Abstract
Tics wax and wane regarding their severity, while their expression is affected by non-motor sensory or cognitive elements that are mostly known as “premonitory urges.” Since premonitory urges are often used in non-pharmacological interventions to decrease tic severity, it is of interest in the present study to examine whether premonitory urges can actually predict tic severity. Fifty-two children and adolescents diagnosed with tics and Tourette syndrome (29 children with provisional tic disorder, 16 children with chronic motor tic disorder, and 7 children with Tourette syndrome) were included in the study. Their age ranged between 6 and 15.7 years (mean age 9 years and 2 months). All participants completed the YGTSS (Yale Global Tic Severity Scale) in order to assess tic severity and the Premonitory Urge for Tics Scale (PUTS) to measure premonitory urges (PU). Regression analysis revealed that PU were present at a higher rate in older subjects (>12 years of age) than in younger children and with a higher level of tic severity. Although the presence of PU was associated with tic severity across the entire age range, there was a stronger association between PU and tic severity in older children. A better insight into the pathophysiology of premonitory urges could possibly lead to the identification of new therapeutic modalities targeting the sensory initiators of tics in future research.
Highlights
Tics are defined as sudden, rapid, recurrent, non-rhythmic motor movements or vocalizations usually appearing in bouts while waxing and waning in frequency, intensity, and manifestation
Patients aged more than 12 years had significantly higher Premonitory Urge for Tics Scale (PUTS) scores (M = 17.15, SD = 4.61) than children aged 6–12 (M = 14.18, SD = 5.19)
The present study provides significant insights into premonitory urges and tic severity and is the first study involving children in our country
Summary
Tics are defined as sudden, rapid, recurrent, non-rhythmic motor movements or vocalizations usually appearing in bouts while waxing and waning in frequency, intensity, and manifestation. The most recent categorizations that emerged in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition regarding motor disorders are developmental coordination disorder, stereotypic movement disorder, Tourette’s disorder, persistent (chronic) motor or vocal tic disorder, provisional tic disorder, other specified tic disorders, and unspecified tic disorders [1]. Differences in the reported prevalence of chronic tic disorders from 0.5% to 4% [3,4,5,6,7] may be due to the fact that most cases of tics are mild and may be misdiagnosed. There is general consensus, that the male to female ratio is at least 2:1 or higher [9, 10], with prevalence rates of tic disorders in general ranging from 5.9% to 18% for males and from 2.9% to 11% for females [6]
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