Objective assessments of longitudinal outcome in Gilles de la Tourette's syndrome
| Autor: | Sue Leurgans, Eric J. Pappert, Elan D. Louis, Lucy M. Blasucci, Christopher G. Goetz |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Adult
Male congenital hereditary and neonatal diseases and abnormalities medicine.medical_specialty Adolescent Tics Health Status Remission Spontaneous Video Recording MEDLINE Neurological disorder Tourette syndrome Central nervous system disease Disability Evaluation symbols.namesake Rating scale mental disorders medicine Humans Interpersonal Relations Longitudinal Studies Child Psychiatry Phonic Tic Learning Disabilities medicine.disease nervous system diseases body regions Bonferroni correction Chronic Disease Disease Progression symbols Physical therapy Female Neurology (clinical) Psychology human activities Antipsychotic Agents Tourette Syndrome |
| Zdroj: | Neurology. 61:936-940 |
| ISSN: | 1526-632X 0028-3878 |
| Popis: | Objective: To define the long-term outcome in Gilles de la Tourette syndrome (GTS) using objective rating measures. Background: Previous historical studies suggest spontaneous improvement of tic symptoms after adolescence, but objective longitudinal data are limited. Methods: The authors reviewed all videotapes in their database (1978 through 1991) of children with GTS (ages 8 to 14) who were seen in their tertiary care movement disorder center and underwent a standardized 5-minute filming protocol (n = 56). Through multiple contact methods, they successfully located 36 of these patients, who are now adults (age >20 years), and recruited 31 (28 men and 3 women) to volunteer for a second videotape and in-person assessment. A blinded rater evaluated the 62 tapes and rated five tic domains: body areas involved, motor and phonic tic frequency, and motor and phonic tic severity. Using standardized GTS videotape rating scale and Wilcoxon signed-rank tests with Bonferroni correction for multiple comparisons, the authors compared the two videotapes for each tic domain as well as the composite tic disability score. Results: Ninety percent of adult patients still had tics. Adult patients who considered themselves tic-free were often inaccurate in their self-assessment: 50% had objective evidence of tics. Mean objective tic disability diminished in comparison to childhood (mean composite tic disability score childhood 9.58 vs adulthood 7.52, p = 0.014). All domains improved by adulthood, and significant improvements occurred in motor tic severity (p = 0.008). The improvements in tic disability did not relate to medication use, as only 13% of adults received medications for tics, compared with 81% of children. Conclusions: In GTS syndrome, tics objectively improve over time but most adults have persistent tics. |
| Databáze: | OpenAIRE |
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