scholarly journals Relationships Between Premonitory Urge and Anxiety in Youth With Chronic Tic Disorders

2014 ◽  
Vol 44 (3) ◽  
pp. 235-248 ◽  
Author(s):  
Michelle Rozenman ◽  
Olivia E. Johnson ◽  
Susanna W. Chang ◽  
Douglas W. Woods ◽  
John T. Walkup ◽  
...  
Keyword(s):  
Tic Disorders ◽  
Chronic Tic Disorders ◽  
Premonitory Urge

scholarly journals Clinical Correlates of Health-Related Quality of Life in Adults With Chronic Tic Disorder

2021 ◽  
Vol 12 ◽  
Author(s):  
David A. Isaacs ◽  
Heather R. Riordan ◽  
Daniel O. Claassen
Keyword(s):  
Quality Of Life ◽  
Tic Disorders ◽  
Self Report ◽  
Obsessive Compulsive ◽  
Quality Of Life Scale ◽  
Tic Severity ◽  
Health Related ◽  
Chronic Tic Disorders ◽  
Premonitory Urge

Tics are the hallmark feature of Tourette syndrome (TS), but psychiatric and sensory symptoms are widely prevalent and increasingly recognized as core manifestations of the disorder. Accumulating evidence suggests that these psychiatric and sensory symptoms exert greater influence on quality of life (QOL) than tics themselves. However, much remains uncertain about determinants of QOL in TS due to the complexity of the clinical presentation. Here, we sought to clarify the association between health-related QOL (HRQOL) and common psychiatric and sensory symptoms in adults with TS and other chronic tic disorders. To do so, we prospectively recruited 52 patients from a tertiary care clinic to complete self-report measures assessing HRQOL (Gilles de la Tourette-Quality of Life Scale, GTS-QOL), depression (Patient Health Questionnaire-9, PHQ-9), anxiety (Generalized Anxiety Disorder Scale-7, GAD-7), obsessive-compulsive symptoms (Dimensional Obsessive-Compulsive Scale, DOCS), attention deficit hyperactivity disorder symptoms (Adult ADHD Self-Report Screening Scale for DSM-5, ASRS-V), and premonitory urge (Premonitory Urge to Tic Scale, PUTS). All participants were also administered the Yale Global Tic Severity Scale (YGTSS) to quantify tic severity. Using correlational analysis and multivariable linear regression modeling, we found that GTS-QOL score was significantly associated with scores from all other rating scales, with the exception of the PUTS. GTS-QOL was most strongly associated with PHQ-9, followed by ASRS-V, GAD-7, DOCS, and YGTSS total tic score. The regression model including these five independent variables, as well as sex, explained 79% of GTS-QOL score variance [F(6,40) = 29.6, p < 0.001]. Specific psychiatric symptoms differentially impacted physical, psychological, and cognitive HRQOL. Systematic assessment of psychiatric comorbidities is imperative for clinical care and clinical research efforts directed at improving QOL in adults with chronic tic disorders.

Premonitory Urge for Tics Scale (PUTS): replication and extension of psychometric properties in youth with chronic tic disorders (CTDs)

2017 ◽  
Vol 125 (4) ◽  
pp. 727-734 ◽  
Author(s):  
Jeremy M. Raines ◽  
Kimberly R. Edwards ◽  
Martin F. Sherman ◽  
Christopher I. Higginson ◽  
Joel B. Winnick ◽  
...  
Keyword(s):  
Psychometric Properties ◽  
Tic Disorders ◽  
Chronic Tic Disorders ◽  
Premonitory Urge

scholarly journals Predictors of therapeutic treatment outcome in adolescent chronic tic disorders

BJPsych Open ◽  
2019 ◽  
Vol 5 (5) ◽  
Author(s):  
J. B. Nissen ◽  
E. T. Parner ◽  
P. H. Thomsen
Keyword(s):  
Treatment Outcome ◽  
Depressive Symptoms ◽  
Functional Impairment ◽  
Therapeutic Intervention ◽  
Tic Disorders ◽  
Individual Treatment ◽  
Habit Reversal Training ◽  
Tic Severity ◽  
Chronic Tic Disorders ◽  
Premonitory Urge

Background Chronic tic disorders may have a major impact on a child's function. A significant effect has been shown for combined habit reversal training (HRT) and exposure response prevention (ERP) treatment delivered in an individual and group setting. Aims The present study examines predictors and moderators of treatment outcome after an acute therapeutic intervention. Method Fifty-nine children and adolescents were randomised to manualised treatment combining HRT and ERP as individual or group training. Age, gender, baseline tic severity, Premonitory Urge for Tics Scale (PUTS) scores, Beliefs about Tic Scale (BATS) scores, hypersensitivity and comorbid psychiatric symptoms were analysed as predictors of outcome. The same characteristics were examined as moderators for individual versus group treatment. Outcome measures included the change in total tic severity (TTS) score and functional impairment score (as measured by the Yale Global Tic Severity Scale (YGTSS)). Results Internalising symptoms predicted a lesser decrease in functional impairment. The occurrence of obsessive–compulsive symptoms predicted a larger decrease in TTS. Baseline hypersensitivity and high scores on depressive symptoms favoured individual treatment. High baseline PUTS scores favoured group therapy. Conclusions This is the first study examining factors predicting and moderating perceived functional impairment following a therapeutic intervention. The study adds to the knowledge on predictors and moderators of TTS. Furthermore, this is the first study examining the effect of the BATS score. The study points towards factors that may influence treatment outcome and that require consideration when choosing supplemental treatment. This applies to comorbid anxiety and depressive symptoms, and to the child's belief about their tics and premonitory urge. Declaration of interest None.

scholarly journals Altered urinary tetrahydroisoquinoline derivatives in patients with Tourette syndrome: reflection of dopaminergic hyperactivity?

2020 ◽  
Author(s):  
Philipp Capetian ◽  
Veit Roessner ◽  
Caroline Korte ◽  
Susanne Walitza ◽  
Franz Riederer ◽  
...  
Keyword(s):  
Tourette Syndrome ◽  
Diagnostic Value ◽  
Tic Disorders ◽  
Operating Characteristics ◽  
Roc Curve Analysis ◽  
Two Phase ◽  
Dopaminergic Neurotransmission ◽  
Hyperactivity Disorder ◽  
The Central Nervous System ◽  
Chronic Tic Disorders

AbstractTetrahydroisoquinolines (TIQs) such as salsolinol (SAL), norsalsolinol (NSAL) and their methylated derivatives N-methyl-norsalsolinol (NMNSAL) and N-methyl-salsolinol (NMSAL), modulate dopaminergic neurotransmission and metabolism in the central nervous system. Dopaminergic neurotransmission is thought to play an important role in the pathophysiology of chronic tic disorders, such as Tourette syndrome (TS). Therefore, the urinary concentrations of these TIQ derivatives were measured in patients with TS and patients with comorbid attention-deficit/hyperactivity disorder (TS + ADHD) compared with controls. Seventeen patients with TS, 12 with TS and ADHD, and 19 age-matched healthy controls with no medication took part in this study. Free levels of NSAL, NMNSAL, SAL, and NMSAL in urine were measured by a two-phase chromatographic approach. Furthermore, individual TIQ concentrations in TS patients were used in receiver-operating characteristics (ROC) curve analysis to examine the diagnostic value. NSAL concentrations were elevated significantly in TS [434.67 ± 55.4 nmol/l (standard error of mean = S.E.M.), two-way ANOVA, p < 0.0001] and TS + ADHD patients [605.18 ± 170.21 nmol/l (S.E.M.), two-way ANOVA, p < 0.0001] compared with controls [107.02 ± 33.18 nmol/l (S.E.M.), two-way ANOVA, p < 0.0001] and NSAL levels in TS + ADHD patients were elevated significantly in comparison with TS patients (two-way ANOVA, p = 0.017). NSAL demonstrated an AUC of 0.93 ± 0.046 (S.E.M) the highest diagnostic value of all metabolites for the diagnosis of TS. Our results suggest a dopaminergic hyperactivity underlying the pathophysiology of TS and ADHD. In addition, NSAL concentrations in urine may be a potential diagnostic biomarker of TS.

scholarly journals The CANNA-TICS Study Protocol: A Randomized Multi-Center Double-Blind Placebo Controlled Trial to Demonstrate the Efficacy and Safety of Nabiximols in the Treatment of Adults With Chronic Tic Disorders

2020 ◽  
Vol 11 ◽  
Author(s):  
Ewgeni Jakubovski ◽  
Anna Pisarenko ◽  
Carolin Fremer ◽  
Martina Haas ◽  
Marcus May ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Alternative Treatment ◽  
Tic Disorders ◽  
Driving Ability ◽  
Efficacy And Safety ◽  
Double Blind ◽  
Psychiatric Comorbidities ◽  
Double Blind Placebo ◽  
Cannabis Extract ◽  
Chronic Tic Disorders

Background: Gilles de la Tourette syndrome (TS) is a chronic neuropsychiatric disorder characterized by motor and vocal tics. First-line treatments for tics are antipsychotics and tic-specific behavioral therapies. However, due to a lack of trained therapists and adverse events of antipsychotic medication many patients seek alternative treatment options including cannabis. Based on the favorable results obtained from case studies on different cannabis-based medicines as well as two small randomized controlled trials using delta-9-tetrahydrocannabinol (THC), we hypothesize that the cannabis extract nabiximols can be regarded as a promising new and safe treatment strategy in TS.Objective: To test in a double blind randomized clinical trial, whether treatment with the cannabis extract nabiximols is superior to placebo in patients with chronic tic disorders.Patients and Methods: This is a multicenter, randomized, double-blind, placebo controlled, parallel-group, phase IIIb trial, which aims to enroll 96 adult patients with chronic tic disorders (TS or chronic motor tic disorder) across 6 centers throughout Germany. Patients will be randomized with a 2:1 ratio into a nabiximols and a placebo arm. The primary efficacy endpoint is defined as tic reduction of at least 30% (compared to baseline) according to the Total Tic Score of the Yale Global Tic Severity Scale (YGTSS-TTS) after 13 weeks of treatment. In addition, several secondary endpoints will be assessed including changes in different psychiatric comorbidities, quality of life, driving ability, and safety assessments.Discussion: This will be the first large, controlled study investigating efficacy and safety of a cannabis-based medicine in patients with TS. Based on available data using different cannabis-based medicines, we expect not only a reduction of tics, but also an improvement of psychiatric comorbidities. If the cannabis extract nabiximols is proven to be safe and effective, it will be a valuable alternative treatment option. The results of this study will be of high health-economic relevance, because a substantial number of patients uses cannabis (illegally) as self-medication.Conclusion: The CANNA-TICS trial will clarify whether nabiximols is efficacious and safe in the treatment of patients with chronic tic disorders.Clinical Trial Registration: This trial is registered at clinicaltrialsregister.eu (Eudra-CT 2016-000564-42) and clinicaltrials.gov (NCT03087201).

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