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Echophenomena and Coprophenomena
Published in Alexander R. Toftness, Incredible Consequences of Brain Injury, 2023
The pathophysiology of tic disorders is extremely complex, and there isn't just one part of the brain that can be pointed to as the source of the symptoms. Instead, symptoms such as echophenomena and coprophenoma are related to “multiple brain areas and complex pathways” (Yael et al., 2015, p. 1171). More specifically, research has indicated the importance of cortico-striatal-thalamo-cortical circuits of brain cells, as well as other circuits such as frontoparietal connections, to the features of tic disorders (Naro et al., 2020). Essentially, the symptoms arise because of functional abnormalities in the ways that these various regions of the brain communicate with one another. However, this still isn't a very satisfying answer as to what is occurring in the brain that causes the symptoms.
Gilles de la Tourette’s syndrome
Published in David Enoch, Basant K. Puri, Hadrian Ball, Uncommon Psychiatric Syndromes, 2020
David Enoch, Basant K. Puri, Hadrian Ball
Other tic disorders in DSM-5 include persistent (or chronic) motor or vocal tic disorder and provisional tic disorder. The diagnostic criteria are similar to those given above; for persistent (or chronic) motor or vocal tic disorder the criteria include:The presence of at least one motor tic or at least one vocal tic, but not bothTics occur many times daily or nearly daily or on and off for a period of more than one yearOnset before the age of 18 yearsSymptoms are not the result of medication, other drugs or another medical condition which can cause tics (e.g. seizures, Huntingtons’ disease or post-viral encephalitis)Not diagnosed with Tourette syndrome
Nail tic disorders
Published in Archana Singal, Shekhar Neema, Piyush Kumar, Nail Disorders, 2019
Tic disorders generally start in childhood and are characterized by multiple sudden, rapid, recurrent, and non-rhythmic movements (motor tics) or utterances (vocal tics), or both. They are mostly transient and may fade away in adolescence. However, sometimes they may be chronic and tend to persist lifelong. Tic disorders have been classified under neuropsychiatric disorders. Nail tic disorders are tics pertaining to nail unit.1 Their occurrence is not only limited to cosmetic disfigurement of the nail but is associated with psychopathological states that can affect a patient’s quality of life. Nail tic disorders are poorly understood and often pose a management challenge.
Antiseizure medication-induced obsessive-compulsive disorder and tic disorder: a pragmatic review
Published in Expert Review of Neurotherapeutics, 2022
Minakshi Doobay, Verinder Sharma, Heidi Eccles
Up to 30% of individuals with OCD have a lifetime diagnosis of tic disorders. Due to the repetitive behaviors that occur in OCD and tic disorders, these disorders can be conceptualized as a continuum. The DSM tic disorders are characterized by sudden, rapid, recurrent, nonrhythmic vocal or motor movements. A persistent or chronic tic disorder has either vocal or motor tics whereas a diagnosis of Tourette’s disorder requires both motor and vocal tics [1]. More than 80% of patients with Tourette’s disorder have at least one comorbid psychiatric disorder; the most common comorbidities being attention deficit hyperactivity disorder (ADHD) and OCD [3]. The increased risk of psychiatric comorbidity among individuals with Tourette’s disorder is likely due to shared neural pathways involving dysfunction of the dopamine system and basal ganglia-thalamocortical circuits [4]. These shared pathways may explain the high comorbidity and difficulty in distinguishing between OCD, tic disorders, and Tourette’s disorder. Candidate gene approaches have implicated genes in the serotonergic, and glutamatergic pathways [5]. A genome-wide association study (GWAS) of Tourette disorder and OCD found shared genetic variants contributing to susceptibility to these disorders as well as variants providing phenotypic specificity for each disorder [6].
Current pharmacotherapy for tic disorders
Published in Expert Opinion on Pharmacotherapy, 2020
Nicholas Cothros, Alex Medina, Tamara Pringsheim
A wide variety of drugs have been studied for the treatment of tic disorders. Alpha agonists and antipsychotics appear frequently in the literature and have been tested in several randomized controlled trials. Antipsychotics – in particular, haloperidol, risperidone, aripiprazole, and tiapride – these have emerged as effective treatments for tics, with reasonable effect sizes and clinically meaningful improvement in tics. Clonidine is also supported by comparatively good evidence, though the magnitude of its treatment effect falls below that of the antipsychotics listed above. Though supported by limited evidence, botulinum toxin injections, in contrast, are likely highly effective in the treatment of simple motor tics arising from muscles amenable to injection, or aggressive vocal tics via laryngeal injections. There is currently weak evidence supporting topiramate. Results from randomized controlled trials evaluating the use of dopamine depleters for tics are expected in the near future.
Neurocognitive function in paediatric obsessive-compulsive disorder
Published in The World Journal of Biological Psychiatry, 2018
Daniel A. Geller, Amitai Abramovitch, Andrew Mittelman, Abigail Stark, Kesley Ramsey, Allison Cooperman, Lee Baer, S. Evelyn Stewart
The prevalence of comorbid conditions is presented in Table 3. In order to assess the potential impact of comorbid disorders on neuropsychological test performance (for tests where a significant difference was found between the groups), we examined the impact of (1) the presence of a comorbid condition, (2) functional impairment severity of the comorbid diagnosis using the K-SADS (i.e., mild, moderate and severe) and (3) the number of comorbid conditions. In order to allow sufficient statistical power, these factors were analysed only for comorbid conditions that were identified in at least 20% of patients (i.e., major depressive disorder (MDD), simple phobia, generalised anxiety disorder, ADHD, tic disorders and Tourette’s syndrome and oppositional defiant disorder, see Table 3). For the purpose of this analysis we combined the Tourette’s syndrome and chronic tic disorder conditions into one group (henceforth termed TS). For all analyses, we first examined differences in gender, age and estimated IQ. In cases where the groups (e.g. OCD + MDD vs OCD-MDD) differed on these factors, an ANCOVA was conducted, controlling for the relevant factors.