The Experts below are selected from a list of 5874 Experts worldwide ranked by ideXlab platform
Ruud B Minderaa - One of the best experts on this subject based on the ideXlab platform.
-
Plasma kynurenine and related measures in Tic Disorder patients.
European child & adolescent psychiatry, 2020Co-Authors: Pieter J Hoekstra, George M Anderson, Pieter W Troost, Cees G M Kallenberg, Ruud B MinderaaAbstract:Increased plasma kynurenine has been reported in Tic Disorder patients, and this observation has been suggested to be indicative of immune dysregulation. In the present study, we examined plasma levels of kynurenine and related molecules in a group of Tic Disorder patients. Plasma concentrations of tryptophan, kynurenine, cortisol, and neopterin were determined in Dutch Tic Disorder patients (N = 59), and healthy volunteers (N = 32). Group means were compared and age-controlled intra-individual correlations between Tic severity and plasma levels of these molecules were examined. No significant differences were found between patient and control groups in plasma levels of tryptophan, kynurenine, and cortisol concentrations, nor in the kynurenine/tryptophan ratio. However, neopterin was significantly (p = 0.035) higher in patients (mean = 5.13 nmol/l) than in controls (mean = 3.30 nmol/l). Plasma levels of these molecules did not correlate with Tic severity, with the exception of tryptophan (r = -0.289, p = 0.049). In patients, plasma neopterin correlated with kynurenine (r = 0.438, p = 0.002); in healthy subjects, tryptophan correlated with kynurenine (r = 0.670, p < 0.001). While the observed elevation in plasma neopterin is consistent with immune activation in a subset of Tic Disorder patients, metabolism of tryptophan through the kynurenine pathway appears to be unaltered in Tic Disorder patients.
-
cytokines and soluble adhesion molecules in children and adolescents with a Tic Disorder
Progress in Neuro-psychopharmacology & Biological Psychiatry, 2010Co-Authors: Netty G P Bosveneman, Cees G M Kallenberg, Ruud B Minderaa, Johan Bijzet, P C Limburg, Pieter J HoekstraAbstract:Abstract Aim Dysregulation of the immune system may play a role in Tic Disorders. We screened for immune disturbances by investigating serum levels of cytokines and soluble adhesion molecules in patients with a Tic Disorder. Methods Serum levels of interleukin (IL)-2, IL-4, IL-5, IL-10, IL-12, soluble IL-2 receptor (sIL2R), tumor necrosis factor (TNF)-α, interferon (IFN)-γ, soluble vascular cell adhesion molecule-1 (sVCAM-1), and intercellular adhesion molecule-1 (sICAM-1) of 66 children and adolescents with a Tic Disorder and 71 healthy volunteers were compared. We also addressed possible relations between concentrations of the immune markers and severity of Tics and comorbid obsessive–compulsive symptoms. Results Median serum concentrations did not differ significantly between patients and healthy subjects. Serum IL-2 concentrations were positively associated with Tic severity ratings; serum IL-12 concentrations negatively with severity ratings of obsessive–compulsive symptoms. Conclusions These preliminary findings do not reveal major immune activation in children with a Tic Disorder but may suggest more subtle disturbances related to disease expression.
-
role of perinatal adversities on Tic severity and symptoms of attention deficit hyperactivity Disorder in children and adolescents with a Tic Disorder
Journal of Developmental and Behavioral Pediatrics, 2010Co-Authors: Netty G P Bosveneman, Ruud B Minderaa, Anne Kuin, Pieter J HoekstraAbstract:Objective: To investigate the role of perinatal adversities with regard to Tic severity and comorbid attention deficit/hyperactivity Disorder (ADHD) symptoms in children with a Tic Disorder. Methods: In 75 children and adolescents with a Tic Disorder, we retrospectively assessed presence of pregnancy, delivery, and postnatal complications and of prenatal exposure to smoking and alcohol. Children with and without these perinatal adversities were compared regarding Tic and ADHD symptom severity. Furthermore, through linear regressions, we investigated whether perinatal adversities would interact with presence in first-degree relatives of Tic or any mental Disorders with the Tic or ADHD measure as outcome. Results: Presence of delivery complications was related to Tic severity and prenatal smoking exposure to severity of comorbid ADHD symptoms. The relationship between smoking exposure in utero and ADHD symptom severity appeared to be more pronounced in children with a positive family history of mental Disorders. Conclusion: This study provides evidence of a role for perinatal adversities in the etiology of Tic Disorders. Children with perinatal adversities may be vulnerable to develop more severe Tics or comorbid ADHD symptoms in the presence of a positive family history of mental Disorders, suggesting a role for gene-environment interactions.
-
plasma kynurenine and related measures in Tic Disorder patients
European Child & Adolescent Psychiatry, 2007Co-Authors: Pieter J Hoekstra, George M Anderson, Pieter W Troost, Cees G M Kallenberg, Ruud B MinderaaAbstract:Objective Increased plasma kynurenine has been reported in Tic Disorder patients, and this observation has been suggested to be indicative of immune dysregulation. In the present study, we examined plasma levels of kynurenine and related molecules in a group of Tic Disorder patients.
-
Plasma kynurenine and related measures in Tic Disorder patients
European Child & Adolescent Psychiatry, 2007Co-Authors: Pieter J Hoekstra, George M Anderson, Pieter W Troost, Cees G M Kallenberg, Ruud B MinderaaAbstract:Objective Increased plasma kynurenine has been reported in Tic Disorder patients, and this observation has been suggested to be indicative of immune dysregulation. In the present study, we examined plasma levels of kynurenine and related molecules in a group of Tic Disorder patients. Methods Plasma concentrations of tryptophan, kynurenine, cortisol, and neopterin were determined in Dutch Tic Disorder patients (N = 59), and healthy volunteers (N = 32). Group means were compared and age-controlled intra-individual correlations between Tic severity and plasma levels of these molecules were examined. Results No significant differences were found between patient and control groups in plasma levels of tryptophan, kynurenine, and cortisol concentrations, nor in the kynurenine/tryptophan ratio. However, neopterin was significantly (p = 0.035) higher in patients (mean = 5.13 nmol/1) than in controls (mean = 3.30 nmol/1). Plasma levels of these molecules did not correlate with Tic severity, with the exception of tryptophan (r = -0.289, p = 0.049). In patients, plasma neopterin correlated with kynurenine (r = 0.438, P = 0.002); in healthy subjects, tryptophan correlated with kynurenine (r = 0.670, p
Pieter J Hoekstra - One of the best experts on this subject based on the ideXlab platform.
-
Plasma kynurenine and related measures in Tic Disorder patients.
European child & adolescent psychiatry, 2020Co-Authors: Pieter J Hoekstra, George M Anderson, Pieter W Troost, Cees G M Kallenberg, Ruud B MinderaaAbstract:Increased plasma kynurenine has been reported in Tic Disorder patients, and this observation has been suggested to be indicative of immune dysregulation. In the present study, we examined plasma levels of kynurenine and related molecules in a group of Tic Disorder patients. Plasma concentrations of tryptophan, kynurenine, cortisol, and neopterin were determined in Dutch Tic Disorder patients (N = 59), and healthy volunteers (N = 32). Group means were compared and age-controlled intra-individual correlations between Tic severity and plasma levels of these molecules were examined. No significant differences were found between patient and control groups in plasma levels of tryptophan, kynurenine, and cortisol concentrations, nor in the kynurenine/tryptophan ratio. However, neopterin was significantly (p = 0.035) higher in patients (mean = 5.13 nmol/l) than in controls (mean = 3.30 nmol/l). Plasma levels of these molecules did not correlate with Tic severity, with the exception of tryptophan (r = -0.289, p = 0.049). In patients, plasma neopterin correlated with kynurenine (r = 0.438, p = 0.002); in healthy subjects, tryptophan correlated with kynurenine (r = 0.670, p < 0.001). While the observed elevation in plasma neopterin is consistent with immune activation in a subset of Tic Disorder patients, metabolism of tryptophan through the kynurenine pathway appears to be unaltered in Tic Disorder patients.
-
cytokines and soluble adhesion molecules in children and adolescents with a Tic Disorder
Progress in Neuro-psychopharmacology & Biological Psychiatry, 2010Co-Authors: Netty G P Bosveneman, Cees G M Kallenberg, Ruud B Minderaa, Johan Bijzet, P C Limburg, Pieter J HoekstraAbstract:Abstract Aim Dysregulation of the immune system may play a role in Tic Disorders. We screened for immune disturbances by investigating serum levels of cytokines and soluble adhesion molecules in patients with a Tic Disorder. Methods Serum levels of interleukin (IL)-2, IL-4, IL-5, IL-10, IL-12, soluble IL-2 receptor (sIL2R), tumor necrosis factor (TNF)-α, interferon (IFN)-γ, soluble vascular cell adhesion molecule-1 (sVCAM-1), and intercellular adhesion molecule-1 (sICAM-1) of 66 children and adolescents with a Tic Disorder and 71 healthy volunteers were compared. We also addressed possible relations between concentrations of the immune markers and severity of Tics and comorbid obsessive–compulsive symptoms. Results Median serum concentrations did not differ significantly between patients and healthy subjects. Serum IL-2 concentrations were positively associated with Tic severity ratings; serum IL-12 concentrations negatively with severity ratings of obsessive–compulsive symptoms. Conclusions These preliminary findings do not reveal major immune activation in children with a Tic Disorder but may suggest more subtle disturbances related to disease expression.
-
role of perinatal adversities on Tic severity and symptoms of attention deficit hyperactivity Disorder in children and adolescents with a Tic Disorder
Journal of Developmental and Behavioral Pediatrics, 2010Co-Authors: Netty G P Bosveneman, Ruud B Minderaa, Anne Kuin, Pieter J HoekstraAbstract:Objective: To investigate the role of perinatal adversities with regard to Tic severity and comorbid attention deficit/hyperactivity Disorder (ADHD) symptoms in children with a Tic Disorder. Methods: In 75 children and adolescents with a Tic Disorder, we retrospectively assessed presence of pregnancy, delivery, and postnatal complications and of prenatal exposure to smoking and alcohol. Children with and without these perinatal adversities were compared regarding Tic and ADHD symptom severity. Furthermore, through linear regressions, we investigated whether perinatal adversities would interact with presence in first-degree relatives of Tic or any mental Disorders with the Tic or ADHD measure as outcome. Results: Presence of delivery complications was related to Tic severity and prenatal smoking exposure to severity of comorbid ADHD symptoms. The relationship between smoking exposure in utero and ADHD symptom severity appeared to be more pronounced in children with a positive family history of mental Disorders. Conclusion: This study provides evidence of a role for perinatal adversities in the etiology of Tic Disorders. Children with perinatal adversities may be vulnerable to develop more severe Tics or comorbid ADHD symptoms in the presence of a positive family history of mental Disorders, suggesting a role for gene-environment interactions.
-
plasma kynurenine and related measures in Tic Disorder patients
European Child & Adolescent Psychiatry, 2007Co-Authors: Pieter J Hoekstra, George M Anderson, Pieter W Troost, Cees G M Kallenberg, Ruud B MinderaaAbstract:Objective Increased plasma kynurenine has been reported in Tic Disorder patients, and this observation has been suggested to be indicative of immune dysregulation. In the present study, we examined plasma levels of kynurenine and related molecules in a group of Tic Disorder patients.
-
Plasma kynurenine and related measures in Tic Disorder patients
European Child & Adolescent Psychiatry, 2007Co-Authors: Pieter J Hoekstra, George M Anderson, Pieter W Troost, Cees G M Kallenberg, Ruud B MinderaaAbstract:Objective Increased plasma kynurenine has been reported in Tic Disorder patients, and this observation has been suggested to be indicative of immune dysregulation. In the present study, we examined plasma levels of kynurenine and related molecules in a group of Tic Disorder patients. Methods Plasma concentrations of tryptophan, kynurenine, cortisol, and neopterin were determined in Dutch Tic Disorder patients (N = 59), and healthy volunteers (N = 32). Group means were compared and age-controlled intra-individual correlations between Tic severity and plasma levels of these molecules were examined. Results No significant differences were found between patient and control groups in plasma levels of tryptophan, kynurenine, and cortisol concentrations, nor in the kynurenine/tryptophan ratio. However, neopterin was significantly (p = 0.035) higher in patients (mean = 5.13 nmol/1) than in controls (mean = 3.30 nmol/1). Plasma levels of these molecules did not correlate with Tic severity, with the exception of tryptophan (r = -0.289, p = 0.049). In patients, plasma neopterin correlated with kynurenine (r = 0.438, P = 0.002); in healthy subjects, tryptophan correlated with kynurenine (r = 0.670, p
Cees G M Kallenberg - One of the best experts on this subject based on the ideXlab platform.
-
Plasma kynurenine and related measures in Tic Disorder patients.
European child & adolescent psychiatry, 2020Co-Authors: Pieter J Hoekstra, George M Anderson, Pieter W Troost, Cees G M Kallenberg, Ruud B MinderaaAbstract:Increased plasma kynurenine has been reported in Tic Disorder patients, and this observation has been suggested to be indicative of immune dysregulation. In the present study, we examined plasma levels of kynurenine and related molecules in a group of Tic Disorder patients. Plasma concentrations of tryptophan, kynurenine, cortisol, and neopterin were determined in Dutch Tic Disorder patients (N = 59), and healthy volunteers (N = 32). Group means were compared and age-controlled intra-individual correlations between Tic severity and plasma levels of these molecules were examined. No significant differences were found between patient and control groups in plasma levels of tryptophan, kynurenine, and cortisol concentrations, nor in the kynurenine/tryptophan ratio. However, neopterin was significantly (p = 0.035) higher in patients (mean = 5.13 nmol/l) than in controls (mean = 3.30 nmol/l). Plasma levels of these molecules did not correlate with Tic severity, with the exception of tryptophan (r = -0.289, p = 0.049). In patients, plasma neopterin correlated with kynurenine (r = 0.438, p = 0.002); in healthy subjects, tryptophan correlated with kynurenine (r = 0.670, p < 0.001). While the observed elevation in plasma neopterin is consistent with immune activation in a subset of Tic Disorder patients, metabolism of tryptophan through the kynurenine pathway appears to be unaltered in Tic Disorder patients.
-
cytokines and soluble adhesion molecules in children and adolescents with a Tic Disorder
Progress in Neuro-psychopharmacology & Biological Psychiatry, 2010Co-Authors: Netty G P Bosveneman, Cees G M Kallenberg, Ruud B Minderaa, Johan Bijzet, P C Limburg, Pieter J HoekstraAbstract:Abstract Aim Dysregulation of the immune system may play a role in Tic Disorders. We screened for immune disturbances by investigating serum levels of cytokines and soluble adhesion molecules in patients with a Tic Disorder. Methods Serum levels of interleukin (IL)-2, IL-4, IL-5, IL-10, IL-12, soluble IL-2 receptor (sIL2R), tumor necrosis factor (TNF)-α, interferon (IFN)-γ, soluble vascular cell adhesion molecule-1 (sVCAM-1), and intercellular adhesion molecule-1 (sICAM-1) of 66 children and adolescents with a Tic Disorder and 71 healthy volunteers were compared. We also addressed possible relations between concentrations of the immune markers and severity of Tics and comorbid obsessive–compulsive symptoms. Results Median serum concentrations did not differ significantly between patients and healthy subjects. Serum IL-2 concentrations were positively associated with Tic severity ratings; serum IL-12 concentrations negatively with severity ratings of obsessive–compulsive symptoms. Conclusions These preliminary findings do not reveal major immune activation in children with a Tic Disorder but may suggest more subtle disturbances related to disease expression.
-
plasma kynurenine and related measures in Tic Disorder patients
European Child & Adolescent Psychiatry, 2007Co-Authors: Pieter J Hoekstra, George M Anderson, Pieter W Troost, Cees G M Kallenberg, Ruud B MinderaaAbstract:Objective Increased plasma kynurenine has been reported in Tic Disorder patients, and this observation has been suggested to be indicative of immune dysregulation. In the present study, we examined plasma levels of kynurenine and related molecules in a group of Tic Disorder patients.
-
Plasma kynurenine and related measures in Tic Disorder patients
European Child & Adolescent Psychiatry, 2007Co-Authors: Pieter J Hoekstra, George M Anderson, Pieter W Troost, Cees G M Kallenberg, Ruud B MinderaaAbstract:Objective Increased plasma kynurenine has been reported in Tic Disorder patients, and this observation has been suggested to be indicative of immune dysregulation. In the present study, we examined plasma levels of kynurenine and related molecules in a group of Tic Disorder patients. Methods Plasma concentrations of tryptophan, kynurenine, cortisol, and neopterin were determined in Dutch Tic Disorder patients (N = 59), and healthy volunteers (N = 32). Group means were compared and age-controlled intra-individual correlations between Tic severity and plasma levels of these molecules were examined. Results No significant differences were found between patient and control groups in plasma levels of tryptophan, kynurenine, and cortisol concentrations, nor in the kynurenine/tryptophan ratio. However, neopterin was significantly (p = 0.035) higher in patients (mean = 5.13 nmol/1) than in controls (mean = 3.30 nmol/1). Plasma levels of these molecules did not correlate with Tic severity, with the exception of tryptophan (r = -0.289, p = 0.049). In patients, plasma neopterin correlated with kynurenine (r = 0.438, P = 0.002); in healthy subjects, tryptophan correlated with kynurenine (r = 0.670, p
-
association of common cold with exacerbations in pediatric but not adult patients with Tic Disorder a prospective longitudinal study
Journal of Child and Adolescent Psychopharmacology, 2005Co-Authors: Pieter J Hoekstra, Cees G M Kallenberg, Markpeter Steenhuis, Willem L Manson, Ruud B MinderaaAbstract:Cross-sectional data and case studies suggest a temporal relationship between fluctuations in Tic severity and preceding infections. In this study, we aimed to examine this possible relationship in a prospective longitudinal design. Two groups of Tic Disorder patients were included, a pediatric group between 7 and 15 years of age (n = 20), and an adult group over 15 years of age (n = 41). During a 24-week period, parTicipants were asked to fill out weekly selfquestionnaires regarding the presence of Tic exacerbations and the experience of the common cold. In addition, 6 throat swabs were taken at monthly intervals and cultured for streptococci; also, 3 serial serum assessments of streptococcal antibodies were performed at 8-week intervals. In the pediatric group, our results indicated a strong association between the selfreport of a common cold and a symptom exacerbation 4 weeks later (Odds ratio = 4.685; p = 0.001). In the adult group, we found no association between reports of common cold and Tic exacer...
Kevin J Black - One of the best experts on this subject based on the ideXlab platform.
-
hippocampal volume in provisional Tic Disorder predicts Tic severity at 12 month follow up
Journal of Clinical Medicine, 2020Co-Authors: Deanna J Greene, Emily C Bihun, Jonathan M Koller, Bradley L Schlaggar, Carolina Badke Dandrea, Bridget Oreilly, Kevin J BlackAbstract:Previous studies have investigated differences in the volumes of subcorTical structures (e.g., caudate nucleus, putamen, thalamus, amygdala, and hippocampus) between individuals with and without Tourette syndrome (TS), as well as the relationships between these volumes and Tic symptom severity. These volumes may also predict clinical outcome in Provisional Tic Disorder (PTD), but that hypothesis has never been tested. This study aimed to examine whether the volumes of subcorTical structures measured shortly after Tic onset can predict Tic symptom severity at one-year post-Tic onset, when TS can first be diagnosed. We obtained T1-weighted structural MRI scans from 41 children with PTD (25 with prospective motion correction (vNavs)) whose Tics had begun less than 9 months (mean 4.04 months) prior to the first study visit (baseline). We re-examined them at the 12-month anniversary of their first Tic (follow-up), assessing Tic severity using the Yale Global Tic Severity Scale. We quantified the volumes of subcorTical structures using volBrain software. Baseline hippocampal volume was correlated with Tic severity at the 12-month follow-up, with a larger hippocampus at baseline predicting worse Tic severity at follow-up. The volumes of other subcorTical structures did not significantly predict Tic severity at follow-up. Hippocampal volume may be an important marker in predicting prognosis in Provisional Tic Disorder.
-
Case Report: DSM–5 misses an edge case in Tic Disorders nosology
F1000Research, 2020Co-Authors: Kevin J BlackAbstract:A boy with multiple phonic Tics, one lifetime motor Tic, and no impairment or marked distress does not meet criteria for any DSM–5 Tic Disorder diagnosis. The next version of the DiagnosTic and StatisTical Manual should adjust the criteria for Tourette's Disorder and/or for "other specified Tic Disorder" and "unspecified Tic Disorder."
-
hippocampal volume in provisional Tic Disorder predicts Tic severity at 12 month follow up
bioRxiv, 2020Co-Authors: Deanna J Greene, Emily C Bihun, Jonathan M Koller, Bradley L Schlaggar, Carolina Badke Dandrea, Bridget Oreilly, Kevin J BlackAbstract:Background: Previous studies have investigated differences in the volumes of subcorTical structures (e.g., caudate nucleus, putamen, thalamus, amygdala, hippocampus) between individuals with and without Tourette syndrome (TS), as well as the relationships between these volumes and Tic symptom severity. These volumes may also predict clinical outcome in Provisional Tic Disorder (PTD), but that hypothesis has never been tested. Objective: This study aimed to examine whether the volumes of subcorTical structures measured shortly after Tic onset can predict Tic symptom severity at one year post Tic onset, when TS can first be diagnosed. Methods: We obtained T1-weighted structural MRI scans from 41 children with PTD (25 with prospective motion correction [vNavs]) whose Tics had begun less than 9 months (median 3.7 months) prior to the first study visit (baseline). We re-examined them at the 12-month anniversary of their first Tic (follow-up), assessing Tic severity using the Yale Global Tic Severity Scale. We quantified the volumes of subcorTical structures using volBrain software. Results: Baseline hippocampal volume was correlated with Tic severity at the 12-month follow-up, with a larger hippocampus at baseline predicting worse Tic severity at follow-up. This result was confirmed in the subgroup scanned with prospective motion correction. The volumes of other subcorTical structures did not significantly predict Tic severity at follow-up. Conclusion: These findings suggest that hippocampal volume may be an important marker in predicting prognosis in Provisional Tic Disorder.
-
provisional Tic Disorder is not so transient
Scientific Reports, 2019Co-Authors: Deanna J Greene, Emily C Bihun, Jonathan M Koller, Jacqueline M Hampton, Haley K Acevedo, Angela M Reiersen, Bradley L Schlaggar, Kevin J BlackAbstract:Motor and vocal Tics are common in childhood. The received wisdom among clinicians is that for most children the Tics are temporary, disappearing within a few months. However, that common clinical teaching is based largely on biased and incomplete data. The present study was designed to prospectively assess outcome of children with what the current nomenclature calls Provisional Tic Disorder. We identified 43 children with recent onset Tics (mean 3.3 months since Tic onset) and re-examined 39 of them on the 12-month anniversary of their first Tic. Tic symptoms improved on a group level at the 12-month follow-up, and only two children had more than minimal impairment due to Tics. Remarkably, however, Tics were present in all children at follow-up, although in several cases Tics were apparent only when the child was observed remotely by video. Our results suggest that remission of Provisional Tic Disorder is the exception rather than the rule. We also identified several clinical features present at the first examination that predict one-year outcome; these include baseline Tic severity, subsyndromal autism spectrum symptoms, and the presence of an anxiety Disorder.
-
provisional Tic Disorder what to tell parents when their child first starts Ticcing
F1000Research, 2016Co-Authors: Kevin J Black, Deanna J Greene, Elizabeth Rose Black, Bradley L SchlaggarAbstract:The child with recent onset of Tics is a common patient in a pediatrics or child neurology pracTice. If the child’s first Tic was less than a year in the past, the diagnosis is usually Provisional Tic Disorder (PTD). Published reviews by experts reveal substantial consensus on prognosis in this situation: the Tics will almost always disappear in a few months, having remained mild while they lasted. Surprisingly, however, the sparse existing data may not support these opinions. PTD may have just as much importance for science as for clinical care. It provides an opportunity to prospectively observe the spontaneous remission of Tics. Such prospective studies may aid identification of genes or biomarkers specifically associated with remission rather than onset of Tics. A better understanding of Tic remission may also suggest novel treatment strategies for Tourette syndrome, or may lead to secondary prevention of Tic Disorders. This review summarizes the limited existing data on the epidemiology, phenomenology, and outcome of PTD, highlights areas in which prospective study is sorely needed, and proposes that Tic Disorders may completely remit much less often than is generally believed.
Bradley L Schlaggar - One of the best experts on this subject based on the ideXlab platform.
-
hippocampal volume in provisional Tic Disorder predicts Tic severity at 12 month follow up
Journal of Clinical Medicine, 2020Co-Authors: Deanna J Greene, Emily C Bihun, Jonathan M Koller, Bradley L Schlaggar, Carolina Badke Dandrea, Bridget Oreilly, Kevin J BlackAbstract:Previous studies have investigated differences in the volumes of subcorTical structures (e.g., caudate nucleus, putamen, thalamus, amygdala, and hippocampus) between individuals with and without Tourette syndrome (TS), as well as the relationships between these volumes and Tic symptom severity. These volumes may also predict clinical outcome in Provisional Tic Disorder (PTD), but that hypothesis has never been tested. This study aimed to examine whether the volumes of subcorTical structures measured shortly after Tic onset can predict Tic symptom severity at one-year post-Tic onset, when TS can first be diagnosed. We obtained T1-weighted structural MRI scans from 41 children with PTD (25 with prospective motion correction (vNavs)) whose Tics had begun less than 9 months (mean 4.04 months) prior to the first study visit (baseline). We re-examined them at the 12-month anniversary of their first Tic (follow-up), assessing Tic severity using the Yale Global Tic Severity Scale. We quantified the volumes of subcorTical structures using volBrain software. Baseline hippocampal volume was correlated with Tic severity at the 12-month follow-up, with a larger hippocampus at baseline predicting worse Tic severity at follow-up. The volumes of other subcorTical structures did not significantly predict Tic severity at follow-up. Hippocampal volume may be an important marker in predicting prognosis in Provisional Tic Disorder.
-
hippocampal volume in provisional Tic Disorder predicts Tic severity at 12 month follow up
bioRxiv, 2020Co-Authors: Deanna J Greene, Emily C Bihun, Jonathan M Koller, Bradley L Schlaggar, Carolina Badke Dandrea, Bridget Oreilly, Kevin J BlackAbstract:Background: Previous studies have investigated differences in the volumes of subcorTical structures (e.g., caudate nucleus, putamen, thalamus, amygdala, hippocampus) between individuals with and without Tourette syndrome (TS), as well as the relationships between these volumes and Tic symptom severity. These volumes may also predict clinical outcome in Provisional Tic Disorder (PTD), but that hypothesis has never been tested. Objective: This study aimed to examine whether the volumes of subcorTical structures measured shortly after Tic onset can predict Tic symptom severity at one year post Tic onset, when TS can first be diagnosed. Methods: We obtained T1-weighted structural MRI scans from 41 children with PTD (25 with prospective motion correction [vNavs]) whose Tics had begun less than 9 months (median 3.7 months) prior to the first study visit (baseline). We re-examined them at the 12-month anniversary of their first Tic (follow-up), assessing Tic severity using the Yale Global Tic Severity Scale. We quantified the volumes of subcorTical structures using volBrain software. Results: Baseline hippocampal volume was correlated with Tic severity at the 12-month follow-up, with a larger hippocampus at baseline predicting worse Tic severity at follow-up. This result was confirmed in the subgroup scanned with prospective motion correction. The volumes of other subcorTical structures did not significantly predict Tic severity at follow-up. Conclusion: These findings suggest that hippocampal volume may be an important marker in predicting prognosis in Provisional Tic Disorder.
-
provisional Tic Disorder is not so transient
Scientific Reports, 2019Co-Authors: Deanna J Greene, Emily C Bihun, Jonathan M Koller, Jacqueline M Hampton, Haley K Acevedo, Angela M Reiersen, Bradley L Schlaggar, Kevin J BlackAbstract:Motor and vocal Tics are common in childhood. The received wisdom among clinicians is that for most children the Tics are temporary, disappearing within a few months. However, that common clinical teaching is based largely on biased and incomplete data. The present study was designed to prospectively assess outcome of children with what the current nomenclature calls Provisional Tic Disorder. We identified 43 children with recent onset Tics (mean 3.3 months since Tic onset) and re-examined 39 of them on the 12-month anniversary of their first Tic. Tic symptoms improved on a group level at the 12-month follow-up, and only two children had more than minimal impairment due to Tics. Remarkably, however, Tics were present in all children at follow-up, although in several cases Tics were apparent only when the child was observed remotely by video. Our results suggest that remission of Provisional Tic Disorder is the exception rather than the rule. We also identified several clinical features present at the first examination that predict one-year outcome; these include baseline Tic severity, subsyndromal autism spectrum symptoms, and the presence of an anxiety Disorder.
-
provisional Tic Disorder what to tell parents when their child first starts Ticcing
F1000Research, 2016Co-Authors: Kevin J Black, Deanna J Greene, Elizabeth Rose Black, Bradley L SchlaggarAbstract:The child with recent onset of Tics is a common patient in a pediatrics or child neurology pracTice. If the child’s first Tic was less than a year in the past, the diagnosis is usually Provisional Tic Disorder (PTD). Published reviews by experts reveal substantial consensus on prognosis in this situation: the Tics will almost always disappear in a few months, having remained mild while they lasted. Surprisingly, however, the sparse existing data may not support these opinions. PTD may have just as much importance for science as for clinical care. It provides an opportunity to prospectively observe the spontaneous remission of Tics. Such prospective studies may aid identification of genes or biomarkers specifically associated with remission rather than onset of Tics. A better understanding of Tic remission may also suggest novel treatment strategies for Tourette syndrome, or may lead to secondary prevention of Tic Disorders. This review summarizes the limited existing data on the epidemiology, phenomenology, and outcome of PTD, highlights areas in which prospective study is sorely needed, and proposes that Tic Disorders may completely remit much less often than is generally believed.
-
reward enhances Tic suppression in children within months of Tic Disorder onset
Developmental Cognitive Neuroscience, 2015Co-Authors: Deanna J Greene, Emily C Bihun, Jonathan M Koller, Bradley L Schlaggar, Amy Robichauxviehoever, Kevin J BlackAbstract:Tic Disorders are childhood onset neuropsychiatric Disorders characterized by motor and/or vocal Tics. Research has demonstrated that children with chronic Tics (including Tourette syndrome and Chronic Tic Disorder: TS/CTD) can suppress Tics, parTicularly when an immediate, contingent reward is given for successful Tic suppression. As a diagnosis of TS/CTD requires Tics to be present for at least one year, children in these Tic suppression studies had been living with Tics for quite some time. Thus, it is unclear whether the ability to inhibit Tics is learned over time or present at Tic onset. Resolving that issue would inform theories of how Tics develop and how behavior therapy for Tics works. We investigated Tic suppression in school-age children as close to the time of Tic onset as possible, and no later than six months after onset. Children were asked to suppress their Tics both in the presence and absence of a contingent reward. Results demonstrated that these children, like children with TS/CTD, have some capacity to suppress Tics, and that immediate reward enhances that capacity. These findings demonstrate that the modulating effect of reward on inhibitory control of Tics is present within months of Tic onset, before Tics have become chronic.
