European clinical guidelines for Tourette syndrome and other tic disorders-version 2.0. Part I: assessment

Natalia Szejko^{1

2

3}, Sally Robinson⁴, Andreas Hartmann⁵, Christos Ganos⁶, Nanette M Debes⁷, Liselotte Skov⁷, Martina Haas⁸, Renata Rizzo⁹, Jeremy Stern¹⁰, Alexander Münchau¹¹, Virginie Czernecki⁵, Andrea Dietrich¹², Tara L Murphy¹³, Davide Martino¹⁴, Zsanett Tarnok¹⁵, Tammy Hedderly⁴, Kirsten R Müller-Vahl^#⁹, Danielle C Cath^#¹⁶

Affiliations

¹ Department of Neurology, Medical University of Warsaw, Warsaw, Poland.
² Department of Bioethics, Medical University of Warsaw, Warsaw, Poland.
³ Department of Neurology, Yale School of Medicine, Yale University, New Haven, USA.
⁴ Tic and Neurodevelopmental Movements Service (TANDeM), Children's Neurosciences Centre, Evelina London Children's Hospital, Guys and St Thomas' NHS Foundation Trust, London, UK.
⁵ Department of Neurology, Salpetriere Hospital, Paris, France.
⁶ Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany.
⁷ Paediatric Department, Herlev University Hospital, Herlev, Denmark.
⁸ Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany.
⁹ Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
¹⁰ Department of Neurology, St George's Hospital, St George's University of London, London, UK.
¹¹ Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.
¹² Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
¹³ Tic Disorder Clinic, Great Ormond Street Hospital NHS Foundation Trust, London, UK.
¹⁴ Department of Clinical Neurosciences, University of Calgary, Calgary, Canada.
¹⁵ Vadaskert Child Psychiatry Hospital, Budapest, Hungary.
¹⁶ Department of Psychiatry, University Medical Center Groningen, Rijks Universiteit Groningen, GGZ Drenthe Mental Health Institution, Hanzeplein 1, Assen, 9713, Groningen, The Netherlands. cath@xs4all.nl.

^# Contributed equally.

PMID: 34661764
PMCID: PMC8521086
DOI: 10.1007/s00787-021-01842-2

Review

European clinical guidelines for Tourette syndrome and other tic disorders-version 2.0. Part I: assessment

Natalia Szejko et al. Eur Child Adolesc Psychiatry. 2022 Mar.

. 2022 Mar;31(3):383-402.

doi: 10.1007/s00787-021-01842-2. Epub 2021 Oct 18.

Authors

Affiliations

¹ Department of Neurology, Medical University of Warsaw, Warsaw, Poland.
² Department of Bioethics, Medical University of Warsaw, Warsaw, Poland.
³ Department of Neurology, Yale School of Medicine, Yale University, New Haven, USA.
⁴ Tic and Neurodevelopmental Movements Service (TANDeM), Children's Neurosciences Centre, Evelina London Children's Hospital, Guys and St Thomas' NHS Foundation Trust, London, UK.
⁵ Department of Neurology, Salpetriere Hospital, Paris, France.
⁶ Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany.
⁷ Paediatric Department, Herlev University Hospital, Herlev, Denmark.
⁸ Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany.
⁹ Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
¹⁰ Department of Neurology, St George's Hospital, St George's University of London, London, UK.
¹¹ Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.
¹² Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
¹³ Tic Disorder Clinic, Great Ormond Street Hospital NHS Foundation Trust, London, UK.
¹⁴ Department of Clinical Neurosciences, University of Calgary, Calgary, Canada.
¹⁵ Vadaskert Child Psychiatry Hospital, Budapest, Hungary.
¹⁶ Department of Psychiatry, University Medical Center Groningen, Rijks Universiteit Groningen, GGZ Drenthe Mental Health Institution, Hanzeplein 1, Assen, 9713, Groningen, The Netherlands. cath@xs4all.nl.

^# Contributed equally.

PMID: 34661764
PMCID: PMC8521086
DOI: 10.1007/s00787-021-01842-2

Abstract

In 2011 a working group of the European Society for the Study of Tourette Syndrome (ESSTS) has developed the first European assessment guidelines for Tourette syndrome (TS). Now, we present an updated version 2.0 of these European clinical guidelines for Tourette syndrome and other tic disorders, part I: assessment. Therefore, the available literature has been thoroughly screened, supplemented with national guidelines across countries and discussions among ESSTS experts. Diagnostic changes between DSM-IV and DSM-5 classifications were taken into account and new information has been added regarding differential diagnoses, with an emphasis on functional movement disorders in both children and adults. Further, recommendations regarding rating scales to evaluate tics, comorbidities, and neuropsychological status are provided. Finally, results from a recently performed survey among ESSTS members on assessment in TS are described. We acknowledge that the Yale Global Tic Severity Scale (YGTSS) is still the gold standard for assessing tics. Recommendations are provided for scales for the assessment of tics and psychiatric comorbidities in patients with TS not only in routine clinical practice, but also in the context of clinical research. Furthermore, assessments supporting the differential diagnosis process are given as well as tests to analyse cognitive abilities, emotional functions and motor skills.

Keywords: Assessment; Scales; Tics; Tourette syndrome.

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Conflict of interest statement

CG received research grants from the VolkswagenStiftung (Freigeist Fellowship) and the German Parkinson Society and was also supported by the Deutsche Forschungsgemeinschaft (GA2031/1-1 and GA2031/1-2) and Actelion Pharmaceuticals. He also received financial support/honoraria to speak at meetings by Actelion pharmaceuticals and as ad hoc advisory board for Lundbeck. DM has received personal compensation for consultancies for Sunovion and serves in Advisory Boards of Sunovion and Paladin Labs. He was also granted honoraria from Dystonia Medical Research Foundation Canada and royalties from Springer-Verlag. He was funded grants from Ipsen Corporate, Dystonia Medical Research Foundation Canada, Parkinson Canada, The Owerko Foundation, and the Michael P Smith Family. AH has received consultancy honoraria from Lundbeck and Noema Pharma. He has received research grants from the Association Française pour le Syndrome Gilles de la Tourette (AFSGT). RR has received financial research support from EU (FP7-Health 2011N. 278367. The University of Catania research plan 2016–2018. She has carried out clinical trials in cooperation with Otsuka, Angelini, TEVA companies. DC received grant from the EU (TS EUROTRAIN), grant nr. 316978), several grants from ZONMW and MAGW (the Netherlands), from TSA-USA (2008), from Sunovion (DS028 (2019). From Espria fonds, Drenthe, the Netherlands. She has received speakers’ fees from ECNP, Psyfar, Benecke, Pfizer. KMV has received financial or material research support from the EU (FP7-HEALTH-2011 No. 278367, FP7-PEOPLE-2012-ITN No. 316978), the German Research Foundation (DFG: GZ MU 1527/3-1), the German Ministry of Education and Research (BMBF: 01KG1421), the National Institute of Mental Health (NIMH), the Tourette Gesellschaft Deutschland e.V., the Else-Kröner-Fresenius-Stiftung, and Abide Therapeutics, Almirall Hermal GmbH, GW pharmaceuticals, Lundbeck, Syneos Health, and Therapix Biosciences Ltd.She has received consultant's honoraria from Abide Therapeutics, Bionorica Ethics GmbH, CannaMedical Pharma GmbH, Canopy Grouth, Columbia Care, CTC Communications Corp., Eurox Deutschland GmbH, Global Praxis Group Limited, Lundbeck, Resalo Vertrieb GmbH, Sanity Group, Synendos Therapeutics AG, and Tilray. She is/was a consultant or advisory board member for Abide Therapeutics, The Academy of Medical Cannabis Limited, Alirio, Aphria Deutschland GmbH, CannaMedical Pharma GmbH, Boehringer Ingelheim International GmbH, Bionorica Ethics GmbH, CannaXan GmbH, Canopy Growth, Columbia Care, CTC Communications Corp., Leafly Deutschland GmbH, Lundbeck, Nomovo Pharm, Nuvelution TS Pharma Inc., Resalo Vertrieb GmbH, Sanity Group, Syqe Medical Ltd., Therapix Biosciences Ltd., Tilray, Wayland Group, Zynerba Pharmaceuticals, and CTC Communications Corporation.She has received speaker’s fees from Aphria Deutschland GmbH, Cogitando GmbH, Emalex, Eurox group, Ever pharma GmbH, PR Berater, Tilray, and Wayland Group. She has received royalties from Medizinisch Wissenschaftliche Verlagsgesellschaft Berlin, Elsevier, and Kohlhammer. She holds shares of Nomovo Pharm. She served as a Guest editor for Frontiers in Neurology on the research topic “The neurobiology and genetics of Gilles de la Tourette syndrome: new avenues through large-scale collaborative projects” and is Associate editor for “Cannabis and Cannabinoid Research”, Editorial Board Member for “Medical Cannabis and Cannabinoids” and “MDPI-Reports”, and scientific board member for “Zeitschrift für Allgemeinmedizin”. AM has received commercial research support from: Pharm Allergan, Ipsen, Merz Pharmaceuticals, Actelion. He was granted honoraria for lectures: Pharm Allergan, Ipsen, Merz Pharmaceuticals, Actelion, GlaxoSmithKline, Desitin, Teva, Takeda; consultancies from: Desitin, Merz Pharmaceuticals, Admedicum. He is also supported from the following Foundations: Possehl-Stiftung (Lübeck, Germany), Margot und Jürgen Wessel Stiftung (Lübeck, Germany), Tourette Syndrome Association (Germany), Interessenverband Tourette Syndrom (Germany), CHDI, Damp-Stiftung. He also was funded the following academic research support: Deutsche Forschungsgemeinschaft (DFG): projects 1692/3-1, 4-1, SFB 936, and FOR 2698 (project numbers 396914663, 396577296, 396474989), Innovationsausschuss of the Gemeinsamer Bundesausschuss: Translate NAMSE (structural support for the Lübeck Center for Rare Diseases); European Reference Network—Rare Neurological Diseases (ERN—RND); Royalties for the book Neurogenetics (Oxford University Press). He serves in Advisory Boards of German Tourette syndrome Association and Alliance of patients with chronic rare diseases. All other authors have no conflicts to report.

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European clinical guidelines for Tourette syndrome and other tic disorders-version 2.0. Part I: assessment

Affiliations

European clinical guidelines for Tourette syndrome and other tic disorders-version 2.0. Part I: assessment

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

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Medical