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Tic Disorder

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1. Comprehensive Systematic Review Summary: Treatment of Tics in People with Tourette Syndrome and Chronic Tic Disorders

Comprehensive Systematic Review Summary: Treatment of Tics in People with Tourette Syndrome and Chronic Tic Disorders 1 Practice Guideline: The treatment of tics in people with Tourette syndrome and chronic tic disorders Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology Authors Tamara Pringsheim, MD, MSc 1 ; Yolanda Holler-Managan, MD 2 ; Michael S. Okun, MD 3 ; Joseph Jankovic, MD 4 ; John Piacentini, PhD 5 ; Andrea E (...) Intervention for Tics CBT: cognitive behavioral therapy CI: confidence interval COI: conflict of interest DBS: deep brain stimulation DSM-5: Diagnostic and Statistical Manual of Mental Disorders (DSM–5), Fifth Edition GDDI: Guideline Development, Dissemination, and Implementation GRADE: Grading of Recommendations Assessment, Development, and Evaluation HRT: habit reversal training OCD: obsessive-compulsive disorder rTMS: repetitive transcranial magnetic stimulation SMD: standardized mean difference THC

2019 American Academy of Neurology

2. Pharmacological treatment for attention deficit hyperactivity disorder (ADHD) in children with comorbid tic disorders. (PubMed)

Pharmacological treatment for attention deficit hyperactivity disorder (ADHD) in children with comorbid tic disorders. This is an update of the original Cochrane Review published in Issue 4, 2011.Attention deficit hyperactivity disorder (ADHD) is the most prevalent of the comorbid psychiatric disorders that complicate tic disorders. Medications commonly used to treat ADHD symptoms include stimulants such as methylphenidate and amphetamine; non-stimulants, such as atomoxetine; tricyclic (...) antidepressants; and alpha agonists. Alpha agonists are also used as a treatment for tics. Due to the impact of ADHD symptoms on the child with tic disorder, treatment of ADHD is often of greater priority than the medical management of tics. However, for many decades, clinicians have been reluctant to use stimulants to treat children with ADHD and tics for fear of worsening their tics.  OBJECTIVES: To assess the effects of pharmacological treatments for ADHD in children with comorbid tic disorders on symptoms

2018 Cochrane

3. Comprehensive systematic review summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders

Comprehensive systematic review summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders To systematically evaluate the efficacy of treatments for tics and the risks associated with their use.This project followed the methodologies outlined in the 2011 edition of the American Academy of Neurology's guideline development process manual. We included systematic reviews and randomized controlled trials on the treatment of tics that included at least 20 participants (10 (...) , aripiprazole, tiapride, clonidine, onabotulinumtoxinA injections, 5-ling granule, Ningdong granule, and deep brain stimulation of the globus pallidus were probably more likely than placebo to reduce tics. There was low confidence that pimozide, ziprasidone, metoclopramide, guanfacine, topiramate, and tetrahydrocannabinol were possibly more likely than placebo to reduce tics. Evidence of harm associated with various treatments was also demonstrated, including weight gain, drug-induced movement disorders

2019 EvidenceUpdates

4. Practice guideline recommendations summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders

Practice guideline recommendations summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders To make recommendations on the assessment and management of tics in people with Tourette syndrome and chronic tic disorders.A multidisciplinary panel consisting of 9 physicians, 2 psychologists, and 2 patient representatives developed practice recommendations, integrating findings from a systematic review and following an Institute of Medicine-compliant process to ensure (...) transparency and patient engagement. Recommendations were supported by structured rationales, integrating evidence from the systematic review, related evidence, principles of care, and inferences from evidence.Forty-six recommendations were made regarding the assessment and management of tics in individuals with Tourette syndrome and chronic tic disorders. These include counseling recommendations on the natural history of tic disorders, psychoeducation for teachers and peers, assessment for comorbid

2019 EvidenceUpdates

5. Tic disorders

Tic disorders Tic disorders - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Tic disorders Last reviewed: February 2019 Last updated: November 2018 Summary Brief, sudden, repetitive movements and/or sounds that increase with stress, anxiety, or excitement. Occur most commonly in children and adolescents, with boys more frequently affected than girls. The exact pathophysiological mechanisms are unknown (...) , but the disorders are likely to be due to disturbances of the cortico-striatal-thalamo-circuitry. Comorbid conditions such as anxiety, obsessive-compulsive disorder, and ADHD are common. Tics are often intermittent and mild in children and may not require treatment. Treatment is indicated only for those patients whose tics are interfering with activities of daily living or social interactions, or who experience significant tic-related physical pain. Definition Tics are brief, sudden, repetitive movements

2018 BMJ Best Practice

6. Tic disorders

Tic disorders Tic disorders - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Tic disorders Last reviewed: February 2019 Last updated: November 2018 Summary Brief, sudden, repetitive movements and/or sounds that increase with stress, anxiety, or excitement. Occur most commonly in children and adolescents, with boys more frequently affected than girls. The exact pathophysiological mechanisms are unknown (...) , but the disorders are likely to be due to disturbances of the cortico-striatal-thalamo-circuitry. Comorbid conditions such as anxiety, obsessive-compulsive disorder, and ADHD are common. Tics are often intermittent and mild in children and may not require treatment. Treatment is indicated only for those patients whose tics are interfering with activities of daily living or social interactions, or who experience significant tic-related physical pain. Definition Tics are brief, sudden, repetitive movements

2018 BMJ Best Practice

7. Tic disorders revisited: introduction of the term "tic spectrum disorders". (PubMed)

Tic disorders revisited: introduction of the term "tic spectrum disorders". Although the DSM-5 chronic motor tic disorder (CMTD) and Tourette syndrome (TS) are distinct diagnostic categories, there is no genetic or phenotypic evidence that supports this diagnostic categorization. The aim of this study was to compare patients with both diagnoses along a number of clinical characteristics to provide further diagnostic clarity. Our sample consisted of 1018 patients (including adult and child (...) patients) suffering from chronic tic disorders. Tic severity was assessed via Shapiro Tourette-Syndrome Severity Scale (STSS). Lifetime prevalence of other comorbid conditions was assessed in a semi-structured clinical interview. The data were gained through retrospective chart analysis. The two groups did not differ significantly in any of the clinical or demographic variables. Patients only differed in tic severity, with CMTD patients (n = 40) having lower mean tic severity (STSS = 2.0 vs. 2.8; p

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2019 European child & adolescent psychiatry

8. Practice guideline recommendations summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders. (PubMed)

Practice guideline recommendations summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders. To make recommendations on the assessment and management of tics in people with Tourette syndrome and chronic tic disorders.A multidisciplinary panel consisting of 9 physicians, 2 psychologists, and 2 patient representatives developed practice recommendations, integrating findings from a systematic review and following an Institute of Medicine-compliant process to ensure (...) transparency and patient engagement. Recommendations were supported by structured rationales, integrating evidence from the systematic review, related evidence, principles of care, and inferences from evidence.Forty-six recommendations were made regarding the assessment and management of tics in individuals with Tourette syndrome and chronic tic disorders. These include counseling recommendations on the natural history of tic disorders, psychoeducation for teachers and peers, assessment for comorbid

Full Text available with Trip Pro

2019 Neurology

9. Comprehensive systematic review summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders. (PubMed)

Comprehensive systematic review summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders. To systematically evaluate the efficacy of treatments for tics and the risks associated with their use.This project followed the methodologies outlined in the 2011 edition of the American Academy of Neurology's guideline development process manual. We included systematic reviews and randomized controlled trials on the treatment of tics that included at least 20 participants (10 (...) , aripiprazole, tiapride, clonidine, onabotulinumtoxinA injections, 5-ling granule, Ningdong granule, and deep brain stimulation of the globus pallidus were probably more likely than placebo to reduce tics. There was low confidence that pimozide, ziprasidone, metoclopramide, guanfacine, topiramate, and tetrahydrocannabinol were possibly more likely than placebo to reduce tics. Evidence of harm associated with various treatments was also demonstrated, including weight gain, drug-induced movement disorders

Full Text available with Trip Pro

2019 Neurology

10. Self-esteem in adults with Tourette syndrome and chronic tic disorders: The roles of tic severity, treatment, and comorbidity. (PubMed)

Self-esteem in adults with Tourette syndrome and chronic tic disorders: The roles of tic severity, treatment, and comorbidity. Tourette syndrome (TS) and chronic tic disorders (CTD) are stigmatizing disorders that may significantly impact self-esteem. Alternatively, comorbid psychiatric illnesses may affect self-esteem more than tics themselves. Extant research on self-esteem in TS/CTD is limited, has inconsistently examined the effect of comorbidities on self-esteem, and yields mixed (...) findings.This study aimed to clarify the roles of tics versus comorbid diagnoses on self-esteem in a large, carefully diagnosed sample of adults with TS/CTD (N = 122) receiving 10 weeks of Comprehensive Behavioral Intervention for Tics (CBIT) or Psychoeducation and Supportive Therapy (PST).Baseline self-esteem did not differ between adults with TS/CTD only and normative means, whereas self-esteem was significantly lower among adults with TS/CTD with a comorbid psychiatric illness. In a multiple regression

2019 Comprehensive psychiatry Controlled trial quality: uncertain

11. Predictors of therapeutic treatment outcome in adolescent chronic tic disorders. (PubMed)

Predictors of therapeutic treatment outcome in adolescent chronic tic disorders. 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.The present study examines predictors and moderators of treatment outcome after an acute therapeutic intervention.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

2019 BJPsych open Controlled trial quality: uncertain

12. Inflammation as a contributor to the etiology of obsessive-compulsive disorder and tic disorders in youth: what is the evidence? A systematic review

Inflammation as a contributor to the etiology of obsessive-compulsive disorder and tic disorders in youth: what is the evidence? A systematic review Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content

2019 PROSPERO

13. Patterns and Predictors of Tic Suppressibility in Youth With Tic Disorders (PubMed)

Patterns and Predictors of Tic Suppressibility in Youth With Tic Disorders Tic suppression is the primary target of tic disorder treatment, but factors that influence voluntary tic inhibition are not well understood. Several studies using the Tic Suppression Task have demonstrated significant inter-individual variability in tic suppressibility but have individually been underpowered to address correlates of tic suppression. The present study explored patterns and clinical correlates of reward (...) -enhanced tic suppression in youth with tic disorders using a large, pooled dataset. Individual-level data from nine studies using the Tic Suppression Task were pooled, yielding a sample of 99 youth with tic disorders. Analyses examined patterns of tic suppressibility and the relationship between tic suppressibility and demographic and clinical characteristics. A large majority of youth demonstrated a high degree of tic suppression, but heterogeneous patterns of tic suppressibility were also observed

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2018 Frontiers in Psychiatry

14. Association of Tourette Syndrome and Chronic Tic Disorder With Metabolic and Cardiovascular Disorders. (PubMed)

Association of Tourette Syndrome and Chronic Tic Disorder With Metabolic and Cardiovascular Disorders. There are limited data concerning the risk of metabolic and cardiovascular disorders among individuals with Tourette syndrome (TS) or chronic tic disorder (CTD).To investigate the risk of metabolic and cardiovascular disorders among individuals with TS or CTD over a period of 40 years.This longitudinal population-based cohort study included all individuals living in Sweden between January 1 (...) and transient ischemic attack, and arteriosclerosis).Of the 14 045 026 individuals in the cohort, 7804 individuals (5964 males [76.4%]; median age at first diagnosis, 13.3 years [interquartile range, 9.9-21.3 years]) had a registered diagnosis of TS or CTD in specialist care. Of 2 675 482 families with at least 2 singleton full siblings, 5141 families included siblings who were discordant for these disorders. Individuals with TS or CTD had a higher risk of any metabolic or cardiovascular disorders compared

2019 JAMA neurology

15. Extended-Release Guanfacine Does Not Show a Large Effect on Tic Severity in Children with Chronic Tic Disorders. (PubMed)

Extended-Release Guanfacine Does Not Show a Large Effect on Tic Severity in Children with Chronic Tic Disorders. To evaluate the tolerability, safety, and preliminary efficacy of extended-release guanfacine in children with chronic tic disorders, including Tourette's disorder (collectively referred to as CTD).This was a multisite, 8-week, randomized, double-blind, placebo-controlled trial. The primary outcome measure was the Yale Global Tic Severity Scale (YGTSS) total score. Key secondary (...) outcomes included the Improvement item of Clinical Global Impressions-Improvement (CGI-I) scale and the Tic Symptom Self-report (TSSR). Adverse events were monitored at each visit.Thirty-four subjects (23 boys and 11 girls) of ages 6 to 17 years (mean = 11.1 ± 3.1) with CTD were randomly assigned to extended-release guanfacine (n = 16) or placebo (n = 18). At baseline, the mean YGTSS total score was 26.3 ± 6.6 for the guanfacine group versus 27.7 ± 8.7 for the placebo group. Within the guanfacine group

2017 Journal of Child and Adolescent Psychopharmacology Controlled trial quality: predicted high

16. Outpatient Treatment of Tic Disorders Among Children and Adults (PubMed)

Outpatient Treatment of Tic Disorders Among Children and Adults Limited information is available regarding treatment practices in applied settings for children and adults with tic disorders (TDs). We describe, for the first time, the treatment of TDs in U.S. children and adults in the outpatient setting.Data from the 2003-2010 National Ambulatory Medical Care Survey and the National Hospital Ambulatory Care Survey were used. Descriptive statistics for modality of treatment and class (...) (SRIs) (19%), atypical antipsychotics (18%), anxiolytics (14%), anticonvulsants (11%), and typical antipsychotics (8%). Comorbid disorders and chronicity of problems were significantly associated with the receipt of certain classes of medications. Relatively few patients (18%) received psychotherapy.If the decision is made to treat tic disorders, the choice of medication is dependent on the primary complaints, severity, chronicity, and the presence of comorbid psychiatric disorders. In general

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2017 Movement disorders clinical practice

17. Risk factors of tic disorders in Chinese children: a systematic review and meta-analysis

Risk factors of tic disorders in Chinese children: a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites

2019 PROSPERO

18. The effectiveness of Chinese herbal medicine for tic disorders: a meta-analysis

The effectiveness of Chinese herbal medicine for tic disorders: a meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email

2019 PROSPERO

19. A systematic and critical review of the goal-directed and habitual control of behaviour in OCD and tic disorders

A systematic and critical review of the goal-directed and habitual control of behaviour in OCD and tic disorders Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated

2019 PROSPERO

20. Psychological and pharmacological treatments of adults with tics or Tourette syndrome

are involuntary, repeated actions that are difficult to control. Examples of motor tics are eye blinking and movements with arms and legs. Examples of vocal tics are throat clearing and words. Tic disorders are a spectrum of conditions were Tourette syndrome belongs to the most severe. In many cases the symptoms diminish by adulthood. Question Which psychological and pharmacological treatments are effective in adults with tics or Tourette syndrome? Identified literature Roessner V, Plessen KJ, Rothenberger (...) A, Ludolph AG, Rizzo R, Skov L, et al. European clinical guidelines for Tourette syndrome and other tic disorders. Part II: pharmacological treatment. Eur Child Adolesc Psychiatry 2011;20:173-96. Pringsheim T, Doja A, Gorman D, McKinlay D, Day L, Billinghurst L, et al. Canadian guidelines for the evidence-based treatment of tic disorders: Pharmacotherapy. The Canadian Journal of Psychiatry / La Revue canadienne de psychiatrie 2012;57:133-143. Steeves T, McKinlay BD, Gorman D, Billinghurst L, Day L

2018 Swedish Council on Technology Assessement

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