Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020:5:e200012.
doi: 10.20900/jpbs.20200012. Epub 2020 May 27.

The New Tics study: A Novel Approach to Pathophysiology and Cause of Tic Disorders

Affiliations

The New Tics study: A Novel Approach to Pathophysiology and Cause of Tic Disorders

Kevin J Black et al. J Psychiatr Brain Sci. 2020.

Abstract

We report on the ongoing project "The New Tics Study: A Novel Approach to Pathophysiology and Cause of Tic Disorders," describing the work completed to date, ongoing studies and long-term goals. The overall goals of this research are to study the pathophysiology of Provisional Tic Disorder, and to study tic remission (or improvement) in a prospective fashion. Preliminary data collection for the project began almost 10 years ago. The current study is nearing completion of its third year, and has already reported several novel and important results. First, surprisingly, at least 90% of children who had experienced tics for only a mean of 3 months still had tics at the 12-month anniversary of their first tic, though in some cases tics were seen only with remote video observation of the child sitting alone. Thus almost all of them now had a DSM-5 diagnosis of Tourette's Disorder or Persistent (Chronic) Tic Disorder. Baseline clinical features that predicted 12-month outcome included tic severity, subsyndromal autism spectrum symptoms, an anxiety disorder, and a history of 3 or more phonic tics. Second, we found that poorer tic suppression ability when immediately rewarded for suppression predicted greater tic severity at follow-up. Third, striatal volumes did not predict outcome as hypothesized, but a larger hippocampus at baseline predicted worse severity at follow-up. Enrollment and data collection continue, including functional connectivity MRI (fcMRI) imaging, and additional analyses are planned once the full sample is enrolled.

Keywords: MRI; Provisional Tic Disorder; Tourette syndrome; anxiety; hippocampus; inhibition (psychology); prognosis; tic disorders; tic suppression.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.. Overall study design.
Children are examined thoroughly at a baseline visit no more than 9 months after their first tic (median 3.5 months). The follow-up visit occurs as close as possible to the one-year anniversary of their first tic, when DSM-5 Tourette’s Disorder can first be diagnosed.
Figure 2.
Figure 2.. Tic duration at study entry and follow-up visits.
The horizontal axis represents days since first tic. Individual participants are shown as horizontal lines, with their first study visit marked by an open circle and their 12-month follow-up visit marked by a filled circle. The solid red line marks the current mean duration at the baseline study visit, the dashed red line marks the original 6-month cutoff for enrollment, the thick black line marks the current 9-month cutoff, and the thin black vertical line marks 1 year after the first tic.

Similar articles

Cited by

References

    1. Black KJ. Tics In: Kompoliti K, Verhagen Metman L, Cornelia C, Goetz C, Goldman J, Kordower J, et al., editors. Encyclopedia of Movement Disorders. Oxford (UK): Elsevier (Academic Press); 2010. p. 231–6.
    1. Schlaggar BL, Mink JW. Movement disorders in children. Pediatr Rev. 2003;24(2):39–51. - PubMed
    1. Leckman JF, Zhang H, Vitale A, Lahnin F, Lynch K, Bondi C, et al. Course of tic severity in Tourette syndrome: the first two decades. Pediatrics. 1998;102(1 Pt 1):14–9. - PubMed
    1. The Tourette Syndrome Classification Study Group. Definitions and classification of tic disorders. Arch Neurol. 1993;50(10):1013–6. - PubMed
    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Arlington (VA, USA): American Psychiatric Association; 2013.