Course of Tic Disorders Over the Lifespan

Black, Kevin J.; Kim, Soyoung; Yang, Nancy Y. C.; Greene, Deanna J.

doi:10.1007/s40474-021-00231-3

Cited by 38 publications

(25 citation statements)

References 67 publications

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“… Cravedi et al, 2018 ). Finally, and in this respect, one of the most important tasks in TS research will be to gather more solid epidemiological and longitudinal data ( Black et al, 2021 ).…”

Section: The Problemmentioning

confidence: 99%

Is Tourette syndrome a rare condition?

et al. 2021

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Section: The Problemmentioning

confidence: 99%

Is Tourette syndrome a rare condition?

et al. 2021

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“…In addition to chronic motor and chronic vocal tic disorders (characterized by the occurrence of only motor or vocal tics), Tourette syndrome (TS) is defined as a chronic combined multiple motor and vocal tic disorder. The prevalence of TS in childhood is estimated to be about 0.5% and, in most patients, symptoms persist into adulthood, although often with a very low severity [ 2 , 3 ]. However, a small but relevant proportion of adult patients still suffers from impairing tics [ 2 ], resulting in reduced quality of life [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…The prevalence of TS in childhood is estimated to be about 0.5% and, in most patients, symptoms persist into adulthood, although often with a very low severity [ 2 , 3 ]. However, a small but relevant proportion of adult patients still suffers from impairing tics [ 2 ], resulting in reduced quality of life [ 4 ]. In addition, TS is a cost-intensive disease that causes high direct and in particular high indirect costs [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

ONLINE-TICS: Internet-Delivered Behavioral Treatment for Patients with Chronic Tic Disorders

Haas

Jakubovski

Kunert

et al. 2022

JCM

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Comprehensive Behavioral Intervention for Tics (CBIT) is considered a first-line therapy for tics. However, availability of CBIT is extremely limited due to a lack of qualified therapists. This study is a multicenter (n = 5), randomized, controlled, observer-blind trial including 161 adult patients with chronic tic disorders (CTD) to provide data on efficacy and safety of an internet-delivered, completely therapist-independent CBIT intervention (iCBIT Minddistrict®) in the treatment of tics compared to placebo and face-to-face (f2f) CBIT. Using a linear mixed model with the change to baseline of Yale Global Tic Severity Scale-Total Tic Score (YGTSS-TTS) as a dependent variable, we found a clear trend towards significance for superiority of iCBIT (n = 67) over placebo (n = 70) (−1.28 (−2.58; 0.01); p = 0.053). In addition, the difference in tic reduction between iCBIT and placebo increased, resulting in a significant difference 3 (−2.25 (−3.75; −0.75), p = 0.003) and 6 months (−2.71 (−4.27; −1.16), p < 0.001) after the end of treatment. Key secondary analysis indicated non-inferiority of iCBIT in comparison to f2f CBIT (n = 24). No safety signals were detected. Although the primary endpoint was narrowly missed, it is strongly suggested that iCBIT is superior compared to placebo. Remarkably, treatment effects of iCBIT even increased over time.

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“…Tic symptoms generally start at the age of 7-8 years and reach their utmost severity at approximately 8-12 years old ( 11 , 12 ), with occasional reoccurrences throughout the lifespan in many cases ( 13 ). Accumulated evidence has suggested that relapse of tic symptoms during the long pathophysiological course of TS might be triggered by improper immune activation and inflammation ( 14 , 15 ).…”

Section: Introductionmentioning

confidence: 99%

Profiles of Proinflammatory Cytokines and T Cells in Patients With Tourette Syndrome: A Meta-Analysis

et al. 2022

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BackgroundTic disorder is a neurodevelopmental disorder characterized by motor and phonic tic symptoms. Tourette syndrome (TS) is a subtype of tic disorder that shows more persistent tic symptoms. The etiological mechanism of TS concerning immune dysfunction remains unclear due to limited evidence, especially for pediatric TS patients.MethodIn the present study, a meta-analysis was performed to confirm the identified changes in proinflammatory cytokines and T cells of pediatric TS patients. A total of five databases, including PubMed, Web of Science, PsycINFO, Google Scholar and the China National Knowledge Infrastructure (CNKI), were used for the literature search. The standardized mean difference (SMD) and mean difference (MD) with a 95% confidence interval (CI) were used to present the effect size of each type of proinflammatory cytokine and T cell. Sensitivity analysis, subgroup analysis and meta-regression analysis were used to explore the heterogeneity of the meta-analysis. This meta-analysis was registered in the International Platform of Registered Systematic Review and Meta-analysis Protocols (number: INPLASY2021110079).ResultsIn the 25 studies included in this meta-analysis, thirteen studies focused on the levels of T cells, and twelve studies focused on the levels of proinflammatory cytokines. Based on the random-effects model, the pooled MDs are -1.45 (95% CI: -3.44, 0.54) for CD3 cells, -4.44 (95% CI: -6.80, -2.08) for CD4 cells, and 1.94 (95% CI: -0.08, 3.97) for CD8 cells. The pooled SMDs are1.36 for IL-6 (95% CI: 0.00, 2.72) and 2.39 for tumor necrosis factor alpha (TNF-α) (95% CI: 0.93, 3.84).ConclusionWe provided evidence of immune dysfunction in pediatric TS patients, with elevated levels of particular proinflammatory cytokines and disproportionate changes in T-cell subpopulations. Small to large effect sizes were identified for increased IL-6 levels as well as a reduced number of T helper cells, while a large effect size was identified for increased TNF-α levels. These results indicate a close association between peripheral immune activation and TS. However, the most direct and meaningful interaction between peripheral immune status and microglial activation in the central nervous system in TS patients requires further exploration.

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Course of Tic Disorders Over the Lifespan

Cited by 38 publications

References 67 publications

Is Tourette syndrome a rare condition?

Is Tourette syndrome a rare condition?

ONLINE-TICS: Internet-Delivered Behavioral Treatment for Patients with Chronic Tic Disorders

Profiles of Proinflammatory Cytokines and T Cells in Patients With Tourette Syndrome: A Meta-Analysis

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