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1. European clinical guidelines for Tourette Syndrome and other tic disorders. Part I

Author

Cath, Danielle C., Tammy, Hedderly, Ludolph, Andrea G., Stern, Jeremy S., Tara, Murphy, Andreas, Hartmann, Virginie, Czernecki, Mary May Robertson, Davide, Martino, Munchau, A., Rizzo, R., Essts Guidelines Group Androutsos, C., Aschauer, H., Baird, G., Bos Veneman, N., Brambilla, A., Cardona, Francesco Carmelo Giovanni, Cath, D. c., Cavanna, A., Czernecki, V., Dehning, S., Eapter, A., Farkas, L., Gadaros, J., Hartmann, A., Hauser, E., Heyman, I., Hedderly, T., Hoekstra, P. j., Korsgaard, A., Jackson, G. m., Larsson, L., Ludolph, A. g., Martino, D., Menghetti, C., Mol Debes, N., Muller, N., Muller Vahl, K., Murphy, T., Musil, R., Nagy, P., Nurnberger, J., Oostra, B., Paschou, P., Pasquini, M., Plessen, K. j., Porta, M., Rickards, H., Robertson, M. m., Roessner, V., Rothenberger, A., Servello, D., Skov, L., Stern, J. s., Strand, G., Tarnok, Z., Termine, C., Van Der Griendt, J., Verdellen, C., Visser Vandewalle, V., Wannag, E., Wolanczyck, T., Department of Clinical and Health Psychology, Utrecht University/Altrecht Academic Anxiety Outpatient Services, Tourettes Clinic-Evelina Childrens Hospital at Guys and St. Thomas', Kings Health Partners AHSC, Department of Child and Adolescent Psychiatry, Universität Ulm - Ulm University [Ulm, Allemagne], UK Tourette SyndromeAssociation, Department of Neurology, St George's Hospital, Tourette SyndromeClinic, Great Ormond Street Hospital for Children [London] (GOSH), Centre De Référence National 'Syndrome Gilles de la Tourette', Pôle des Maladies du Système Nerveux [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière (CRICM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Department of Mental Health Sciences, UCL, Department of Neurological and Psychiatric Sciences, Università degli studi di Bari Aldo Moro (UNIBA), Department of Neurology, University Hospital Medical Centre, Department of Child and Adolescent Neurology and Psychiatry, Catania University, Cath, D, Hedderly, T, Ludolph, A, Stern, J, Murphy, T, Hartmann, A, Czernecki, V, Robertson, M, Martino, D, Munchau, A, Rizzo, R, Androutsos, C, Aschauer, H, Baird, G, Bos-Veneman, N, Brambilla, A, Cardona, F, Cavanna, A, Dehning, S, Eapter, A, Farkas, L, Gadaros, J, Hauser, E, Heyman, I, Hoekstra, P, Korsgaard, A, Jackson, G, Larsson, L, Menghetti, C, Debes, N, Muller, N, Muller-Vahl, K, Musil, R, Nagy, P, Nurnberger, J, Oostra, B, Paschou, P, Pasquini, M, Plessen, K, Porta, M, Rickards, H, Roessner, V, Rothenberger, A, Servello, D, Skov, L, Strand, G, Tarnok, Z, Termine, C, Van Der Griendt, J, Verdellen, C, Visser-Vandewalle, V, Wannag, E, Wolanczyck, T, Neurochirurgie, RS: MHeNs School for Mental Health and Neuroscience, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Università degli studi di Bari Aldo Moro = University of Bari Aldo Moro (UNIBA), Università degli studi di Catania = University of Catania (Unict), and University of Groningen

Subjects
YOUNG-PEOPLE, Comorbidity, Neuropsychological Tests, Guideline, Severity of Illness Index, Tourette syndrome, 0302 clinical medicine, DEFICIT-HYPERACTIVITY DISORDER, QUALITY-OF-LIFE, Developmental and Educational Psychology, Child and adolescent psychiatry, Tic, Tourette, Assessment, Guidelines, medicine.diagnostic_test, ATTENTION-DEFICIT/HYPERACTIVITY DISORDER, Neuropsychology, General Medicine, 3. Good health, Europe, Psychiatry and Mental health, assessment, guidelines, tics, tourette, Tics, TEST-RETEST RELIABILITY, Psychology, medicine.medical_specialty, Tourette, Physical examination, Article, SELF-REPORT, Diagnosis, Differential, 03 medical and health sciences, VERSION DISC-R, Quality of life (healthcare), medicine, Humans, Attention deficit hyperactivity disorder, Pediatrics, Perinatology, and Child Health, Psychiatry, Physical Examination, DIAGNOSTIC INTERVIEW SCHEDULE, Tic, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, OBSESSIVE-COMPULSIVE DISORDER, medicine.disease, 030227 psychiatry, PSYCHOMETRIC PROPERTIES, Tic Disorders, Pediatrics, Perinatology and Child Health, 030217 neurology & neurosurgery, Tourette Syndrome
Abstract

International audience; A working group of the European Society for the Study of Tourette Syndrome (ESSTS) has developed the first European assessment guidelines of Tourette Syndrome (TS). The available literature including national guidelines was thoroughly screened and extensively discussed in the expert group of ESSTS members. Detailed clinical assessment guidelines of tic disorders and their comorbidities in both children and adults are presented. Screening methods that might be helpful and necessary for specialists' differential diagnosis process are suggested in order to further analyse cognitive abilities, emotional functions and motor skills. Besides clinical interviews and physical examination, additional specific tools (questionnaires, checklists and neuropsychological tests) are recommended.

Published
2011

2. European clinical guidelines for Tourette syndrome and other tic disorders. Part II

Author

Veit, Roessner, Plessen, Kerstin J., Aribert, Rothenberger, Ludolph, Andrea G., Renata, Rizzo, Liselotte, Skov, Gerd, Strand, Stern, Jeremy S., Cristiano, Termine, Hoekstra, Pieter J., Guidelines Group Androutsos, Essts C., Aschauer, H., Baird, G., Bos Veneman, N., Brambilla, A., Cardona, Francesco Carmelo Giovanni, Cath, D. c., Cavanna, A. e., Czernecki, V., Dehning, S., Eapter, A., Farkas, L., Gadaros, J., Hartmann, A., Hauser, E., Heyman, I., Hedderly, T., Hoekstra, P. j., Korsgaard, A., Jackson, G. m., Larsson, L., Ludolph, A. g., Martino, D., Menghetti, C., Mol Debes, N., Muller, N., Muller Vahl, K., Munchau, A., Murphy, T., Musil, R., Nagy, P., Nurnberger, J., Oostra, B., Paschou, P., Pasquini, M., Plessen, K. j., Porta, M., Rickards, H., Rizzo, R., Robertson, M. m., Roessner, V., Rothenberger, A., Servello, D., Skov, L., Stern, J. s., Strand, G., Tarnok, Z., Termine, C., Van Der Griendt, J., Verdellen, C., Visser Vandewalle, V., Wannag, E., Wolanczyck, T., Department of Child and Adolescent Psychiatry, University of Dresden Medical School, Centre for Child and Adolescent Psychiatry at Bispebjerg, Capital Region Psychiatry, Department of Neurology, Psychiatry and Sensory Sciences, Faculty of Health and Medical Sciences, University of Copenhagen = Københavns Universitet (KU)-University of Copenhagen = Københavns Universitet (KU), University of Göttingen - Georg-August-Universität Göttingen, Universität Ulm - Ulm University [Ulm, Allemagne], Renata Rizzo Child and Adolescent Neurology and Psichiatry, Maternal Infantile and Radiological Sciences Department, Catania University, Department of Pediatrics, Glostrup University Hospital, Norwegian Resource Center for AD/HD, Tourette Syndrome and Narcolepsy, Ullevål University Hospital, St George's Hospital Neurology, Child Neuropsychiatry Unit, Department of Experimental Medicine, Universitá degli Studi dell’Insubria, Department of Psychiatry, University Medical Center Groningen [Groningen] (UMCG), Roessner, V, Plessen, K, Rothenberger, A, Ludolph, A, Rizzo, R, Skov, L, Strand, G, Stern, J, Termine, C, Hoekstra, P, Androutsos, C, Aschauer, H, Baird, G, Bos-Veneman, N, Brambilla, A, Cardona, F, Cath, D, Cavanna, A, Czernecki, V, Dehning, S, Eapter, A, Farkas, L, Gadaros, J, Hartmann, A, Hauser, E, Heyman, I, Hedderly, T, Korsgaard, A, Jackson, G, Larsson, L, Martino, D, Menghetti, C, Debes, N, Muller, N, Muller-Vahl, K, Munchau, A, Murphy, T, Musil, R, Nagy, P, Nurnberger, J, Oostra, B, Paschou, P, Pasquini, M, Porta, M, Rickards, H, Robertson, M, Servello, D, Tarnok, Z, Van Der Griendt, J, Verdellen, C, Visser-Vandewalle, V, Wannag, E, Wolanczyck, T, Neurochirurgie, and RS: MHeNs School for Mental Health and Neuroscience

Subjects
Placebo-controlled study, Pharmacologic, Guideline, PLACEBO-CONTROLLED TRIAL, Tourette syndrome, Pharmacologic treatment, DOUBLE-BLIND, 0302 clinical medicine, DEFICIT-HYPERACTIVITY DISORDER, Developmental and Educational Psychology, SIMPLE MOTOR TICS, Tic, Tourette, Assessment, ATTENTION-DEFICIT/HYPERACTIVITY DISORDER, LONG-TERM TREATMENT, General Medicine, 3. Good health, Europe, Psychiatry and Mental health, TRANSDERMAL NICOTINE, Tics, BOTULINUM TOXIN INJECTION, Psychology, guidelines, pharmacologic, tics, tourette, treatment, Antipsychotic Agents, medicine.medical_specialty, MEDLINE, Habit reversal training, RETROSPECTIVE CASE-NOTE, Guidelines, Article, 03 medical and health sciences, Tourette, Treatment, medicine, Humans, Medicine & Public Health, Psychiatry, Pediatrics, Perinatology, and Child Health, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, Tic, Evidence-based medicine, OBSESSIVE-COMPULSIVE DISORDER, medicine.disease, 030227 psychiatry, Tic Disorders, Treatment of Tourette syndrome, Pediatrics, Perinatology and Child Health, 030217 neurology & neurosurgery, Tourette Syndrome
Abstract

International audience; To develop a European guideline on pharmacologic treatment of Tourette syndrome (TS) the available literature was thoroughly screened and extensively discussed by a working group of the European Society for the Study of Tourette syndrome (ESSTS). Although there are many more studies on pharmacotherapy of TS than on behavioral treatment options, only a limited number of studies meets rigorous quality criteria. Therefore, we have devised a two-stage approach. First, we present the highest level of evidence by reporting the findings of existing Cochrane reviews in this field. Subsequently, we provide the first comprehensive overview of all reports on pharmacological treatment options for TS through a MEDLINE, PubMed, and EMBASE search for all studies that document the effect of pharmacological treatment of TS and other tic disorders between 1970 and November 2010. We present a summary of the current consensus on pharmacological treatment options for TS in Europe to guide the clinician in daily practice. This summary is, however, rather a status quo of a clinically helpful but merely low evidence guideline, mainly driven by expert experience and opinion, since rigorous experimental studies are scarce.

Published
2011

3. European clinical guidelines for Tourette syndrome and other tic disorders. Part III: behavioural and psychosocial interventions

Author

Verdellen, C., Van De Griendt, J., Hartmann, A., Tara, Murphy, Essts Guidelines Group Androutsos, C., Aschauer, H., Baird, G., Bos Veneman, N., Brambilla, A., Cardona, Francesco Carmelo Giovanni, Cath, D. c., Cavanna, A. e., Czernecki, V., Dehning, S., Eapter, A., Farkas, L., Gadaros, J., Hauser, E., Heyman, I., Hedderly, T., Hoekstra, P. j., Korsgaard, A., Jackson, G. m., Larsson, L., Ludolph, A. g., Martino, D., Menghetti, C., Mol Debes, N., Muller, N., Muller Vahl, K., Munchau, A., Murphy, T., Musil, R., Nagy, P., Nurnberger, J., Oostra, B., Paschou, P., Pasquini, M., Plessen, K. j., Porta, M., Rickards, H., Rizzo, R., Robertson, M. m., Roessner, V., Rothenberger, A., Servello, D., Skov, L., Stern, J. s., Strand, G., Tarnok, Z., Termine, C., Van Der Griendt, J., Visser Vandewalle, V., Wannag, E., Wolanczyck, T., Verdellen, C, Van De Griendt, J, Hartmann, A, Murphy, T, Androutsos, C, Aschauer, H, Baird, G, Bos-Veneman, N, Brambilla, A, Cardona, F, Cath, D, Cavanna, A, Czernecki, V, Dehning, S, Eapter, A, Farkas, L, Gadaros, J, Hauser, E, Heyman, I, Hedderly, T, Hoekstra, P, Korsgaard, A, Jackson, G, Larsson, L, Ludolph, A, Martino, D, Menghetti, C, Debes, N, Muller, N, Muller-Vahl, K, Munchau, A, Musil, R, Nagy, P, Nurnberger, J, Oostra, B, Paschou, P, Pasquini, M, Plessen, K, Porta, M, Rickards, H, Rizzo, R, Robertson, M, Roessner, V, Rothenberger, A, Servello, D, Skov, L, Stern, J, Strand, G, Tarnok, Z, Termine, C, Visser-Vandewalle, V, Wannag, E, Wolanczyck, T, HSK Group/Expertise Centre Tics, CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Tourette Syndrome Clinic, Great Ormond Street Hospital for Children [London] (GOSH), Neurochirurgie, RS: MHeNs School for Mental Health and Neuroscience, and University of Groningen

Subjects
literature review, medicine.medical_treatment, Psychological intervention, CHILDREN, Cochrane Library, Guideline, NEUROFEEDBACK, Tourette syndrome, THERAPY, law.invention, 0302 clinical medicine, Randomized controlled trial, law, Behavior Therapy, ADOLESCENTS, Developmental and Educational Psychology, guidelines, behavioural treatment, Tourette, Tic disorders, Behavioural treatment, Psychosocial interventions, SUPPORTIVE PSYCHOTHERAPY, General Medicine, Tic disorder, RANDOMIZED CONTROLLED-TRIAL, 3. Good health, Europe, Psychiatry and Mental health, psychosocial interventions, tic disorders, tourette, Psychology, Psychosocial, medicine.medical_specialty, Tics, Habit reversal training, RELAXATION, HABIT-REVERSAL, 03 medical and health sciences, Psychoeducation, medicine, Humans, Psychosocial intervention, Psychiatry, PEER, SUPPRESSION, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, medicine.disease, 030227 psychiatry, Tic Disorders, Pediatrics, Perinatology and Child Health, 030217 neurology & neurosurgery, Tourette Syndrome
Abstract

International audience; This clinical guideline provides recommendations for the behavioural and psychosocial interventions (BPI) of children and adolescents with tic disorders prepared by a working group of the European Society for the Study of Tourette Syndrome (ESSTS). A systematic literature search was conducted to obtain an update on the efficacy of BPI for tics. Relevant studies were identified using computerised searches of the Medline and PsycINFO databases and the Cochrane Library for the years 1950-2010. The search identified no meta-analyses, yet twelve (systematic) reviews and eight randomised controlled trials provided evidence for the current review. Most evidence was found for habit reversal training (HRT) and the available but smaller evidence also supports the efficacy of exposure with response prevention (ERP). Both interventions are considered first line behavioural treatments for tics for both children and adults and should be offered to a patient, taking into account his preference. Treatments that are considered second line or add-on behavioural treatments are contingency management, function based interventions and relaxation training. Neurofeedback is still experimental. Almost no research was identified that examined the efficacy of psychosocial interventions, e.g., psychoeducation and group work. Based on clinical practice, this guideline recommends behavioural treatment as first line offer to patients in most cases. It should be embedded within a psychoeducational and supportive context and can be combined with drug treatment.

Published
2011

4. European clinical guidelines for Tourette syndrome and other tic disorders. Part IV: Deep brain stimulation

Author

Muller Vahl, K. r., Cath, Danielle C., Cavanna, Andrea E., Sandra, Dehning, Mauro, Porta, Robertson, Mary M., Veerle Visser Vandewalle, Essts Guidelines Group Androutsos, C., Aschauer, H., Baird, G., Bos Veneman, N., Brambilla, A., Cardona, Francesco Carmelo Giovanni, Cath, D. c., Cavanna, A. e., Czernecki, V., Dehning, S., Eapter, A., Farkas, L., Gadaros, J., Hartmann, A., Hauser, E., Heyman, I., Hedderly, T., Hoekstra, P. j., Korsgaard, A., Jackson, G. m., Larsson, L., Ludolph, A. g., Martino, D., Menghetti, C., Mol Debes, N., Muller, N., Muller Vahl, K., Munchau, A., Murphy, T., Musil, R., Nagy, P., Nurnberger, J., Oostra, B., Paschou, P., Pasquini, M., Plessen, K. j., Porta, M., Rickards, H., Rizzo, R., Robertson, M. m., Roessner, V., Rothenberger, A., Servello, D., Skov, L., Stern, J. s., Strand, G., Tarnok, Z., Termine, C., Van Der Griendt, J., Verdellen, C., Visser Vandewalle, V., Wannag, E., Wolanczyck, T., University of Groningen, Clinic of Psychiatry, Socialpsychiatry and Psychotherapy, Hannover Medical School [Hannover] (MHH), Department of Clinical and Health Psychology, Utrecht University/Altrecht Academic Anxiety Outpatient Services, Department of Neuropsychiatry, Birmingham and Solihull Mental Health NHS Foundation, Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München (LMU), Movement Disorders and Tourette Centre, Department of Mental Health Sciences, UCL, Department of Neurosurgery, University Hospital Maastricht, Neurochirurgie, RS: MHeNs School for Mental Health and Neuroscience, Muller-Vahl, K, Cath, D, Cavanna, A, Dehning, S, Porta, M, Robertson, M, Visser-Vandewalle, V, and the ESSTS Guidelines, G

Subjects
Pediatrics, Tic, Tourette, Deep Brain Stimulation, Treatment, ASSESSMENT RECOMMENDATIONS, SURGERY, medicine.medical_treatment, DBS, Guideline, Tourette syndrome, law.invention, 0302 clinical medicine, Randomized controlled trial, law, Developmental and Educational Psychology, Deep brain stimulation, THALAMIC-STIMULATION, General Medicine, 3. Good health, Europe, Psychiatry and Mental health, Tics, Anxiety, medicine.symptom, Psychology, medicine.medical_specialty, NUCLEUS-ACCUMBENS, Context (language use), IMPROVEMENT, Guidelines, PATIENT SELECTION, 03 medical and health sciences, medicine, Humans, Tourette, Psychiatry, GLOBUS-PALLIDUS INTERNUS, Tic, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, medicine.disease, 030227 psychiatry, GPI, Supportive psychotherapy, Tic Disorders, Pediatrics, Perinatology and Child Health, 030217 neurology & neurosurgery, Tourette Syndrome
Abstract

International audience; Ten years ago deep brain stimulation (DBS) has been introduced as an alternative and promising treatment option for patients suffering from severe Tourette syndrome (TS). It seemed timely to develop a European guideline on DBS by a working group of the European Society for the Study of Tourette Syndrome (ESSTS). For a narrative review a systematic literature search was conducted and expert opinions of the guidelines group contributed also to the suggestions. Of 63 patients reported so far in the literature 59 had a beneficial outcome following DBS with moderate to marked tic improvement. However, randomized controlled studies including a larger number of patients are still lacking. Although persistent serious adverse effects (AEs) have hardly been reported, surgery-related (e.g., bleeding, infection) as well as stimulation-related AEs (e.g., sedation, anxiety, altered mood, changes in sexual function) may occur. At present time, DBS in TS is still in its infancy. Due to both different legality and practical facilities in different European countries these guidelines, therefore, have to be understood as recommendations of experts. However, among the ESSTS working group on DBS in TS there is general agreement that, at present time, DBS should only be used in adult, treatment resistant, and severely affected patients. It is highly recommended to perform DBS in the context of controlled trials.

Published
2011

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