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Background: Neck motor tics in Tourette's syndrome can cause severe neck complications. Although addressed in a few longitudinal studies, the clinical course of Tourette's syndrome has not been quantitatively assessed. We had previously developed a method for quantifying the angular movements of neck tics using a compact gyroscope. Here, we present a follow-up study aimed at elucidating the clinical course of neck tics at both the group and individual levels., Methods: Eleven patients with Tourette's syndrome from our previous study participated in the present study, and their neck tics were recorded during a 5-min observation period. The severity of neck symptoms was assessed using the Yale Global Tic Severity Scale. The peak angular velocities and accelerations, tic counts, and severity scores in our previous study (baseline) and the present study (2-year follow-up) were compared at the group and individual levels. The individual level consistency between baseline and follow-up were calculated using intra-class correlation coefficients (ICCs, one-way random, single measure)., Results: At the group level, no significant change was observed between baseline and follow-up. At the individual level, angular velocity (ICC 0.73) and YGTSS scores (ICC 0.75) had substantial consistency over the two time points, and angular acceleration (ICC 0.59) and tic counts (ICC 0.69) had moderate consistency., Conclusions: The intensity and frequency of neck tics did not change over time. Therefore, quantification of angular neck motor tics will aid in identifying patients with neck tics at high risk for severe neck complications., Competing Interests: The authors have declared that no competing interests exist.

Background: Though Gilles de la Tourette's syndrome (GTS) has significant impact on the quality of life of its patients, measures of health-related quality of life (HR-QOL) specific to adolescents and adults with GTS were not developed until recently. The present study provides evidence on the validity of the Gilles de la Tourette Syndrome-Quality of Life Scale (GTS-QOL), the first disease-specific HR-QOL instrument for GTS patients, for the first time in an East Asian sample. Methods: One hundred and two Japanese individuals aged 13 and above with GTS were included in our study. Internal consistency was evaluated using Cronbach's alpha. The 4-factor structure of the GTS-QOL was assessed using confirmatory factor analysis, using goodness of fit indices, factor loadings of each questionnaire item, and covariances between factors. Validity was assessed using interscale correlations. Convergent and discriminate construct validity was evaluated using correlations with other scales such as the 28-item General Health Questionnaire, the Yale Global Tic Severity Scale, and the short version of the Padua Inventory. Results: Scaling assumptions were met. Internal consistency reliability was high, with a Cronbach's alpha of 0.96. Confirmatory factor analysis revealed sufficient factor loadings and goodness of fit. All measures of goodness of fit corroborated the fit of the 4-factor model. Standardized covariances between factors in the confirmatory factor analysis were >0.8. There were significant correlations with other well-validated scales, and thus convergent and discriminate construct validity was sufficient. Conclusion: The GTS-QOL is a valid and reliable instrument to measure disease-specific HR-QOL of GTS patients in Japan. [ABSTRACT FROM AUTHOR]

Awareness of premonitory urge in Tourette syndrome (TS) may facilitate tic suppression; however, previous studies have not supported this observation. We aimed to clarify the relationship between tic-associated sensation and tic suppression by identifying the subtypes of tic-associated sensations, including the Premonitory Urge for Tics Scale (PUTS). We developed a new questionnaire called "Rumination and Awareness Scale for tic-associated sensations" (RASTS) to assess the two additional aspects of tic-associated sensations: the intensity of somatosensory hyperawareness and the ability to identify signals of emerging tics. Sixty-two individuals with TS participated in the study (mean age = 19.2 ± 10.3 years). All participants completed the RASTS, PUTS, and Tic Suppression Scale. Of all participants, 41 were evaluated by the Yale Global Tic Severity Scale (YGTSS), while another group of 41 completed both the Leyton Obsessional Inventory-Child Version (LOI-CV) and the Tics Symptom Self-Report (TSSR). Factor analyses including nine items of the PUTS and the RASTS were conducted, and their relationships with patients' tic suppression ability were examined. The results support using RASTS for the two supposed dimensions (rumination about sensation and premonitory awareness) for assessing the two different tic-associated sensations, and PUTS for three dimensions for assessing the two types of quality of premonitory urges and intensity of premonitory urges. Premonitory awareness correlated with tic suppression ability. Conversely, rumination about sensation, PUTS total score, and the three subscales of PUTS correlated with obsessive-compulsive symptoms. In summary, being aware of signals for emerging tics facilitated self-initiated tic suppression, while ruminative tic-associated sensations did not. This study provides new insights into behavioral therapy for tics by identifying two distinct aspects of tic-associated sensations that include premonitory urges. [ABSTRACT FROM AUTHOR]

Sensory phenomena and related features of Tourette syndrome are related to poorer quality of life. Therefore, sensory phenomena might also have a negative impact on global functioning. However, the influence of sensory phenomena, tics, and obsessive–compulsive symptoms (OCS) on global functioning after several years of usual treatment has not been investigated. Twenty out of 45 Japanese patients with Tourette syndrome who had previously undergone an evaluation of these clinical features were assessed again after an average of four years. We conducted a panel of assessments for premonitory urges, broader sensory phenomena, tic severity, OCS, and global functioning. Based on Pearson's correlation coefficient, current global functioning was significantly negatively correlated with previous tics and marginally negatively correlated with previous broader sensory phenomena. Current global functioning was marginally correlated with change in tics. Change in global functioning was significantly correlated with change in OCS and marginally correlated with change in premonitory urges. Due to the small sample size, it was not possible to use a multiple regression analysis to conclude that sensory phenomena, tics, and OCS predict global functioning in adolescents and adults with TS. However, it was suggested that further investigation of this relationship would be meaningful. [ABSTRACT FROM AUTHOR]

Highlights • In two cases, tics and premonitory urges improved after DBS. • Sensory phenomena and obsessive-compulsive symptoms differed between cases. • Where such symptoms were less improved, global functioning also improved less. • Assessing sensory phenomena is important to evaluate DBS efficacy for tics. Abstract Here, we assess sensory phenomena (SP) and obsessive-compulsive symptoms (OCS) in two patients with refractory Tourette syndrome (TS) before and after deep brain stimulation (DBS) targeting the centromedian-parafascicular complex (CM-Pfc)-ventral oral nuclei of the bilateral thalami. Based on changes in these clinical features, we also aimed to elucidate useful information regarding the use of DBS in TS. We administered the Yale Global Tic Severity Scale (YGTSS) to assess tics, the Premonitory Urge for Tics Scale (PUTS) for premonitory urges, the University of São Paulo Sensory Phenomena Scale (USP-SPS) for broader SP, the Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS) for OCS, and the Global Assessment of Functioning (GAF) scale for global functioning. We report on two male patients who showed consistent improvement in tics, premonitory urges, and global functioning two years after DBS. In contrast, there were differences between the patients in broader SP, including "just right" perceptions, and OCS. Our results suggest that systematic assessment of a wide range of SP and OCS dimensions is necessary to elucidate the usefulness of DBS in TS. [ABSTRACT FROM AUTHOR]

Objective Because of the semi-voluntary nature of tics, patients with Tourette’ syndrome (TS) often report self-initiated coping with tics. Our goals were to understand the experiences of self-initiated coping with tics by individuals with TS (e.g., suppression frequency, suppression ability, and side effects of tic suppression), and investigate the effects of tic control on quality of life (QOL). Method One hundred participants with TS (38 children and 62 adults) answered a questionnaire concerning tic control, QOL, and other clinical characteristics. Result Fifty-eight percent of the participants always or frequently tried to suppress tics daily. In contrast, over 90% felt uncomfortable or incomplete when they suppressed tics and needed concentration or extra effort to suppress them. Thirty-four percent could suppress tics for less than one minute and 65% could suppress tics for less than 10 min. Higher subjective satisfaction with tic control was positively correlated with life satisfaction and QOL. Conclusion Individuals with TS often attempt self-initiated coping in their daily lives, especially through tic suppression, despite experiencing subjective discomfort and being aware that the duration of tic suppression is often limited. Moreover, it was found that their subjective satisfaction with tic control and effective tic suppression might have a positive influence on their life satisfaction and QOL. Thus, self-initiated coping with tics is vital for improving the QOL of individuals with TS and intervention aimed at enhancing subjective satisfaction with tic control could help manage TS. [ABSTRACT FROM AUTHOR]