; Obsessive-Compulsive Disorder; Tics; Tourette Syndrome
PubMed: 35460927
DOI: 10.1016/j.bj.2022.04.004 -
Movement Disorders Clinical Practice Jul 2021Driving ability may be impaired in patients with various movement disorders, but it has not been studied in patients with Tourette syndrome (TS).
BACKGROUND
Driving ability may be impaired in patients with various movement disorders, but it has not been studied in patients with Tourette syndrome (TS).
CASES
We describe a series of 6 patients from our large cohort of TS patients followed in our movement disorders clinic in whom severe tics have had interfered with their driving abilities. The motor tics involved facial muscles and caused visual impairment because of frequent blinking and transient blepharospasm (dystonic tic), but complex limb and truncal tics also seriously impacted their driving.
CONCLUSIONS
Although majority of patients with TS have no functional impairment, severe motor tics in some patients may adversely affect their driving ability, potentially causing danger to themselves and others. Screening for such troublesome tics should be considered in patients with TS, particularly in teenagers who are being evaluated for driver's licensing.
PubMed: 34307750
DOI: 10.1002/mdc3.13225 -
Frontiers in Psychiatry 2020The capacity to efficiently control motor output, by either refraining from prepotent actions or disengaging from ongoing motor behaviors, is necessary for our ability... (Review)
Review
The capacity to efficiently control motor output, by either refraining from prepotent actions or disengaging from ongoing motor behaviors, is necessary for our ability to thrive in a stimulus-rich and socially complex environment. Failure to engage in successful inhibitory motor control could lead to aberrant behaviors typified by an excess of motor performance. In tic disorders and Tourette syndrome (TS) - the most common tic disorder encountered in clinics - surplus motor output is rarely the only relevant clinical sign. A range of abnormal behaviors is often encountered which are historically viewed as "disinhibition phenomena". Here, we present the different clinical features of TS from distinct categorical domains (motor, sensory, complex behavioral) that evoke the concept of disinhibition and discuss their associations. We also present evidence for their consideration as phenomena of inhibitory dysfunction and provide an overview of studies on TS pathophysiology which support this view. We then critically dissect the concept of disinhibition in TS and illuminate other salient aspects, which should be considered in a unitary pathophysiological approach. We briefly touch upon the dangers of oversimplification and emphasize the necessity of conceptual diversity in the scientific exploration of TS, from disinhibition and beyond.
PubMed: 32161555
DOI: 10.3389/fpsyt.2020.00021 -
F1000Research 2022Recent years have seen a dramatic increase in new "tic" cases in teens and young adults. These individuals often present with fulminant onset of symptoms not commonly...
Recent years have seen a dramatic increase in new "tic" cases in teens and young adults. These individuals often present with fulminant onset of symptoms not commonly seen in Tourette syndrome (TS) and are often diagnosed with Functional Neurological Symptom Disorder (FND-tic). However, some authors have questioned whether this illness truly differs from typical Provisional Tic Disorder (PTD) and TS. Previous studies have compared FND-tic, usually a few months after symptom onset, to patients with TS, usually years after symptom onset. We sought to test whether the presenting symptoms of FND-tic differ substantially from those in patients at a similar duration of symptoms who are later diagnosed with TS. This comparative study examines clinical features summarized from published reports of FND-tic with novel data from a longitudinal study of PTD. This study came from a referral center for TS and tic disorders and included 89 children with tics whose first tic occurred a median of 3.6 months earlier, nearly all of whom were diagnosed with a chronic tic disorder at follow-up. Specifically, we examine clinical features identified in a recent literature review as supporting a diagnosis of FND-tic, including symptom characteristics, course, severity and comorbidity. Several clinical features dramatically distinguish the patients diagnosed with FND-tic from those diagnosed with typical PTD. For example, coprophenomena are reported at or shortly after symptom onset in over half of FND-tic patients, whereas even several months after onset, coprophenomena had occurred in only 1 of 89 children with PTD. Six clinical features each have a positive predictive value over 90% for FND-tic diagnosis if prior probability is 50%. These new data provide strong evidence supporting the diagnostic validity of FND-tic as distinct from TS.
Topics: Child; Adolescent; Young Adult; Humans; Tics; Longitudinal Studies; Tourette Syndrome; Referral and Consultation
PubMed: 37224324
DOI: 10.12688/f1000research.129252.2 -
Journal of Psychiatry & Neuroscience :... Nov 2018
Topics: Antipsychotic Agents; Child; Diagnostic and Statistical Manual of Mental Disorders; Female; Humans; Obsessive-Compulsive Disorder; Psychiatric Status Rating Scales; Tics
PubMed: 30375839
DOI: 10.1503/jpn.180086 -
The Plant Cell Aug 2018
Topics: Chloroplast Proteins; Chloroplasts; Humans; Peptides; Tics; Toes
PubMed: 30111614
DOI: 10.1105/tpc.18.00618 -
Journal of Neuroscience Methods Dec 2017Recent advances in our understanding of the neurobiology of tics have led to the development of novel rodent models capturing different pathophysiological and phenotypic... (Review)
Review
BACKGROUND
Recent advances in our understanding of the neurobiology of tics have led to the development of novel rodent models capturing different pathophysiological and phenotypic aspects of Tourette syndrome. The proliferation of these models, however, raises vexing questions on what standards should be adopted to assess their theoretical validity and empirical utility. Assessing the homology of a rodent motoric burst with a tic remains problematic, due to our incomplete knowledge of the underpinnings of tics, their high phenotypic complexity and variability, limitations in our ability test key aspects of tic phenomenology (such as premonitory sensory phenomena) in animals, and between-species differences in neuroanatomy and behavioral repertoire. These limitations underscore that any interpretation of behavioral output in an animal model cannot exclusively rely on the recognition of features that bear superficial resemblance with tics, but must be supported by other etiological and convergent phenomenological criteria.
NEW METHOD
Here, we discuss two complementary approaches for the study and validation of tic-like manifestations in rodents, based respectively on the use of contextual modulators and accompanying features of repetitive motor manifestations and on the reproduction of pathogenic factors.
RESULTS
Neither strategy can by itself provide convincing evidence that a model informatively recapitulates tic pathophysiology. Their combination holds promise to enhance the rigorous evaluation and translational relevance of rodent models of tic disorders.
CONCLUSIONS
This systematic consideration of different approaches to the validation and study of animal models of tic pathophysiology provides a framework for future work in this area.
Topics: Animals; Disease Models, Animal; Humans; Rodentia; Tic Disorders
PubMed: 28237575
DOI: 10.1016/j.jneumeth.2017.02.007