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Arbuckle AL, Bihun EC, Schlaggar BL, Black KJ. Functional tic-like presentations differ strikingly from Provisional Tic Disorder. F1000Res 2023; 11:1566. [PMID: 37224324 PMCID: PMC10186060 DOI: 10.12688/f1000research.129252.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/11/2023] [Indexed: 05/26/2023] Open
Abstract
Background: 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. Methods: 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. Results: 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%. Conclusions: These new data provide strong evidence supporting the diagnostic validity of FND-tic as distinct from TS.
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Affiliation(s)
- Amanda L. Arbuckle
- Department of Psychiatry, Washington University in St. Louis, School of Medicine, St. Louis, Missouri, 63110, USA
| | - Emily C. Bihun
- Department of Psychiatry, Washington University in St. Louis, School of Medicine, St. Louis, Missouri, 63110, USA
| | - Bradley L. Schlaggar
- Department of Pediatrics, Johns Hopkins Medicine, Baltimore, MD, 21287, USA
- Department of Neurology, Johns Hopkins Medicine, Baltimore, Maryland, 21287, USA
- Kennedy Krieger Institute, Baltimore, Maryland, 21205, USA
| | - Kevin J. Black
- Department of Psychiatry, Washington University in St. Louis, School of Medicine, St. Louis, Missouri, 63110, USA
- Department of Neurology, Washington University in St. Louis, School of Medicine, St. Louis, Missouri, 63110, USA
- Department of Neuroscience, Washington University in St. Louis, School of Medicine, St. Louis, Missouri, 63110, USA
- Department of Radiology, Washington University in St. Louis, School of Medicine, St. Louis, Missouri, 63110, USA
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Hartmann A, Andrén P, Atkinson-Clement C, Czernecki V, Delorme C, Debes NM, Szejko N, Ueda K, Black K. Tourette syndrome research highlights from 2021. F1000Res 2022; 11:716. [PMID: 35923292 PMCID: PMC9315233 DOI: 10.12688/f1000research.122708.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/05/2022] [Indexed: 11/05/2022] Open
Abstract
We summarize selected research reports from 2021 relevant to Tourette syndrome that the authors consider most important or interesting. The authors welcome article suggestions and thoughtful feedback from readers.
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Affiliation(s)
- Andreas Hartmann
- Department of Neurology, APHP, Sorbonne University, Hôpital de la Pitié-Salpêtrière, Paris, 75013, France,
| | - Per Andrén
- Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Stockholm, Sweden
| | - Cyril Atkinson-Clement
- Paris Brain Institute (ICM), Sorbonne Université, Inserm, CNRS, APHP, Paris, 75013, France
| | - Virginie Czernecki
- Department of Neurology, APHP, Sorbonne University, Hôpital de la Pitié-Salpêtrière, Paris, 75013, France
| | - Cécile Delorme
- Department of Neurology, APHP, Sorbonne University, Hôpital de la Pitié-Salpêtrière, Paris, 75013, France
| | | | - Natalia Szejko
- Department of Neurology, Medical University of Warsaw, Warsaw, Poland
| | - Keisuke Ueda
- Department of Psychiatry, Neurology, Radiology and Neuroscience, Washington University in St. Louis, Saint Louis, Missouri, USA
| | - Kevin Black
- Department of Psychiatry, Neurology, Radiology and Neuroscience, Washington University in St. Louis, Saint Louis, Missouri, USA
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Melillo R, Leisman G, Machado C, Machado-Ferrer Y, Chinchilla-Acosta M, Kamgang S, Melillo T, Carmeli E. Retained Primitive Reflexes and Potential for Intervention in Autistic Spectrum Disorders. Front Neurol 2022; 13:922322. [PMID: 35873782 PMCID: PMC9301367 DOI: 10.3389/fneur.2022.922322] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 06/06/2022] [Indexed: 11/13/2022] Open
Abstract
We provide evidence to support the contention that many aspects of Autistic Spectrum Disorder (ASD) are related to interregional brain functional disconnectivity associated with maturational delays in the development of brain networks. We think a delay in brain maturation in some networks may result in an increase in cortical maturation and development in other networks, leading to a developmental asynchrony and an unevenness of functional skills and symptoms. The paper supports the close relationship between retained primitive reflexes and cognitive and motor function in general and in ASD in particular provided to indicate that the inhibition of RPRs can effect positive change in ASD.
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Affiliation(s)
- Robert Melillo
- Movement and Cognition Laboratory, Department of Physical Therapy, University of Haifa, Haifa, Israel
| | - Gerry Leisman
- Movement and Cognition Laboratory, Department of Physical Therapy, University of Haifa, Haifa, Israel
- Department of Neurology, University of the Medical Sciences of Havana, Havana, Cuba
| | - Calixto Machado
- Department of Clinical Neurophysiology, Institute for Neurology and Neurosurgery, Havana, Cuba
| | - Yanin Machado-Ferrer
- Department of Clinical Neurophysiology, Institute for Neurology and Neurosurgery, Havana, Cuba
| | | | - Shanine Kamgang
- Department of Neuroscience, Carleton University, Ottawa, ON, Canada
| | - Ty Melillo
- Northeast College of the Health Sciences, Seneca Falls, New York, NY, United States
| | - Eli Carmeli
- Movement and Cognition Laboratory, Department of Physical Therapy, University of Haifa, Haifa, Israel
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Black KJ, Kim S, Yang NY, Greene DJ. Course of tic disorders over the lifespan. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2021; 8:121-132. [PMID: 34178575 PMCID: PMC8223879 DOI: 10.1007/s40474-021-00231-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2021] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW To summarize and update information on the course of tic disorders from childhood through later life. RECENT FINDINGS Tics tend to improve substantially over the first year after they appear. However, contrary to widespread opinion, tics usually last longer than one year, though usually at minimal severity. Tics often wane to clinical insignificance over the teen years, possibly resurging occasionally over the lifespan. However, in an important minority of patients, tics remain clinically relevant throughout life. Tics rarely first come to clinical attention later in adulthood, but new reports describe additional such cases. SUMMARY Recent publications have shown tics to persist past a few months more often than previously thought, though often at minimal severity, and recurrence after an asymptomatic period is common. The safety and efficacy of behavior therapy for tics, together with prospective indicators of early prognosis, make feasible the possibility of bettering the lifetime course of tic disorders with early intervention.
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Affiliation(s)
- Kevin J. Black
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, Missouri, 63110
- Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, Missouri, 63110
- Department of Radiology Washington University in St. Louis School of Medicine, St. Louis, Missouri, 63110
- Department of Neurosdence Washington University in St. Louis School of Medicine, St. Louis, Missouri, 63110
| | - Soyoung Kim
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, Missouri, 63110
| | - Nancy Y. Yang
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, Missouri, 63110
| | - Deanna J. Greene
- Department of Cognitive Science, University of California, San Diego, La Jolla, California, 92093
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Abstract
Woods and Himle developed a standardized tic suppression paradigm (TSP) for the experimental setting, to quantify the effects of intentional tic suppression in Tourette syndrome. We previously provided a computer program to facilitate recording tic occurrence and to automate reward delivery during the several experimental conditions of the TSP. The present article describes a web-based program that performs the same functions. Implementing this program on the web allows research sessions to be performed remotely, in tandem with a video calling program. Relevant data for each session, such as the timing of tics and dispensed rewards, are stored in plain text files for later analysis. Expected applications include research on Tourette syndrome and related disorders.
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Affiliation(s)
- Jonathan K Black
- Department of Mechanical Engineering, Brigham Young University, Provo, Utah, 84602, USA
| | - Jonathan M Koller
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri, 63110, USA
- Department of Radiology, Washington University in St. Louis, St. Louis, Missouri, 63110, USA
| | - Kevin J Black
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri, 63110, USA
- Department of Radiology, Washington University in St. Louis, St. Louis, Missouri, 63110, USA
- Department of Neurology, Washington University in St. Louis, St. Louis, Missouri, 63110, USA
- Department of Neuroscience, Washington University in St. Louis, St. Louis, Missouri, 63110, USA
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Black JK, Koller JM, Black KJ. TicTimer Web: software for measuring tic suppression remotely. F1000Res 2020; 9:1264. [PMID: 33824720 PMCID: PMC7993402 DOI: 10.12688/f1000research.26347.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/09/2020] [Indexed: 04/01/2024] Open
Abstract
Woods and Himle developed a standardized tic suppression paradigm (TSP) for the experimental setting, to quantify the effects of intentional tic suppression in Tourette syndrome. We previously provided a computer program to facilitate recording tic occurrence and to automate reward delivery during the several experimental conditions of the TSP. The present article describes a web-based program that performs the same functions. Implementing this program on the web allows research sessions to be performed remotely, in tandem with a video calling program. Relevant data for each session, such as the timing of tics and dispensed rewards, are stored in plain text files for later analysis. Expected applications include research on Tourette syndrome and related disorders.
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Affiliation(s)
- Jonathan K. Black
- Department of Mechanical Engineering, Brigham Young University, Provo, Utah, 84602, USA
| | - Jonathan M. Koller
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri, 63110, USA
- Department of Radiology, Washington University in St. Louis, St. Louis, Missouri, 63110, USA
| | - Kevin J. Black
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri, 63110, USA
- Department of Radiology, Washington University in St. Louis, St. Louis, Missouri, 63110, USA
- Department of Neurology, Washington University in St. Louis, St. Louis, Missouri, 63110, USA
- Department of Neuroscience, Washington University in St. Louis, St. Louis, Missouri, 63110, USA
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Hippocampal Volume in Provisional Tic Disorder Predicts Tic Severity at 12-Month Follow-up. J Clin Med 2020; 9:jcm9061715. [PMID: 32503289 PMCID: PMC7355974 DOI: 10.3390/jcm9061715] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/26/2020] [Accepted: 05/27/2020] [Indexed: 01/18/2023] Open
Abstract
Previous studies have investigated differences in the volumes of subcortical structures (e.g., caudate nucleus, putamen, thalamus, amygdala, and hippocampus) between individuals with and without Tourette syndrome (TS), as well as the relationships between these volumes and tic symptom severity. These volumes may also predict clinical outcome in Provisional Tic Disorder (PTD), but that hypothesis has never been tested. This study aimed to examine whether the volumes of subcortical structures measured shortly after tic onset can predict tic symptom severity at one-year post-tic onset, when TS can first be diagnosed. We obtained T1-weighted structural MRI scans from 41 children with PTD (25 with prospective motion correction (vNavs)) whose tics had begun less than 9 months (mean 4.04 months) prior to the first study visit (baseline). We re-examined them at the 12-month anniversary of their first tic (follow-up), assessing tic severity using the Yale Global Tic Severity Scale. We quantified the volumes of subcortical structures using volBrain software. Baseline hippocampal volume was correlated with tic severity at the 12-month follow-up, with a larger hippocampus at baseline predicting worse tic severity at follow-up. The volumes of other subcortical structures did not significantly predict tic severity at follow-up. Hippocampal volume may be an important marker in predicting prognosis in Provisional Tic Disorder.
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Abstract
A boy with multiple phonic tics, one lifetime motor tic, and no impairment or marked distress does not meet criteria for any DSM-5 tic disorder diagnosis. The next version of the Diagnostic and Statistical Manual should adjust the criteria for Tourette's Disorder and/or for "other specified tic disorder" and "unspecified tic disorder."
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Affiliation(s)
- Kevin J. Black
- Departments of Psychiatry, Neurology, Radiology and Neuroscience, Washington University in St. Louis School of Medicine, St. Louis, MO, 63110-1093, USA
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