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PubMed2005

Clinical significance of tics and attention-deficit hyperactivity disorder (ADHD) in children with pervasive developmental disorder.

The goal of this study was to examine the clinical significance of co-occurring tics and attention-deficit hyperactivity disorder (ADHD) as indicators of a more complex symptomatology in children with and without pervasive developmental disorder. Parents and teachers completed a Diagnostic and Statistical Manual of Mental Disorders-IV-referenced rating scale for 3- to 5- (n = 182/135) and 6- to 12- (n = 301/191) year-old children with pervasive developmental disorder and clinic controls, respectively. The percentage of children with tic behaviors varied with age: preschoolers (25%, 44%) versus elementary schoolchildren (60%, 66%) (parent and teacher ratings, respectively). For many psychiatric symptoms, screening prevalence rates were highest for the ADHD + tics group and lowest for the group with symptoms of neither, but the pattern of group differences varied by age group and informant. In general, there were few differences between the ADHD only and tics only groups. The pattern of ADHD/tic group differences was similar for both children with and without pervasive developmental disorder. We concluded that these findings support the notion that the co-occurrence of ADHD and tics is an indicator of a more complex psychiatric symptomatology in children with pervasive developmental disorder.

Attention Deficit Disorder with Hyperactivity↗
PubMed2006

Tic disorders: neural circuits, neurochemistry, and neuroimmunology.

The neuroanatomy and neurochemistry underlying tic disorders are thought to involve corticostriatothalamocortical circuits and dysregulation of their component neurotransmitter systems. Tourette syndrome is a tic disorder that begins in childhood and follows a waxing and waning course of tic severity. Although it is generally believed to have a genetic component, its etiology has not been fully elucidated. The clinical entity pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS) has led some to suggest that the pathophysiology of tics in some individuals might involve a postinfectious autoimmune component. We review the neural circuits and neurochemistry of Tourette syndrome and evaluate the evidence for and against a role for autoimmunity in the expression of tics.

Animals↗
PubMed1994

Obsessive-compulsive disorder with and without a chronic tic disorder. A comparison of symptoms in 70 patients.

The phenomenological features of 35 obsessive-compulsive disorder (OCD) patients with a lifetime history of tics were compared to 35 age- and sex-matched OCD patients without tics. Seven categories of obsessions and nine categories of compulsions were determined using the symptom checklist of the Yale-Brown Obsessive-Compulsive Scale (YBOCS). Discriminant function analysis revealed that, compared to their counterparts without tics, OCD patients with tics had more touching, tapping, rubbing, blinking and staring rituals, and fewer cleaning rituals, but did not differ on obsessions. These preliminary findings suggest that the types of compulsions present may help to discriminate between two putative subgroups of OCD, i.e. those with and without tics.

Adult↗
PubMed2001

Prevalence of tics in schoolchildren and association with placement in special education.

BACKGROUND: Based on the knowledge that Tourette's syndrome (TS) is associated with several clinical features that can impair school function and growing evidence that the disorder is much more common than previously thought, the authors hypothesized that TS and related tic disorders would be associated with school problems in the childhood population at large. METHODS: Direct, blinded (to educational placement) interviews of 1,596 schoolchildren in Monroe County, Rochester, NY, were conducted. RESULTS: Twenty-seven percent of 341 students classified as receiving special education (SpEd) had tics compared with 19.7% (p = 0.008) of 1,255 students in regular classroom programs (RegEd). The weighted prevalence estimates for tics were 23.4% in SpEd and 18.5% in RegEd. A higher percentage of students in SpEd (7.0%) met diagnostic criteria for TS than students in RegEd (3.8%; p = 0.01). CONCLUSIONS: Although possibly influenced by selection bias, our results indicate that tic disorders are common in children and are highly associated with school dysfunction. Tics may represent an identifiable sign of an underlying brain developmental disorder that contributes to academic difficulties.

Adolescent↗
PubMed2002

The behavioral spectrum of tic disorders: a community-based study.

BACKGROUND: Tourette syndrome (TS) and related tic disorders are commonly associated with obsessive-compulsive disorder (OCD) and attention deficit hyperactivity disorder (ADHD). It has been argued, however, that any observed association between TS and these and other psychopathologies may be due to ascertainment bias in that individuals with multiple problems are more likely to be referred for medical evaluation. METHODS: In order to overcome the potential confounding by ascertainment bias, the authors conducted a community-based study of school children using direct interviews to determine the prevalence of tic disorders and any comorbid psychopathology. A standard psychiatric interview and standardized rating scales were utilized to diagnose childhood behavioral disorders. RESULTS: Of the 1,596 children interviewed, 339 were identified as having tics. The following psychopathologies were found more commonly (p < 0.05) in the children with tics: OCD, ADHD, separation anxiety, overanxious disorder, simple phobia, social phobia, agoraphobia, mania, major depression, and oppositional defiant behavior. CONCLUSION: The behavioral spectrum of tic disorders includes OCD, other anxiety disorders, a mood disorder, and attention-deficit and disruptive behavior disorders.

Adolescent↗
PubMed2001

Tics and Tourette syndrome: clinical evaluation of 44 cases.

We evaluated 44 patients with tics and Tourette's syndrome (TS) emphasising the age of onset of symptoms, sex, classification and localization of tics, associated symptoms and signs and comorbidities. Thirty-three patients (75.2%) had TS defined criteria whereas 10 (22.7%) had chronic motor and/or vocal tics. Simple motor tics were found in 43 cases (97.7%), mainly affecting the eyes (43.2%), mouth (43.2%), face (34.1%). Simple vocal tics occurred in 33 (75%). Coprolalia was found in just 6 cases (13.6%) and copropraxia in just 2 (4.5%). Obsessive compulsive disorder and/or symptoms were found in 26 cases (59.1%) and attention deficit in 17 (38.6%). Eighteen patients (40.9%) had other disorders, such as alcoholism, tabagism, drug abuse, affective disorders, anxiety, sleep and learning disorders. The data obtained are similar to those found by other authors. We highlight the low frequency of coprolalia, as well as the associated neuropsychiatric disorders.

Adolescent↗
PubMed1976

Tics following methylphenidate administration. A report of 20 cases.

Among children receiving methylphenidate hydrochloride, tics developed in 14, and in six children with pre-existing tics, the tics became worse. The clinical diagnosis in 19 cases was minimal brain dysfunction (MBD), and in one case, Gilles de la Tourette syndrome. Duration and dose of medication showed no particular pattern. In only one case did tics persist unchanged after methylphenidate treatment was discontinued. Tics related to methylphenidate administration appear to be rare (20 of 1,520 cases, or 1.3%) and may point to a specific susceptibility possibly related to personality profile (obsessive, perseverative, withdrawn).

Acute Disease↗
PubMed1999

[Tics in childhood].

INTRODUCTION: Tics in infancy often cause problems in social relationships of children and worry to their immediate family. We review some aspects of these abnormal movements and mention Gilles de la Tourette disease, discussing the graduation from simple tics to the more severe tics which occur in this illness. DEVELOPMENT: Tics are the commonest abnormal movements in infancy, when paroxystic disorders are excluded. We review the scant progress made in more than 100 years regarding their aetiology and pathogenesis. Current strategies for the treatment of tics are considered (not only pharmacological) and choice of drug depending on associated disorders.

Child↗
PubMed2004

Psychogenic tics: diagnostic value of the placebo test.

Motor tics are characterized by abrupt onset of brief, unsustained focal movements that are usually preceded by a premonitory sensation and are suppressible. Psychogenic tics (pseudotics) are rarely described. It may not be easy to distinguish organic from functional tics because they can coexist. Using a case illustration, the value of a "staged" placebo test in aiding the diagnosis of psychogenic tics is described. In addition, a concise summary of the clinical phenomenology of tics and the diagnosis and management of psychogenic movement disorders is provided.

Child↗
PubMed1991

[Multiple tics and Gilles de la Tourette syndrome].

Tic disorders are frequent in childhood, varying from transient motor tics over multiple chronic tic disorders to full-blown Gilles de la Tourette syndrome (GTS). GTS is genetically determined. In affected families, relatives of the patient(s) with GTS may show minor symptoms only. The clinical picture is extremely variable, extending from the well known motor tics over complex compulsive obsessive behavior to purely sensory tics. The optimal treatment today is the use of dopamine antagonists.

Antipsychotic Agents↗
PubMed1989

Tic disorders: an overview.

Tics are purposeless and repetitive involuntary movements and vocalizations with variable and complex means of expression. Since up to 24 per cent of children can manifest tics at some point in their lives, growing interest has developed in the genetics, etiology, course, diagnosis, and treatment of the tic disorders. This article is a review of the current knowledge about tics and tic disorders.

Diagnosis, Differential↗
PubMed1988

Tic disorders of childhood.

Tic disorders may be classified as simple tics, chronic motor tics or Tourette syndrome, the most severe of the three types. Tourette syndrome is rather uncommon and is often misdiagnosed. Tic disorders of childhood probably have an organic etiology and a genetic component. An increased incidence of obsessive-compulsive behavior, attention deficit disorder and other abnormalities have been reported in Tourette patients. Haloperidol is often useful in controlling severe tic symptoms, while stimulant drugs may worsen the symptoms.

Attention Deficit Disorder with Hyperactivity↗
PubMed1986

[The concept of tic in the history of abnormal movements].

History of abnormal movements started during the 14th century. At that time the St Vitus' Dance was described, but the nosology of dyskinesias remained confusing during the next five centuries. The concept of tic was elaborated in France during the 18th century. It remained too large a concept however. Definitive semiologies appeared at the end of the 19th century, thus allowing tics to emerge from the "chaos of choreas". The etymology of the word "tic" still remains mysterious. In 1905, Meige thought that the word tic was used for the first time by reference to horses. He referred to the tic of the bear in the horse described by Rudler and Chomel at The Société de Neurologie de Paris in 1903. Veterinarians were thus probably the first to describe the word. If so, however, the horse must leave anteriority to the goat. The word Ticq was used in 1611 as mentioned by the French dictionary Robert. The word is said to be an onomatopea and is compared to the italian word ticchio which means caprice. Another dictionary (Littré) suggest the german word "ticken", which means "to touch slightly", the galic word tacaid (sudden pain) and the german ziki (young goat), a word which could have lead to ticchio as capra, goat in italian, gave capricio.

England↗
PubMed1993

Tourette's syndrome in monozygotic twins. Relationship of tic severity to neuropsychological function.

OBJECTIVE: To determine whether there is a relationship between tic severity and neuropsychological function in Tourette's syndrome (TS). DESIGN: The study employed a case-control series involving monozygotic twin pairs, divided into more severe and less severe groups based on tic severity and tested with a neuropsychological battery of tests. SETTING: Twin pairs were recruited nationwide and evaluated in the National Institute of Mental Health Neuropsychiatric Research Hospital. PATIENTS: Twelve twin pairs (mean age, 10.5 years; range, 8 to 16 years) in which at least one member met criteria for a diagnosis of TS. RESULTS: Global neuropsychological performance was significantly worse in the twins with more severe tic symptoms, with significant differences emerging on individual tests of attention, visuospatial perception, and motor function. In each twin pair, the twin with more severe tics had poorer global neuropsychological function. CONCLUSIONS: The results suggest that the nongenetic factors that influence tic severity in TS exert a similar effect on neuropsychological function, and that these two clinical manifestations of TS may share a common pathophysiologic state.

Adolescent↗
PubMed2003

Validation of the modified telephone interview for cognitive status (TICS-m) in Hebrew.

INTRODUCTION: The validity of the Hebrew version of the Telephone Interview for Cognitive Status-Modified (TICS-m) for Mild Cognitive Impairment (MCI), for dementia, and for cognitive impairment (either MCI or dementia) was investigated. METHODS: Of the 10 059 who took part of the Israel Ischemic Heart Disease Cohort, 1902 of the 2901 survivors in 1999 had TICS-m interviews. Those with a score of 27 or below and a random sample with a score of 28 or 29 were invited to have a physician's examination for the diagnosis of dementia. The analysis was performed on the 576 who agreed. RESULTS: Based on physician's diagnosis, 269 were diagnosed as suffering from dementia, 128 as suffering from MCI, and 179 were diagnosed with no cognitive impairment. The TICS-m Hebrew version's internal consistency was very high (Cronbach's alpha = 0.98) and showed a strong convergent validity with the MMSE (r = 0.82; p < 0.0005). The sensitivity was 100% for each of the conditions. Finally, after controlling for age, education and hearing impairment, TICS-m was a strong predictor of dementia, MCI and cognitive impairment. CONCLUSION: At a cut-off of 27/50 the Hebrew version of the TICS-m is a useful screening instrument to identify subjects suffering from mild cognitive impairment, dementia and cognitive impairment (MCI or dementia).

Aged↗
PubMed2003

Pilot study of effect of emotional stimuli on tic severity in children with Tourette's syndrome.

To assess objectively the effects of emotional stimuli on the severity of tics and to determine if such effects were mediated by the autonomic nervous system, we carried out videotape ratings of tics and electrophysiological monitoring of heart beat and respiration on 4 children with Tourette's syndrome while they were watching a movie known to elicit emotional responses relevant to normal childhood events. Measured tic severity was highest during periods associated with anticipation, resolution of emotional changes, and lower concentration, lowest during periods of anger and happiness, and intermediate during periods of sadness and fear. Tic severity did not correlate with heart or respiratory rate. Thus, tics seem influenced differentially by various emotional states, but this effect does not seem to be autonomically mediated.

Adolescent↗
PubMed1999

Anticipatory grip adjustments are observed in both goal-directed movements and movement tics in an individual with Tourette's syndrome.

We examined grip force adjustments during movements of a hand-held object in a young man (BF) with Tourette's syndrome. We directly compared BF's voluntary up and down movements with tics in the same directions. Movement tics were elicited by cueing BF to move either up or down on a GO signal which appeared after a variable delay. During the delay period, we observed frequent tics which were almost always in the cued movement direction. BF's voluntary movements were well coordinated and featured precise and appropriate anticipatory grip force adjustments such that grip force was modulated in phase with movement-induced fluctuations in load. Precise anticipatory grip force adjustments were also observed in all of BF's movement tics. These results support the hypothesis that tics in Tourette's syndrome are purposeful voluntary movements that are well organized and coordinated.

Adaptation, Physiological↗
PubMed2006

Flux-assisted wetting and spreading of Al on TiC.

The effect of a K-Al-F-based flux on the spreading of Al on TiC, at temperatures up to 900 degrees C, in Ar and in air has been studied. Whilst obtuse contact angles were observed without flux, the flux facilitated rapid spreading to a perfect wetting condition, in both Ar and in air. The atmosphere was found to have a weak effect on the spreading kinetics as the liquid flux provides a locally protective atmosphere by spreading over the TiC surface and also on the solid surface of Al. The flux dissolves the aluminium oxide, covering Al, so that when Al melts, and the oxide layer has been removed or weakened, intimate contact occurs between liquid Al and the TiC substrate facilitating spontaneous spreading and instantaneous wetting of liquid Al on TiC. Since flux-assisted spreading is very rapid and occurs without the formation of a reaction layer at the Al/TiC interface, this process is very different to the reactive wetting behaviour previously reported in the Al-TiC system.

Journal Article↗