Tic disorder is a childhood neuropsychological disorder characterized by abrupt, involuntary, and repetitive stereotyped muscle movement or vocal sound. Tourette's disorder shows a chronic prognosis, and can last for life if no treatment is applied. Although tic disorder has been known for ages, the underlying cause is still not well known. Non-pharmacological treatments have long been used for the tic disorder, but few clinical studies were conducted. However, the European Society for the Study of Tourette's Syndrome recently issued non-pharmacologic guidelines for treatment of tic disorders based on the research findings obtained so far. In addition, guidelines for non-pharmacologic evidence-based treatment were reported in Canada, North America. By synthesizing the newly reported foreign guidelines for treatment and review articles, the aim of this study is to investigate the non-pharmacologic therapies used for treatment of tic disorder or Tourette's disorder.
Canada ; North America ; Prognosis ; Tic Disorders ; Tics* ; Tourette Syndrome*

Tic disorders (TD) are a group of neurodevelopmental disorders that are characterized by motor and/or vocal tics in children and adolescents. The etiology and pathogenesis of TD remain unclear, and it is believed to be caused by a combination of genetic, biological, psychological, and environmental factors. The major treatment for TD includes psychoeducation, behavioral intervention, and drug treatment. To further explore the management of TD, this article reviews the research advances in psychoeducation and behavioral intervention for patients with TD.
Adolescent ; Behavior Therapy ; Child ; Humans ; Tic Disorders ; Tourette Syndrome

No abstract available.
Korea* ; Tic Disorders* ; Tics*

Tic disorders, including Tourette syndrome, are known as neurobiologic disorders and as such, much emphasis has been placed on isolating genetic determinants. Although previous reports involving studies of discordance among monozygotic twins have shown the importance of genetic predisposition, they have also supported a role for environmental factors in the development of tic disorders. Therefore, it is important to consider that both genetic and environmental factors contribute to their clinical expression. The goal of this article was to review recent reports regarding the role of environmental factors in development and progression of tics. Specific environmental factors associated either with a more severe course of illness or improved outcomes were discussed. Given that accumulating evidence had suggested the usefulness of behavior therapies in the suppression of tic disorders, particular emphasis was placed on the impact of several contextual factors.
Behavior Therapy ; Genetic Predisposition to Disease ; Humans ; Risk Factors ; Tic Disorders ; Tics ; Tourette Syndrome ; Twins, Monozygotic

PURPOSE: We evaluated tic symptoms in children with frequent eye-blinking and examined the differences in mothering behavior and childhood behavioral problems between the tic and normal children, and the clinical factors correlated with tics. METHODS: Fifty children with frequent eye-blinking were evaluated by an experienced psychiatrist and the severity of tic symptoms was assessed with the Korean version of Yale Global Tic Severity Scale. The Korean version of Mothering Behavior Rating Instrument and Child Behavior Checklist were accomplished by the mothers of the tic and normal children. RESULTS: Forty three (86%) children were diagnosed as tic disorders. The diagnostic subtypes were as follows : 39 transient tic disorders, two chronic tic disorders, and two Tourette's disorders. Twenty-nine had a simple motor tic, 10 had complex motor tics, and 4 had motor tics with vocal tics. Medication was needed for two children with Tourette's disorders and the other two who revisited with aggravated symptoms after six months. There was no difference in mothering behavior and childhood behavior problems between tic and normal children. The severity of tic was significantly correlated with the somatic symptoms and attentional problems in child behavior problems, and duration of symptoms CONCLUSIONS: Transient tic disorder was the most common diagnosis. Four children with chronic tic and Tourette's disorder needed psychiatric medications. Compared with normal children, there was no difference in mothering and childhood behavior problem in tic children. It is suggested that tics may become more severe with the longer duration of symptom and may influence the somatic symptoms and attention.
Checklist ; Child Behavior ; Child* ; Diagnosis ; Humans ; Mothers ; Psychiatry ; Tic Disorders* ; Tics* ; Tourette Syndrome

Tic disorder is a childhood neuropsychological disorder which has the characteristics of abrupt, involuntary, and repetitive stereotyped muscle movement or voice. Tourette's disorder shows a chronic prognosis, and can last for life if no medical treatment is applied. Though the tic disorder has been known for a long time, the underlying cause is still not well known. Psychotropic drugs have long been used for the tic disorder or Tourette's disorder, but few clinical studies were carried out. However, the European Society for the Study of Tourette's syndrome recently reported the clinical guideline of Tourette's syndrome and other tic disorders based on the research findings obtained so far. Also, the guideline for the evidence-based treatment was reported in Canada, and North America. By synthesizing the newly reported foreign guidelines for treatment and review articles, this study aims to investigate the psychotropic drug therapy used for the tic disorder or Tourette's disorder.
Canada ; Drug Therapy* ; Muscles ; North America ; Prognosis ; Psychotropic Drugs ; Tic Disorders ; Tourette Syndrome* ; Voice

Tics are brief, rapid and repetitive movement and sounds that are either simple or complex in presentation. Tics can be preceded by a premonitory urge (sensation) that decreases after tic is completed. The fourth edition of Diagnostic Statistical Manual of Mental Disorder (DSM- IV) includes diagnoses for Tourettes disorder, chronic motor or vocal tic disorder, transient tic disorder and tic disorder not otherwise specified (Table 1) according to the duration of tic symptoms and degree of complexity. The purposes of treatment of tic disorders must be set up based on the comprehensive evaluation of developmental profiles, strength, weakness, family situation, and school adaptation status. The family education must be included early in treatment process and psychosocial treatment including the cognitive behavioral therapy will be needed to develop and maintain the self-efficacy in controlling the tic symptoms. The most effective and efficient method for the reduction of tic symptoms, however, are drug treatment. The pharmacotherapy is usually one component of treatment for chronic tic disorder and Tourettes disorder. The gold standard for tic reduction is the dopaminergic receptor blocking agent (or antipsychotic agent, neuroleptics). The primary drugs are haloperidol, pimozide, and risperidone. Among theses, risperidone will be the primary choice because of its low side effect profiles, esp, neurologic side effects. In the near future, the studies on the efficacy of the olanzapine, quetiapine and ziprasidone will be more reported. As second line drugs, clionidine, guanfacine, nicotine related drugs can be considered.
Cognitive Therapy ; Diagnosis* ; Drug Therapy ; Education ; Guanfacine ; Haloperidol ; Humans ; Mental Disorders ; Nicotine ; Pimozide ; Risperidone ; Tic Disorders* ; Tics ; Tourette Syndrome

OBJECTIVES: It has been reported that higher percentage of B cells react with monoclonal D8/17 antibody in patients with rheumatic fever, childhood onset obsessive-compulsive disorder, Tourette's disorder, or prepubertal anorexia nervosa. The purpose of this study is to replicate the previous studies in a Korean young population with tic disorder and to identify any relationship between D8/17 and clinical symptoms. METHODS: The binding of D8/17 to B cells was determined in patients with tic disorder (N=21) and healthy controls (N=9) by Fluorescence-Activated Cell Sorter analysis. RESULTS: In the sample examined by this study, the average percentage of B cells expressing D8/17 in tic disorder was 2.05%; healthy controls was 3.15%. No statistically significant differences were found in the mean percentages of D8/17 between the two groups. CONCLUSION: The expression of D8/17 in B cells was very low in this study. No subjects with tic disorder or healthy controls was above 12% in D8/17 positive proportion. Further studies, including higher number of patients and control group members, should be performed.
Adolescent* ; Anorexia Nervosa ; B-Lymphocytes* ; Child* ; Humans ; Obsessive-Compulsive Disorder ; Rheumatic Fever ; Tic Disorders* ; Tics* ; Tourette Syndrome

OBJECTIVES: Diffuse tensor imaging (DTI) was applied to explore the difference in regional distribution and extent of white matter (WM) abnormalities in boys with Attention-deficit/hyperactivity disorder (ADHD) versus boys with comorbid ADHD and tic disorders. METHODS: Fifteen boys with ADHD (mean age 9.3+/-1.8), 24 ADHD boys with chronic tic disorder or Tourette's disorder (9.9+/-1.2) and 9 age-, gender-matched controls (9.2+/-1.8) received DTI assessments. Fractional Anisotropy (FA) maps of WM were compared between groups with a voxel-wise analysis after intersubject registration to MNI space. RESULTS: Both groups, ADHD group and ADHD with tic disorder group, commonly showed decreased FA than healthy control group in left cerebellar middle peduncle and right frontal lobe, increased FA in right middle occipital WM. In the common areas of left cerebellar middle peduncle and right middle occipital WM, comorbid group showed broader areas of significant FA. The comorbid group also showed increased FA in right cerebellar peduncle, additionally. CONCLUSION: The findings in ADHD group support previous ADHD hypothesis of the functional abnormalities in corticocerebellar circuit, and suggest that ADHD might have more complicated pathology of neuronal circuit including occipital visual system. The comorbid group showed common areas of overlapping but more extensive abnormalities and also had additional WM abnormalities. ADHD with chronic tic disorders may represent a severe form of ADHD with additional regions of abnormal connectivity.
Anisotropy ; Attention Deficit Disorder with Hyperactivity ; Diffusion ; Diffusion Tensor Imaging ; Frontal Lobe ; Humans ; Neurons ; Tic Disorders ; Tics ; Tourette Syndrome

An 8-year-old female with Tourette Disorder (TD) was treated with a daily oral dosage of 5 mg of aripiprazole, which did not significantly improve her symptoms. After treatment with 10 mg daily for 3 days, she experienced an acute episode of dystonia with facial muscle spasms, opisthotonus, and torticolis. All symptoms resolved after ingestion of a total of 2 mg of benztropine over 2 days. Previously, aripiprazole was considered to cause few anticholinrgic, antiadrenaline, or antihistamine effects or extrapyramidal symptoms. However, extrapyramidal symptoms have now been reported in patients with TD and in adolescent patients with other psychiatric disorders. We reviewed the literature, and to the best of our knowledge, this is the first report of a child TD patient with acute dystonia. Although the recommended treatment largely precludes acute dystonic reaction, aripiprazole has produced this reaction.
Adolescent ; Benztropine ; Child ; Dystonia ; Eating ; Facial Muscles ; Female ; Humans ; Piperazines ; Quinolones ; Spasm ; Tic Disorders ; Tics ; Tourette Syndrome ; Aripiprazole