Movement Disorders
John W. Scadding, Nicholas A. Losseff in Clinical Neurology, 2011
In a proportion of patients, these chronic tics are accompanied by vocalizations, when the condition is known as Gilles de la Tourette syndrome (GTS), which affects 1 per cent of the population. This illness begins before the age of 18 years with the tics affecting particularly the upper part of the body, especially the face, neck and shoulders. Their severity and distribution tend to wax and wane over time, and one tic may be replaced by another. Sooner or later, patients begin to make involuntary noises, such as grunting, squealing, yelping, throat-clearing, sniffing, coughing or barking. In about 15 per cent of cases, these noises become transformed into swear words (coprolalia). Often the patient recognizes an uncomfortable or even painful sensation (sensory tic) which is relieved by making the movement (itch and scratch analogy). Many Tourette patients also exhibit features of obsessive-compulsive disorder (OCD), and many affected children also display attention-deficit hyperactivity disorder (ADHD).
Gilles de la Tourette’s syndrome
David Enoch, Basant K. Puri, Hadrian Ball in Uncommon Psychiatric Syndromes, 2020
The vulnerability inherited was thought to be transmitted in an autosomal-dominant pattern with a variable penetrance which is greater in males than females (Curtiss et al., 1992); the existence of an X-linked mechanism had previously been postulated to account for the increased prevalence in males (Comings and Comings, 1986). However, in their review of genetic studies of Tourette syndrome, Qi et al. (2017) point out that:Both family and twin studies have shown that the etiology of [Tourette syndrome] is at least partially of genetic origin; however, the inheritance is more likely to be complex than [following a] simple [Mendelian pattern]. In general, [Tourette syndrome] and associated comorbidities have much lower heritability compared to other neuropsychiatric disorders, … indicating other factors during development and from the environment also play some roles in [the] pathogenesis of [Tourette syndrome] and its comorbidities.
Tourette syndrome and the law∗
Carlotta Zanaboni Dina, Mauro Porta, James F. Leckman in Understanding Tourette Syndrome, 2019
Early diagnosis and therapy prevents patients and families from high Social Impairment and from legal issues. Because of its social implications, Tourette syndrome can’t be treated only from a clinical point of view. In order to guarantee a complete case management, Tourette Centres’ clinicians need to co-work with all local stakeholders: caregivers, school/workplace staff, social workers, law professionals and TS associations. The latter are active worldwide in spreading information and defending patients; in the last decades, internet-based support is facilitating this global intervention. The final goal is educating citizens to respect TS patients’ personal and social rights, and therefore improving the TS community’s Quality of Life.
Treatment of psychiatric disturbances in common hyperkinetic movement disorders
Published in Expert Review of Neurotherapeutics, 2019
Isabella Berardelli, Massimo Pasquini, Antonella Conte, Matteo Bologna, Alfredo Berardelli, Giovanni Fabbrini
Tics are spontaneous, brief, repetitive, and stereotyped involuntary muscle contractions that occur on a background of normal activity. Tics may be motor or phonic, are often preceded by a sensation or urge to execute the tic and are accompanied by transient relief once they have been performed [30]. Gilles de la Tourette Syndrome (TS) is characterized by the presence of two or more motor tics and at least one phonic tic with onset <18 years of age; tics in this syndrome occur many times a day nearly every day, and last longer than one year [31]. In addition to motor symptoms, patients with chronic tics, particularly those with TS, often exhibit psychiatric disturbances. These disturbances include obsessive-compulsive disorder (OCD), which may be present in up to 72% of individuals, attention deficit hyperactivity disorder (ADHD), which may be observed in up to 50% of children and adolescents with TS, depression, anxiety, impulse control disorders, sleep disturbances, conduct disorder, rage attacks, oppositional defiant disorder, and self-injurious behavior [3,32–35].
The effect of shorter exposure versus prolonged exposure on treatment outcome in Tourette syndrome and chronic tic disorders – an open trial
Published in International Journal of Psychiatry in Clinical Practice, 2018
Jolande M. T. M. van de Griendt, Maarten K. van Dijk, Cara W. J. Verdellen, Marc J. P. M. Verbraak
Tic disorders, including Gilles de la Tourette syndrome (TS) and chronic tic disorders (CTD), are neuropsychiatric disorders that are characterised by brief, sudden, rapid, recurrent, non-rhythmic, motor movements or sounds, the so called tics (APA, 2013). Usually, tic disorders have a childhood onset occurring more often in boys than in girls. At the end of the spectrum, tics may have severe impact on mental and physical health including social, educational and occupational functioning. Physically, tics may lead to damage due to the self-injurious behaviour, or overstraining of muscles or joints and thus lead to functional impairments for patients (Robertson, 2000). Effective treatment of tics at an early stage is recommended for children whose tic symptoms result in distress and functional impairment.
The Role of Executive Functioning in Treatment Outcome for Child Anxiety
Published in Evidence-Based Practice in Child and Adolescent Mental Health, 2020
Sheina A. Godovich, Christopher J. Senior, Kathryn A. Degnan, Colleen Cummings, Nina D. Shiffrin, Mary K. Alvord, Brendan A. Rich
It is also possible that our ability to identify the predictive power of EF was hampered by our measurement of EF as a broad, single construct. Instead, perhaps EF should be differentiated into components to better understand specific roles of the various functions comprising EF. For example, attention shifting and inhibitory control demonstrated opposite relations with anxiety development in a longitudinal study of children from 24 months to 48 months (White, McDermott, Degnan, Henderson, & Fox, 2011). Flessner et al. (2010) found that processing speed significantly predicted OCD symptom severity, but other executive functions, such as working memory and planning, did not. Working memory and habit learning predicted tic reduction across both behavior therapy and psychoeducation/supportive therapy in a study of children with Tourette syndrome, but inhibition and shifting did not (Chang et al., 2018). A more specific measure of EF may elucidate differential predictive effects of EF components on post-treatment psychosocial functioning. However, due to the overlapping nature of executive functions, it is notable that no measure can completely differentiate specific aspects of EF (Rhoades et al., 2009), and the BASC-2 EF subscale demonstrates convergent validity with other measures such as the BRIEF (Gioia et al., 2000).
Related Knowledge Centers
- Behaviour Therapy
- Coprolalia
- Life Expectancy
- Syndrome
- Attention Deficit Hyperactivity Disorder
- Neurodevelopmental Disorder
- Tic
- Premonitory Urge
- Spectrum Disorder
- Tic Disorder