Are there distinct subtypes in Tourette syndrome? Pure-Tourette syndrome versus Tourette syndrome-plus, and simple versus complex tics

Valsamma Eapen,1,2 Mary M Robertson3,41School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; 2Academic Unit of Child Psychiatry, South Western Sydney Local Health District, Ingham Institute, Liverpool, NSW, Australia; 3Neuropsychiatry, University College London, UK; 4St George...

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Autores principales:	Eapen V, Robertson MM
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/9ca6432a85e043038c2a0cf8bfeb5dc7
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spelling	oai:doaj.org-article:9ca6432a85e043038c2a0cf8bfeb5dc72021-12-02T06:25:43ZAre there distinct subtypes in Tourette syndrome? Pure-Tourette syndrome versus Tourette syndrome-plus, and simple versus complex tics1178-2021https://doaj.org/article/9ca6432a85e043038c2a0cf8bfeb5dc72015-06-01T00:00:00Zhttp://www.dovepress.com/are-there-distinct-subtypes-in-tourette-syndrome-pure-tourette-syndrom-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Valsamma Eapen,1,2 Mary M Robertson3,41School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; 2Academic Unit of Child Psychiatry, South Western Sydney Local Health District, Ingham Institute, Liverpool, NSW, Australia; 3Neuropsychiatry, University College London, UK; 4St Georges Hospital and Medical School, London, UKAbstract: This study addressed several questions relating to the core features of Tourette syndrome (TS) including in particular coprolalia (involuntary utterance of obscene words) and copropraxia (involuntary and inappropriate rude gesturing). A cohort of 400 TS patients was investigated. We observed that coprolalia occurred in 39% of the full cohort of 400 patients and copropraxia occurred in 20% of the cohort. Those with coprolalia had significantly higher Yale Global Tic Severity Scale (YGTSS) and Diagnostic Confidence Index (DCI) total scores and a significantly higher proportion also experienced copropraxia and echolalia. A subgroup of 222 TS patients with full comorbidity data available were also compared based on whether they had pure-TS (motor and vocal tics only) or associated comorbidities and co-existent psychopathologies (TS-plus). Pure-TS and TS-plus groups were compared across a number of characteristics including TS severity, associated clinical features, and family history. In this subgroup, 13.5% had pure-TS, while the remainder had comorbidities and psychopathologies consistent with TS-plus. Thirty-nine percent of the TS-plus group displayed coprolalia, compared to (0%) of the pure-TS group and the difference in proportions was statistically significant. The only other significant difference found between the two groups was that pure-TS was associated with no family history of obsessive compulsive disorder which is an interesting finding that may suggest that additional genes or environmental factors may be at play when TS is associated with comorbidities. Finally, differences between individuals with simple versus complex vocal/motor tics were evaluated. Results indicated that individuals with complex motor/vocal tics were significantly more likely to report premonitory urges/sensations than individuals with simple tics and TS. The implications of these findings for the assessment and understanding of TS are discussed.Keywords: Tourette syndrome, comorbidity, simplex tics, complex ticsEapen VRobertson MMDove Medical PressarticleNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2015, Iss default, Pp 1431-1436 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Eapen V Robertson MM Are there distinct subtypes in Tourette syndrome? Pure-Tourette syndrome versus Tourette syndrome-plus, and simple versus complex tics
description	Valsamma Eapen,1,2 Mary M Robertson3,41School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; 2Academic Unit of Child Psychiatry, South Western Sydney Local Health District, Ingham Institute, Liverpool, NSW, Australia; 3Neuropsychiatry, University College London, UK; 4St Georges Hospital and Medical School, London, UKAbstract: This study addressed several questions relating to the core features of Tourette syndrome (TS) including in particular coprolalia (involuntary utterance of obscene words) and copropraxia (involuntary and inappropriate rude gesturing). A cohort of 400 TS patients was investigated. We observed that coprolalia occurred in 39% of the full cohort of 400 patients and copropraxia occurred in 20% of the cohort. Those with coprolalia had significantly higher Yale Global Tic Severity Scale (YGTSS) and Diagnostic Confidence Index (DCI) total scores and a significantly higher proportion also experienced copropraxia and echolalia. A subgroup of 222 TS patients with full comorbidity data available were also compared based on whether they had pure-TS (motor and vocal tics only) or associated comorbidities and co-existent psychopathologies (TS-plus). Pure-TS and TS-plus groups were compared across a number of characteristics including TS severity, associated clinical features, and family history. In this subgroup, 13.5% had pure-TS, while the remainder had comorbidities and psychopathologies consistent with TS-plus. Thirty-nine percent of the TS-plus group displayed coprolalia, compared to (0%) of the pure-TS group and the difference in proportions was statistically significant. The only other significant difference found between the two groups was that pure-TS was associated with no family history of obsessive compulsive disorder which is an interesting finding that may suggest that additional genes or environmental factors may be at play when TS is associated with comorbidities. Finally, differences between individuals with simple versus complex vocal/motor tics were evaluated. Results indicated that individuals with complex motor/vocal tics were significantly more likely to report premonitory urges/sensations than individuals with simple tics and TS. The implications of these findings for the assessment and understanding of TS are discussed.Keywords: Tourette syndrome, comorbidity, simplex tics, complex tics
format	article
author	Eapen V Robertson MM
author_facet	Eapen V Robertson MM
author_sort	Eapen V
title	Are there distinct subtypes in Tourette syndrome? Pure-Tourette syndrome versus Tourette syndrome-plus, and simple versus complex tics
title_short	Are there distinct subtypes in Tourette syndrome? Pure-Tourette syndrome versus Tourette syndrome-plus, and simple versus complex tics
title_full	Are there distinct subtypes in Tourette syndrome? Pure-Tourette syndrome versus Tourette syndrome-plus, and simple versus complex tics
title_fullStr	Are there distinct subtypes in Tourette syndrome? Pure-Tourette syndrome versus Tourette syndrome-plus, and simple versus complex tics
title_full_unstemmed	Are there distinct subtypes in Tourette syndrome? Pure-Tourette syndrome versus Tourette syndrome-plus, and simple versus complex tics
title_sort	are there distinct subtypes in tourette syndrome? pure-tourette syndrome versus tourette syndrome-plus, and simple versus complex tics
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/9ca6432a85e043038c2a0cf8bfeb5dc7
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Are there distinct subtypes in Tourette syndrome? Pure-Tourette syndrome versus Tourette syndrome-plus, and simple versus complex tics

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