Tic Disorders and Tourette Syndrome: Current Concepts of Etiology and Treatment in Children and Adolescents

Friederike Tagwerker Gloor; Susanne Walitza

doi:10.1055/s-0035-1570492

Neuropediatrics, Table of Contents

Neuropediatrics 2016; 47(02): 084-096
DOI: 10.1055/s-0035-1570492

Review Article

Georg Thieme Verlag KG Stuttgart · New York

Tic Disorders and Tourette Syndrome: Current Concepts of Etiology and Treatment in Children and Adolescents

Friederike Tagwerker Gloor

¹Department of Child and Adolescent Psychiatry and Psychotherapy, University of Zurich, Zurich, Switzerland

,

Susanne Walitza

¹Department of Child and Adolescent Psychiatry and Psychotherapy, University of Zurich, Zurich, Switzerland

› Author Affiliations

Abstract

Tic disorders (TD), including chronic/persistent TD (CTD) and Tourette syndrome, have been described and studied for many years. Within the last two decades, intensified study efforts led to more specific assumptions about genesis and influences of both hereditary and environmental factors. TD in children and adolescents are very often accompanied by attention-deficit/hyperactivity disorders and obsessive-compulsive disorders (OCD) as comorbid disorders. Comorbidities are aggravating factors concerning prognosis and treatment opportunities. Therefore, etiological considerations and treatment strategies have to take associated psychiatric disorders into account. Treatment approaches are symptom targeted and include behavioral treatments and/or medication and show positive outcomes concerning tic symptomatology, global functioning, and associated psychopathology. This review presents an update of the research, definitions, and classification according to ICD-10 and DSM-5 and summarizes the diagnostic procedures and most effective clinical strategies.

Keywords

tic disorders - Tourette syndrome - etiology - treatment - children and adolescents

Full Text

References

References
1 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 5th ed. Washington, DC: American Psychiatric Publishing; 2013
2 Roessner V, Ludolph AG, Müller-Vahl K , et al. Tourette syndrome and other tic disorders in DSM-5–a comment [in German]. Z Kinder Jugendpsychiatr Psychother 2014; 42 (2) 129-134
3 Bloch MH, Leckman JF. Clinical course of Tourette syndrome. J Psychosom Res 2009; 67 (6) 497-501
4 Eddy CM, Cavanna AE, Gulisano M , et al. Clinical correlates of quality of life in Tourette syndrome. Mov Disord 2011; 26 (4) 735-738
5 Eddy CM, Rizzo R, Gulisano M , et al. Quality of life in young people with Tourette syndrome: a controlled study. J Neurol 2011; 258 (2) 291-301
6 Eapen V, Crncec R. Tourette syndrome in children and adolescents: special considerations. J Psychosom Res 2009; 67 (6) 525-532
7 Meidinger AL, Miltenberger RG, Himle M, Omvig M, Trainor C, Crosby R. An investigation of tic suppression and the rebound effect in Tourette's disorder. Behav Modif 2005; 29 (5) 716-745
8 Müller-Vahl KR, Riemann L, Bokemeyer S. Tourette patients' misbelief of a tic rebound is due to overall difficulties in reliable tic rating. J Psychosom Res 2014; 76 (6) 472-476
9 Verdellen CW, Hoogduin CA, Keijsers GP. Tic suppression in the treatment of Tourette's syndrome with exposure therapy: the rebound phenomenon reconsidered. Mov Disord 2007; 22 (11) 1601-1606
10 Conelea CA, Woods DW. The influence of contextual factors on tic expression in Tourette's syndrome: a review. J Psychosom Res 2008; 65 (5) 487-496
11 Reese HE, Scahill L, Peterson AL , et al. The premonitory urge to tic: measurement, characteristics, and correlates in older adolescents and adults. Behav Ther 2014; 45 (2) 177-186
12 Coles ME, Frost RO, Heimberg RG, Rhéaume J. “Not just right experiences”: perfectionism, obsessive-compulsive features and general psychopathology. Behav Res Ther 2003; 41 (6) 681-700
13 Neal M, Cavanna AE. “Not just right experiences” in patients with Tourette syndrome: complex motor tics or compulsions?. Psychiatry Res 2013; 210 (2) 559-563
14 Belluscio BA, Jin L, Watters V, Lee TH, Hallett M. Sensory sensitivity to external stimuli in Tourette syndrome patients. Mov Disord 2011; 26 (14) 2538-2543
15 Kurlan R, McDermott MP, Deeley C , et al. Prevalence of tics in schoolchildren and association with placement in special education. Neurology 2001; 57 (8) 1383-1388
16 Schrag A, Gilbert R, Giovannoni G, Robertson MM, Metcalfe C, Ben-Shlomo Y. Streptococcal infection, Tourette syndrome, and OCD: is there a connection?. Neurology 2009; 73 (16) 1256-1263
17 Knight T, Steeves T, Day L, Lowerison M, Jette N, Pringsheim T. Prevalence of tic disorders: a systematic review and meta-analysis. Pediatr Neurol 2012; 47 (2) 77-90
18 Robertson MM. Movement disorders: Tourette syndrome—beyond swearing and sex?. Nat Rev Neurol 2014; 10 (1) 6-8
19 Cath DC, Hedderly T, Ludolph AG , et al; ESSTS Guidelines Group. European clinical guidelines for Tourette syndrome and other tic disorders. Part I: Assessment. Eur Child Adolesc Psychiatry 2011; 20 (4) 155-171
20 Cohen SC, Leckman JF, Bloch MH. Clinical assessment of Tourette syndrome and tic disorders. Neurosci Biobehav Rev 2013; 37 (6) 997-1007
21 Freeman RD, Fast DK, Burd L, Kerbeshian J, Robertson MM, Sandor P. An international perspective on Tourette syndrome: selected findings from 3,500 individuals in 22 countries. Dev Med Child Neurol 2000; 42 (7) 436-447
22 Freeman RD ; Tourette Syndrome International Database Consortium. Tic disorders and ADHD: answers from a world-wide clinical dataset on Tourette syndrome. Eur Child Adolesc Psychiatry 2007; 16 (Suppl. 01) 15-23
23 Ganos C, Roessner V, Münchau A. The functional anatomy of Gilles de la Tourette syndrome. Neurosci Biobehav Rev 2013; 37 (6) 1050-1062
24 Robertson MM, Cavanna AE. The Gilles de la Tourette syndrome: a principal component factor analytic study of a large pedigree. Psychiatr Genet 2007; 17 (3) 143-152
25 Cavanna AE, Rickards H. The psychopathological spectrum of Gilles de la Tourette syndrome. Neurosci Biobehav Rev 2013; 37 (6) 1008-1015
26 Rothenberger A, Roessner V. The phenomenology of attention-deficit/hyperactivity disorder in Tourette syndrome. In: Martino D, Leckman JF, eds. Tourette Syndrome. New York: Oxford University Press; 2013
27 Robertson MM. Tourette syndrome, associated conditions and the complexities of treatment. Brain 2000; 123 (Pt 3) 425-462
28 Lebowitz ER, Motlagh MG, Katsovich L , et al; Tourette Syndrome Study Group. Tourette syndrome in youth with and without obsessive compulsive disorder and attention deficit hyperactivity disorder. Eur Child Adolesc Psychiatry 2012; 21 (8) 451-457
29 Conelea CA, Woods DW, Zinner SH , et al. Exploring the impact of chronic tic disorders on youth: results from the Tourette Syndrome Impact Survey. Child Psychiatry Hum Dev 2011; 42 (2) 219-242
30 Paschou P. The genetic basis of Gilles de la Tourette Syndrome. Neurosci Biobehav Rev 2013; 37 (6) 1026-1039
31 Gorman DA, Abi-Jaoude E. Uncovering the complexity of Tourette syndrome, little by little. Br J Psychiatry 2014; 204 (1) 6-8
32 Paschou P, Fernandez TV, Sharp F, Heiman GA, Hoekstra PJ. Genetic susceptibility and neurotransmitters in Tourette syndrome. Int Rev Neurobiol 2013; 112: 155-177
33 Swain JE, Scahill L, Lombroso PJ, King RA, Leckman JF. Tourette syndrome and tic disorders: a decade of progress. J Am Acad Child Adolesc Psychiatry 2007; 46 (8) 947-968
34 Albin RL, Mink JW. Recent advances in Tourette syndrome research. Trends Neurosci 2006; 29 (3) 175-182
35 Wylie SA, Claassen DO, Kanoff KE, Ridderinkhof KR, van den Wildenberg WP. Impaired inhibition of prepotent motor actions in patients with Tourette syndrome. J Psychiatry Neurosci 2013; 38 (5) 349-356
36 Peterson BS, Thomas P, Kane MJ , et al. Basal Ganglia volumes in patients with Gilles de la Tourette syndrome. Arch Gen Psychiatry 2003; 60 (4) 415-424
37 Kataoka Y, Kalanithi PS, Grantz H , et al. Decreased number of parvalbumin and cholinergic interneurons in the striatum of individuals with Tourette syndrome. J Comp Neurol 2010; 518 (3) 277-291
38 Kalanithi PS, Zheng W, Kataoka Y , et al. Altered parvalbumin-positive neuron distribution in basal ganglia of individuals with Tourette syndrome. Proc Natl Acad Sci U S A 2005; 102 (37) 13307-13312
39 Peterson BS, Choi HA, Hao X , et al. Morphologic features of the amygdala and hippocampus in children and adults with Tourette syndrome. Arch Gen Psychiatry 2007; 64 (11) 1281-1291
40 Bloch MH, Leckman JF, Zhu H, Peterson BS. Caudate volumes in childhood predict symptom severity in adults with Tourette syndrome. Neurology 2005; 65 (8) 1253-1258
41 Roessner V, Overlack S, Schmidt-Samoa C , et al. Increased putamen and callosal motor subregion in treatment-naïve boys with Tourette syndrome indicates changes in the bihemispheric motor network. J Child Psychol Psychiatry 2011; 52 (3) 306-314
42 Draganski B, Martino D, Cavanna AE , et al. Multispectral brain morphometry in Tourette syndrome persisting into adulthood. Brain 2010; 133 (Pt 12) 3661-3675
43 Wang Z, Maia TV, Marsh R, Colibazzi T, Gerber A, Peterson BS. The neural circuits that generate tics in Tourette's syndrome. Am J Psychiatry 2011; 168 (12) 1326-1337
44 Baym CL, Corbett BA, Wright SB, Bunge SA. Neural correlates of tic severity and cognitive control in children with Tourette syndrome. Brain 2008; 131 (Pt 1) 165-179
45 Marsh R, Zhu H, Wang Z, Skudlarski P, Peterson BS. A developmental fMRI study of self-regulatory control in Tourette's syndrome. Am J Psychiatry 2007; 164 (6) 955-966
46 Plessen KJ, Bansal R, Peterson BS. Imaging evidence for anatomical disturbances and neuroplastic compensation in persons with Tourette syndrome. J Psychosom Res 2009; 67 (6) 559-573
47 Raz A, Zhu H, Yu S , et al. Neural substrates of self-regulatory control in children and adults with Tourette syndrome. Can J Psychiatry 2009; 54 (9) 579-588
48 Eichele H, Plessen KJ. Neural plasticity in functional and anatomical MRI studies of children with Tourette syndrome. Behav Neurol 2013; 27 (1) 33-45
49 Leckman JF, Chittenden EH. Gilles de La Tourette's syndrome and some forms of obsessive-compulsive disorder may share a common genetic diathesis. Encephale 1990; 16 (Spec No) 321-323
50 Mink JW, Walkup J, Frey KA , et al; Tourette Syndrome Association, Inc. Patient selection and assessment recommendations for deep brain stimulation in Tourette syndrome. Mov Disord 2006; 21 (11) 1831-1838
51 Martino D, Cavanna AE. Preface: the metamorphoses of Gilles de la Tourette syndrome. Int Rev Neurobiol 2013; 112: xv-xx
52 Harris K, Singer HS. Tic disorders: neural circuits, neurochemistry, and neuroimmunology. J Child Neurol 2006; 21 (8) 678-689
53 Müller-Vahl KR, Berding G, Kolbe H , et al. Dopamine D2 receptor imaging in Gilles de la Tourette syndrome. Acta Neurol Scand 2000; 101 (3) 165-171
54 Puts NA, Harris AD, Crocetti D , et al. Reduced GABAergic inhibition and abnormal sensory symptoms in children with Tourette syndrome. J Neurophysiol 2015; 114 (2) 808-817
55 Draper A, Stephenson MC, Jackson GM , et al. Increased GABA contributes to enhanced control over motor excitability in Tourette syndrome. Curr Biol 2014; 24 (19) 2343-2347
56 Lemmon ME, Grados M, Kline T, Thompson CB, Ali SF, Singer HS. Efficacy of Glutamate Modulators in Tic Suppression: A Double-Blind, Randomized Control Trial of D-serine and Riluzole in Tourette Syndrome. Pediatr Neurol 2015; 52 (6) 629-634
57 Price RA, Kidd KK, Cohen DJ, Pauls DL, Leckman JF. A twin study of Tourette syndrome. Arch Gen Psychiatry 1985; 42 (8) 815-820
58 Hyde TM, Aaronson BA, Randolph C, Rickler KC, Weinberger DR. Relationship of birth weight to the phenotypic expression of Gilles de la Tourette's syndrome in monozygotic twins. Neurology 1992; 42 (3, Pt 1) 652-658
59 Pauls DL, Raymond CL, Stevenson JM, Leckman JF. A family study of Gilles de la Tourette syndrome. Am J Hum Genet 1991; 48 (1) 154-163
60 Pauls DL, Alsobrook II JP, Goodman W, Rasmussen S, Leckman JF. A family study of obsessive-compulsive disorder. Am J Psychiatry 1995; 152 (1) 76-84
61 Hebebrand J, Klug B, Fimmers R , et al. Rates for tic disorders and obsessive compulsive symptomatology in families of children and adolescents with Gilles de la Tourette syndrome. J Psychiatr Res 1997; 31 (5) 519-530
62 Ercan-Sencicek AG, Stillman AA, Ghosh AK , et al. L-histidine decarboxylase and Tourette's syndrome. N Engl J Med 2010; 362 (20) 1901-1908
63 Kubota Y, Ito C, Sakurai E, Sakurai E, Watanabe T, Ohtsu H. Increased methamphetamine-induced locomotor activity and behavioral sensitization in histamine-deficient mice. J Neurochem 2002; 83 (4) 837-845
64 Fernandez TV, Sanders SJ, Yurkiewicz IR , et al. Rare copy number variants in tourette syndrome disrupt genes in histaminergic pathways and overlap with autism. Biol Psychiatry 2012; 71 (5) 392-402
65 Sundaram SK, Huq AM, Wilson BJ, Chugani HT. Tourette syndrome is associated with recurrent exonic copy number variants. Neurology 2010; 74 (20) 1583-1590
66 Knight D, Xie W, Boulianne GL. Neurexins and neuroligins: recent insights from invertebrates. Mol Neurobiol 2011; 44 (3) 426-440
67 Scharf JM, Yu D, Mathews CA , et al; North American Brain Expression Consortium; UK Human Brain Expression Database. Genome-wide association study of Tourette's syndrome. Mol Psychiatry 2013; 18 (6) 721-728
68 Proenca CC, Gao KP, Shmelkov SV, Rafii S, Lee FS. Slitrks as emerging candidate genes involved in neuropsychiatric disorders. Trends Neurosci 2011; 34 (3) 143-153
69 Hoekstra PJ, Dietrich A, Edwards MJ, Elamin I, Martino D. Environmental factors in Tourette syndrome. Neurosci Biobehav Rev 2013; 37 (6) 1040-1049
70 Chao TK, Hu J, Pringsheim T. Prenatal risk factors for Tourette Syndrome: a systematic review. BMC Pregnancy Childbirth 2014; 14: 53
71 Mathews CA, Bimson B, Lowe TL , et al. Association between maternal smoking and increased symptom severity in Tourette's syndrome. Am J Psychiatry 2006; 163 (6) 1066-1073
72 Mathews CA, Scharf JM, Miller LL, Macdonald-Wallis C, Lawlor DA, Ben-Shlomo Y. Association between pre- and perinatal exposures and Tourette syndrome or chronic tic disorder in the ALSPAC cohort. Br J Psychiatry 2014; 204 (1) 40-45
73 Motlagh MG, Katsovich L, Thompson N , et al. Severe psychosocial stress and heavy cigarette smoking during pregnancy: an examination of the pre- and perinatal risk factors associated with ADHD and Tourette syndrome. Eur Child Adolesc Psychiatry 2010; 19 (10) 755-764
74 Bos-Veneman NG, Kuin A, Minderaa RB, Hoekstra PJ. Role of perinatal adversities on tic severity and symptoms of attention deficit/hyperactivity disorder in children and adolescents with a tic disorder. J Dev Behav Pediatr 2010; 31 (2) 100-106
75 Pringsheim T, Sandor P, Lang A, Shah P, O'Connor P. Prenatal and perinatal morbidity in children with Tourette syndrome and attention-deficit hyperactivity disorder. J Dev Behav Pediatr 2009; 30 (2) 115-121
76 Buse J, Kirschbaum C, Leckman JF, Münchau A, Roessner V. The modulating role of stress in the onset and course of Tourette's syndrome: a review. Behav Modif 2014; 38 (2) 184-216
77 Conelea CA, Woods DW, Brandt BC. The impact of a stress induction task on tic frequencies in youth with Tourette syndrome. Behav Res Ther 2011; 49 (8) 492-497
78 Roessner V, Schoenefeld K, Buse J, Bender S, Ehrlich S, Münchau A. Pharmacological treatment of tic disorders and Tourette syndrome. Neuropharmacology 2013; 68: 143-149
79 Leckman JF, King RA, Gilbert DL , et al. Streptococcal upper respiratory tract infections and exacerbations of tic and obsessive-compulsive symptoms: a prospective longitudinal study. J Am Acad Child Adolesc Psychiatry 2011; 50 (2) 108-118.e3
80 Swedo SE, Leonard HL, Garvey M , et al. Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections: clinical description of the first 50 cases. Am J Psychiatry 1998; 155 (2) 264-271
81 Cardoso F. Sydenham's chorea. Handb Clin Neurol 2011; 100: 221-229
82 Kurlan R, Johnson D, Kaplan EL ; Tourette Syndrome Study Group. Streptococcal infection and exacerbations of childhood tics and obsessive-compulsive symptoms: a prospective blinded cohort study. Pediatrics 2008; 121 (6) 1188-1197
83 Swedo SE, Leckman JF, Rose NR. From Research Subgroup to Clinical Syndrome: Modifying the PANDAS Criteria to Describe PANS (Pediatric Acute-onset Neuropsychiatric Syndrome). Pediatr Therapeut 2012; 2 (2) 1000113
84 Roessner V, Plessen KJ, Rothenberger A , et al; ESSTS Guidelines Group. European clinical guidelines for Tourette syndrome and other tic disorders. Part II: pharmacological treatment. Eur Child Adolesc Psychiatry 2011; 20 (4) 173-196
85 Verdellen C, van de Griendt J, Hartmann A, Murphy T ; ESSTS Guidelines Group. European clinical guidelines for Tourette syndrome and other tic disorders. Part III: behavioural and psychosocial interventions. Eur Child Adolesc Psychiatry 2011; 20 (4) 197-207
86 Mills S, Hedderly T. A guide to childhood motor stereotypies, tic disorders and the tourette spectrum for the primary care practitioner. Ulster Med J 2014; 83 (1) 22-30
87 Azrin NH, Nunn RG. Habit-reversal: a method of eliminating nervous habits and tics. Behav Res Ther 1973; 11 (4) 619-628
88 Piacentini J, Woods DW, Scahill L , et al. Behavior therapy for children with Tourette disorder: a randomized controlled trial. JAMA 2010; 303 (19) 1929-1937
89 Dutta N, Cavanna AE. The effectiveness of habit reversal therapy in the treatment of Tourette syndrome and other chronic tic disorders: a systematic review. Funct Neurol 2013; 28 (1) 7-12
90 Verdellen CW, Keijsers GP, Cath DC, Hoogduin CA. Exposure with response prevention versus habit reversal in Tourettes's syndrome: a controlled study. Behav Res Ther 2004; 42 (5) 501-511
91 Wilhelm S, Peterson AL, Piacentini J , et al. Randomized trial of behavior therapy for adults with Tourette syndrome. Arch Gen Psychiatry 2012; 69 (8) 795-803
92 Azrin NH, Peterson AL. Treatment of Tourette Syndrome by habit reversal: A waiting-list control group comparison. Behav Ther 1990; 21 (3) 305-318
93 O'Connor KP, Brault M, Robillard S, Loiselle J, Borgeat F, Stip E. Evaluation of a cognitive-behavioural program for the management of chronic tic and habit disorders. Behav Res Ther 2001; 39 (6) 667-681
94 Verdellen CW, Hoogduin CA, Kato BS, Keijsers GP, Cath DC, Hoijtink HB. Habituation of premonitory sensations during exposure and response prevention treatment in Tourette's syndrome. Behav Modif 2008; 32 (2) 215-227
95 Reese HE, Vallejo Z, Rasmussen J, Crowe K, Rosenfield E, Wilhelm S. Mindfulness-based stress reduction for Tourette syndrome and chronic tic disorder: a pilot study. J Psychosom Res 2015; 78 (3) 293-298
96 Bate KS, Malouff JM, Thorsteinsson ET, Bhullar N. The efficacy of habit reversal therapy for tics, habit disorders, and stuttering: a meta-analytic review. Clin Psychol Rev 2011; 31 (5) 865-871
97 Wile DJ, Pringsheim TM. Behavior therapy for Tourette syndrome: a systematic review and meta-analysis. Curr Treat Options Neurol 2013; 15 (4) 385-395
98 McGuire JF, Piacentini J, Brennan EA , et al. A meta-analysis of behavior therapy for Tourette syndrome. J Psychiatr Res 2014; 50: 106-112
99 Weisman H, Qureshi IA, Leckman JF, Scahill L, Bloch MH. Systematic review: pharmacological treatment of tic disorders—efficacy of antipsychotic and alpha-2 adrenergic agonist agents. Neurosci Biobehav Rev 2013; 37 (6) 1162-1171
100 van de Griendt JM, Verdellen CW, van Dijk MK, Verbraak MJ. Behavioural treatment of tics: habit reversal and exposure with response prevention. Neurosci Biobehav Rev 2013; 37 (6) 1172-1177
101 Himle MB, Freitag M, Walther M, Franklin SA, Ely L, Woods DW. A randomized pilot trial comparing videoconference versus face-to-face delivery of behavior therapy for childhood tic disorders. Behav Res Ther 2012; 50 (9) 565-570
102 Roessner V, Rothenberger A. Pharmacological treatment of tics. In: Martino D, Leckman JF, eds. Tourette Syndrome. New York: Oxford Press; 2013
103 Roessner V, Rothenberger A. Tic Disorders. Psychiatric Drugs in Children and Adolescents. Wien: Springer-Verlag; 2014: 517-525
104 Scahill L, Leckman JF, Schultz RT, Katsovich L, Peterson BS. A placebo-controlled trial of risperidone in Tourette syndrome. Neurology 2003; 60 (7) 1130-1135
105 Ghanizadeh A, Haghighi A. Aripiprazole versus risperidone for treating children and adolescents with tic disorder: a randomized double blind clinical trial. Child Psychiatry Hum Dev 2014; 45 (5) 596-603
106 Roessner V, Rothenberger A, Rickards H, Hoekstra PJ. European clinical guidelines for Tourette syndrome and other tic disorders. Eur Child Adolesc Psychiatry 2011; 20 (4) 153-154
107 Singer HS. Treatment of tics and tourette syndrome. Curr Treat Options Neurol 2010; 12 (6) 539-561
108 Marras C, Andrews D, Sime E, Lang AE. Botulinum toxin for simple motor tics: a randomized, double-blind, controlled clinical trial. Neurology 2001; 56 (5) 605-610
109 Kwak CH, Hanna PA, Jankovic J. Botulinum toxin in the treatment of tics. Arch Neurol 2000; 57 (8) 1190-1193
110 Simpson DM, Blitzer A, Brashear A , et al; Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Assessment: Botulinum neurotoxin for the treatment of movement disorders (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2008; 70 (19) 1699-1706
111 Swain JE, Leckman JF. Tourette syndrome and tic disorders: overview and practical guide to diagnosis and treatment. Psychiatry (Edgmont) 2005; 2 (7) 26-36