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Clinicians often observe the concurrence of disfluencies / stuttering in patients with tic disorders, without fully understanding how the two are related. Another interesting phenomenon in people who stutter is the concomitance of nonspeech behaviours during stuttering, such as certain facial expressions, gestures, and movements of the trunk or limbs. The purpose of the proposed scoping review is to explore the relationship between childhood-onset fluency disorder, tics, and accompanying nonspeech behaviours during stuttering. This will help clinicians to advise families seeking information on this topic.

2 p. l., [vii]-xii, 191, [1] p. ; 23 cm

This scope review aims to systematically sort out the related research on nursing intervention for tic disorders in children, analyze the types, implementation characteristics, effects of existing intervention strategies and their combination with evidence-based nursing, so as to provide a basis for constructing a comprehensive and effective nursing intervention system.

The purpose of this systematic review is to capture all applicable literature assessing the effectiveness of complementary and integrative medicine for reducing tic severity and improving tic related quality of life in patients with Tourette Syndrome or other chronic tic disorders. The systematic review will ultimately be used as the evidence-base to create a clinical practice guideline on the use of complementary and integrative medicine for tics.

The purpose of this systematic review is to capture all applicable literature assessing the effectiveness of complementary and integrative medicine for reducing tic severity and improving tic related quality of life in patients with Tourette Syndrome or other chronic tic disorders. The systematic review will ultimately be used as the evidence-base to create a clinical practice guideline on the use of complementary and integrative medicine for tics.

This article is from Chinese Medicine , volume 9 . Abstract Background: It was reported that 64% of tic disorder patients used complementary and alternative medicine. This review aims to evaluate the efficacy of herbal medicines in treating tic disorders. Methods: We searched eight databases including MEDLINE and CINAHL from their respective inceptions up to September 2013. The search terms were related to the concept of “herbal medicine” AND “tic disorder OR Tourette’s syndrome”. We included randomised controlled trials (RCTs) of any type of herbal medicines. We assessed the methodological quality of the trials according to the Cochrane risk of bias criteria. Results: Sixty one studies were identified, and four RCTs met the inclusion criteria. Two types of herbal medicines, Qufeng Zhidong Recipe (QZR) decoction and Ningdong (ND) granules, were used in the included RCTs. All four RCTs had a high risk of bias. Two RCTs tested the effects of QZR on the Yale Global Tic Severity Scale (YGTSS) score and response rate compared with conventional medicine. The meta-analysis showed significant effects of QZR on the YGTSS score with high statistical heterogeneity (n = 142; weighted mean difference: −18.34; 95% confidence interval (CI): −23.07 to −13.60; I2 = 97%) and the response rate (n = 142; risk ratio: 1.69; 95% CI: 1.39 to 2.06; I2 = 0%). One RCT compared ND granules with placebo and showed significant effects on the YGTSS score and response rate. The other RCT show significant effects of ND granules plus conventional medicine on the response rate compared with conventional medicine only. Conclusion: This systematic review provided first piece of limited meta-analytic evidence for the effectiveness of herbal medicines in improving the symptoms of tic disorders.

This article is from Chinese Medicine , volume 9 . Abstract Background: It was reported that 64% of tic disorder patients used complementary and alternative medicine. This review aims to evaluate the efficacy of herbal medicines in treating tic disorders. Methods: We searched eight databases including MEDLINE and CINAHL from their respective inceptions up to September 2013. The search terms were related to the concept of “herbal medicine” AND “tic disorder OR Tourette’s syndrome”. We included randomised controlled trials (RCTs) of any type of herbal medicines. We assessed the methodological quality of the trials according to the Cochrane risk of bias criteria. Results: Sixty one studies were identified, and four RCTs met the inclusion criteria. Two types of herbal medicines, Qufeng Zhidong Recipe (QZR) decoction and Ningdong (ND) granules, were used in the included RCTs. All four RCTs had a high risk of bias. Two RCTs tested the effects of QZR on the Yale Global Tic Severity Scale (YGTSS) score and response rate compared with conventional medicine. The meta-analysis showed significant effects of QZR on the YGTSS score with high statistical heterogeneity (n = 142; weighted mean difference: −18.34; 95% confidence interval (CI): −23.07 to −13.60; I2 = 97%) and the response rate (n = 142; risk ratio: 1.69; 95% CI: 1.39 to 2.06; I2 = 0%). One RCT compared ND granules with placebo and showed significant effects on the YGTSS score and response rate. The other RCT show significant effects of ND granules plus conventional medicine on the response rate compared with conventional medicine only. Conclusion: This systematic review provided first piece of limited meta-analytic evidence for the effectiveness of herbal medicines in improving the symptoms of tic disorders.

This article is from Chinese Medicine , volume 9 . Abstract Background: It was reported that 64% of tic disorder patients used complementary and alternative medicine. This review aims to evaluate the efficacy of herbal medicines in treating tic disorders. Methods: We searched eight databases including MEDLINE and CINAHL from their respective inceptions up to September 2013. The search terms were related to the concept of “herbal medicine” AND “tic disorder OR Tourette’s syndrome”. We included randomised controlled trials (RCTs) of any type of herbal medicines. We assessed the methodological quality of the trials according to the Cochrane risk of bias criteria. Results: Sixty one studies were identified, and four RCTs met the inclusion criteria. Two types of herbal medicines, Qufeng Zhidong Recipe (QZR) decoction and Ningdong (ND) granules, were used in the included RCTs. All four RCTs had a high risk of bias. Two RCTs tested the effects of QZR on the Yale Global Tic Severity Scale (YGTSS) score and response rate compared with conventional medicine. The meta-analysis showed significant effects of QZR on the YGTSS score with high statistical heterogeneity (n = 142; weighted mean difference: −18.34; 95% confidence interval (CI): −23.07 to −13.60; I2 = 97%) and the response rate (n = 142; risk ratio: 1.69; 95% CI: 1.39 to 2.06; I2 = 0%). One RCT compared ND granules with placebo and showed significant effects on the YGTSS score and response rate. The other RCT show significant effects of ND granules plus conventional medicine on the response rate compared with conventional medicine only. Conclusion: This systematic review provided first piece of limited meta-analytic evidence for the effectiveness of herbal medicines in improving the symptoms of tic disorders.

The objective of this scoping review is to examine published, original research investigating the characteristics, clinical correlates, and neurobiological correlates of premonitory urge in tic disorders.

The aim of this review is to summarize the literature examining parenting in the context of tic disorders, including parenting behaviors, stress, and psychopathology; describe how these factors relate to wellbeing and functioning in children and adolescents with tic disorders; and review interventions involving parents. This scoping review will inform the literature on the family environment in the context of tic disorders and on future directions for parenting interventions in tic disorders.

The aim of this review is to summarize the literature examining parenting in the context of tic disorders, including parenting behaviors, stress, and psychopathology; describe how these factors relate to wellbeing and functioning in children and adolescents with tic disorders; and review interventions involving parents. This scoping review will inform the literature on the family environment in the context of tic disorders and on future directions for parenting interventions in tic disorders.

Behavior analysis has been at the forefront in establishing effective treatments for children and adults with chronic tic disorders. As is customary in behavior analysis, the efficacy of these treatments has been established using direct-observation assessment methods. Although behavior-analytic treatments have enjoyed acceptance and integration into mainstream health care practices for tic disorders (e.g., psychiatry and neurology), the use of direct observation as a primary assessment tool has been neglected in favor of less objective methods. Hesitation to use direct observation appears to stem largely from concerns about the generalizability of clinic observations to other settings (e.g., home) and a lack of consensus regarding the most appropriate and feasible techniques for conducting and scoring direct observation. The purpose of the current study was to evaluate and establish a reliable, valid, and feasible direct-observation protocol capable of being transported to research and clinical settings. A total of 43 children with tic disorders, collected from two outpatient specialty clinics, were assessed using direct (videotape samples) and indirect (Yale Global Tic Severity Scale; YGTSS) methods. Videotaped observation samples were collected across 3 consecutive weeks and two different settings (clinic and home), were scored using both exact frequency counts and partial-interval coding, and were compared to data from a common indirect measure of tic severity (the YGTSS). In addition, various lengths of videotaped segments were scored to determine the optimal observation length. Results show that (a) clinic-based observations correspond well to home-based observations, (b) brief direct-observation segments scored with time-sampling methods reliably quantified tics, and (c) indirect methods did not consistently correspond with the direct methods. (Contains 5 tables.)

Cletus Vortex - Tic Disorders

Cletus Vortex - Tic Disorders

This is a mixed methods study to develop the Tourette Discrimination-Stigmatization (TD-STIGMA) Scale and evaluate its psychometric properties.

This is a mixed methods study to develop the Tourette Discrimination-Stigmatization (TD-STIGMA) Scale and evaluate its psychometric properties.

20 pages : (8vo)

20 pages : (8vo)

Royal College of Physicians of Edinburgh

Causal relationships between Tic Disorders and five types of neoplasm by Mendelian randomization methods.

Causal relationships between Tic Disorders and five types of neoplasm by Mendelian randomization methods.

This article is from Tremor and Other Hyperkinetic Movements , volume 2 . Abstract Introduction: Tic disorders are neurodevelopmental disorders of childhood associated with psychiatric comorbidity and academic problems. Estimating the prevalence and understanding the epidemiology of tic disorders is more complex than was once thought. Until fairly recently, tic disorders were thought to be rare, but today tics are believed to be the most common movement disorder, with 0.2–46.3% of schoolchildren experiencing tics during their lifetime. Tentative explanations for differing prevalence estimates include the multidimensional nature of tics with a varied and heterogeneous presentation, and the use of different epidemiological methods and study designs. Methods: Literature review and analysis of methodological issues pertinent to epidemiological studies of tic disorders. Results: Epidemiological studies of tic disorders were reviewed, and the main elements of epidemiological studies, including sample selection, case ascertainment strategy, definition of tic disorders, and the degree of coverage of the eligible population (i.e., the response rate) were examined. Discussion: In order to improve the quality of epidemiological studies of tic disorders, a number of recommendations were made, including but not limited to a review of the diagnostic criteria for tic disorders, and inclusion of new tic disorder categories for those with tics of secondary etiology.

We develop a neuroscientifically-informed gamified tic-therapy platform. We previously identified tic-triggering elements in movies and video games. Next, we employed these elements to generate and validate a gamified intervention protocol, which is based on a video game we designed (called XTics). The pre-registered study tests the efficacy of the gamified tool integrated in an exposure and response prevention (ERP) protocol to enhance both patient's compliance and clinical outcome.

We aim at investigating possible deviations in interoceptive accuracy (IA) in patients with tic disorders (TD) and relate these to levels of premonitory urges. As we assume that compared to HC, TD patients show higher levels of behavior problems (YSR, CBCL), antipsychotic medication use and more comorbid mental disorders, we will control for these variables.

Chronic tic disorders (CTD) are neurodevelopmental disorders affecting 0.5-1% of children and adolescents [1]. Tics present as sudden, rapid, repetitive, non-rhythmic movements or vocalizations, and often they vary in intensity, symptom presentation and localization [2]. Tics may be extremely distressing in a child's life, but the severity is often highly variable between individuals. Tics may result in impairment that affects social well-being, academic achievements, and physical well-being [3]. European guidelines recommend a behavioural and psychosocial intervention as primary treatment of tic disorders [3]. Pharmacological treatment is viewed as a supplemental treatment. The therapeutic treatments include habit reversal treatment (HRT) and exposure and response prevention (ERP) [3, 4, 5]. Premonitory urge is a sensory phenomenon preceding the tic symptom and both HRT and ERP are centred around the premonitory urge and represent different approaches to this [1]. The demand for specialized therapeutic treatment of tics has been steadily increasing in recent years. Child and Adolescent Psychiatry in Denmark is challenged by the increasing number of referrals, which increases the requirement for assessment and treatment in psychiatry, but also requires a strengthening of treatment options outside hospital settings. In Children and Adolescent Psychiatric Department, Aarhus University Hospital (AUH), we have unique data in relation to manualized therapeutic treatment of children and adolescents with tics on attendance at the hospital [1]. In 2018, our group published a manual describing therapeutic treatment as a group-based or individualized treatment [5, 6]. The diversity of tics both depending on age, comorbidities, and family challenges, increase the demand of a more step-cared perspective and treatment options [7]. The inclusion and expansion of telepsychiatry will be able to meet the growing need for relevant treatment at a high professional level and despite distances. Often families are generally burdened by the child's/ adolescent’s tic disorder and the current requirement for frequent attendance as part of the treatment may be perceived as an additional stress factor in relation to the organization of work and absence from school or youth education. App-based self-training or short-term video consultations for a group of patients, will free up time for training instead of e.g. transportation. Introducing a stepped-care perspective will also secure a more optimal use of resources in psychiatry, where the less affected children and adolescents could be treated in municipalities instead of waiting for treatment in hospital. Then the specialized departments can focus on the more difficult cases as well as guidance for therapists in the municipalities. Telepsychiatry thus moves the treatment into the home, and the training can take place in the environment where the disorders burden and challenge the child, adolescent and the family. This will be beneficial in case of later relapse. Working with symptoms at home will also benefit the youngest and some of the autistic children and adolescents, who may have difficulty transferring experience from the hospital to their everyday life. In the overall study we evaluate the efficacy and successful implementation of app-assisted treatment in children and adolescents with chronic tic disorders. In the present sub-study we use qualitative interviews to assess the feasibility and acceptability of the app-assisted treatment for professionals and families respectively. Improved knowledge on how the professionals and families experience the app-assisted treatment will help us to better understand the needs of the target groups, allowing us to customise and improve the app. To the best of our knowledge, an assessment of acceptability of app-assisted treatment of tics has not previously been explored and described in detail based on interviews with professionals and families.