TikTok Tics: A Pandemic Within a Pandemic

Abstract

Background TikTok is a social media platform where users create and share videos. During the COVID‐19 pandemic, the use of this site greatly expanded. Tic and Tourette syndrome content also increased dramatically along with the number of patients with tics in neurology clinics. Objectives We compared the phenomenology of “TikTok tics” to typical tic disorders. We chose to analyze the most widely viewed videos and therefore focused on the most popular content creators. Methods Videos with the keywords “tic,” “Tourette,” or “tourettes” were reviewed to identify content creators between March 11, 2020 and March 30, 2021. We performed a quantitative assessment of TikTok tics as well as a descriptive analysis of the entire series of videos of each content creator. Results The mean age of the cohort was 18.8 years old, and the majority were women. Unlike the predominance of facial movements in typical tics, arm movements were most frequent. Average tics per minute was 29, and almost all recorded TikTok tics were severe, causing significant disability. Whereas coprolalia and self‐injurious behavior are only infrequently encountered in typical tic disorders, they were present in the overwhelming majority of TikTok subjects. Conclusions TikTok tics are distinct from what is typically seen in patients with Tourette syndrome, although share many characteristics with functional tics. We believe this to be an example of mass sociogenic illness, which involves behaviors, emotions, or conditions spreading spontaneously through a group. A modern clinician needs to remain abreast of social media sources as knowledge of media content is essential in managing patients in the current environment.

Relationship between COVID‐19 and movement disorders: A narrative review

“…At the same time, several clinicians and researchers have witnessed a striking, “epidemic” increase in the incidence of first‐ever, acute onset tic‐like behaviours, mainly functional in nature, presumably related to pandemic‐related social restrictions, changes in frequency and modality of routine social and academic activities, specific social media exposures related to tics and tic‐like behaviours, and pandemic‐related stress and anxiety levels in vulnerable adolescents and young adults [61]. Similar observations were made by different clinicians and researchers across Canada, the United States, Europe, and Australia [61–67]. These young patients exhibit an unusually rapid onset of complex movements and vocalizations, in some cases reflecting shared exposure to social media triggers, and high prevalence of comorbid anxiety and depressive disorders.…”

Updates in Functional Movement Disorders: from Pathophysiology to Treatment Advances

“…The authors describe six teenage girls who developed an explosive onset of tic-like movements after witnessing the same social media personality on TikTok. Olvera et al [ 36 ] corroborated this finding and further differentiated the rising “TikTok tics” from conventional tic disorders. Patients with “TikTok tics” were mostly women with a mean age of 18.18 years old.…”

The Rise of Functional Tic-Like Behaviors: What Do the COVID-19 Pandemic and Social Media Have to Do With It? A Narrative Review

“…Clinical expertise and prior case studies suggest there are some key distinguishing features ( 10 , 12 , 65 – 68 ). While most individuals with pre-existing FMD reported no change in symptoms with the COVID-19 pandemic, there has been a dramatic increase in new FT ( 7 – 11 , 69 , 70 ).…”

“…Tic severity was overall severe with a high degree of tic attacks reported. There was a female predominance with 64.3% female, 17.6% male, and 14.3% nonbinary based on self-report of gender identity in the user's profile ( 7 ). Mean age reported was 18.8 years old although limitations included lack of age disclosure as well as unclear timing of video to onset of symptoms ( 7 ).…”