Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-6bf8c574d5-vmclg Total loading time: 0 Render date: 2025-02-20T06:53:37.193Z Has data issue: false hasContentIssue false

Chapter 45 - Gilles de la Tourette Syndrome and Other Tics

from Section 3: - Hyperkinetic Movement Disorders

Published online by Cambridge University Press:  07 January 2025

By
Andreas Hartmann
Edited by
Erik Ch. Wolters  and
Christian R. Baumann
Erik Ch. Wolters
Affiliation:
Universität Zürich
Christian R. Baumann
Affiliation:
Universität Zürich
Get access

Summary

Tics are brief, sudden, non-rhythmic, repetitive movements. Tics can be motor or vocal. Further, both motor and vocal tics can be either simple or complex. Simple tics typically involve only one group of muscles and are brief and meaningless, whereas complex tics may last longer and appear more purposeful. Tic disorders usually begin in childhood and are classified according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) into four groups: (1) provisional tic disorder, (2) chronic motor or vocal tic disorder, (3) Tourette disorder (or Gilles de la Tourette syndrome), (4) tic disorder not otherwise specified. As tics can resemble almost any other movement disorder, phenotypic analysis alone is insufficient and patients must be questioned whether the execution is preceded by a premonitory sensation (urge to do, urge to move) and whether a temporary control of the movement can be achieved. Also, relief following execution of the tic is frequently reported. There are no biomarkers available for tics and diagnosis therefore remains strictly clinical.

Keywords

TicsTourette syndromegeneticspathophysiologycognitive-behavioral therapydopamine-blocking agentsdeep brain stimulation
Type
Chapter
Information
International Compendium of Movement Disorders , pp. 559 - 567
Publisher: Cambridge University Press
Print publication year: 2025

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Washington: American Psychiatric Association; 2013.Google Scholar
Black, KJ, Kim, S, Yang, NY, et al. Course of tic disorders over the lifespan. Curr Dev Disord Rep 2021;8:121–32.CrossRefGoogle ScholarPubMed
Vinner, E, Belelovsky, K, Bar-Gad, I. Generating acute and chronic experimental models of motor tic expression in rats. J Vis Exp 2021;171.Google Scholar
Tremblay, L, Worbe, Y, Thobois, S, Sgambato-Faure, V, Féger, J. Selective dysfunction of basal ganglia subterritories: from movement to behavioral disorders. Mov Disord 2015;30:1155–1170.CrossRefGoogle ScholarPubMed
Ganos, C. Tics and Tourette’s: update on pathophysiology and tic control. Curr Opin Neurol 2016;29:513–518.CrossRefGoogle ScholarPubMed
Alexander, GE, DeLong, MR, Strick, PL. Parallel organization of functionally segregated circuits linking basal ganglia and cortex. Annu Rev Neurosci 1986;9:357–381.CrossRefGoogle ScholarPubMed
Kalanithi, PS, Zheng, W, Kataoka, Y, et al. Altered parvalbumin-positive neuron distribution in basal ganglia of individuals with Tourette syndrome. Proc Natl Acad Sci U S A 2005;102:13307–13312.CrossRefGoogle ScholarPubMed
Kataoka, Y, Kalanithi, PS, Grantz, H, et al. Decreased number of parvalbumin and cholinergic interneurons in the striatum of individuals with Tourette syndrome. J Comp Neurol 2010;518:277–291.CrossRefGoogle ScholarPubMed
Marín, O. Interneuron dysfunction in psychiatric disorders. Nat Rev Neurosci 2012;13:107–120.CrossRefGoogle ScholarPubMed
Heise, KF, Steven, B, Liuzzi, G, et al. Altered modulation of intracortical excitability during movement preparation in Gilles de la Tourette syndrome. Brain 2010;133:580–590.CrossRefGoogle ScholarPubMed
Minzer, K, Lee, O, Hong, JJ, Singer, HS. Increased prefrontal D2 protein in Tourette syndrome: a postmortem analysis of frontal cortex and striatum. J Neurol Sci 2004;219:55–61.CrossRefGoogle ScholarPubMed
Worbe, Y, Lehericy, S, Hartmann, A. Neuroimaging of tic genesis: present status and future perspectives. Mov Disord 2015;30:1179–1183.CrossRefGoogle ScholarPubMed
Martino, D, Ganos, C, Worbe, Y. Neuroimaging applications in Tourette’s syndrome. Int Rev Neurobiol 2018;143:65–108.CrossRefGoogle ScholarPubMed
Peterson, BS, Staib, L, Scahill, L, et al. Regional brain and ventricular volumes in Tourette syndrome. Arch Gen Psychiatry 2001;58:427–440.CrossRefGoogle ScholarPubMed
Bloch, MH, Leckman, JF, Zhu, H, et al. Caudate volumes in childhood predict symptom severity in adults with Tourette syndrome. Neurology 2005;65:1253–1258.CrossRefGoogle ScholarPubMed
Neuner, I, Kupriyanova, Y, Stöcker, T, et al. White-matter abnormalities in Tourette syndrome extend beyond motor pathways. Neuroimage 2010;51:1184–1193.CrossRefGoogle ScholarPubMed
Bäumer, T, Thomalla, G, Kroeger, J, et al. Interhemispheric motor networks are abnormal in patients with Gilles de la Tourette syndrome. Mov Disord 2010;25:2828–2837.CrossRefGoogle ScholarPubMed
Wang, Z, Maia, TV, Marsh, R, et al. The neural circuits that generate tics in Tourette’s syndrome. Am J Psychiatry 2011;168:1326–1337.CrossRefGoogle ScholarPubMed
Mazzone, L, Yu, S, Blair, C, et al. An fMRI study of frontostriatal circuits during the inhibition of eye blinking in persons with Tourette syndrome. Am J Psychiatry 2010;167:341–349.CrossRefGoogle ScholarPubMed
Maia, TV, Conceição, VA. Dopaminergic disturbances in Tourette syndrome: an integrative account. Biol Psychiatry 2018;84:332–344.CrossRefGoogle ScholarPubMed
Augustine, F, Singer, HS. Merging the pathophysiology and pharmacotherapy of tics. Tremor Other Hyperkinet Mov 2019;8:595.CrossRefGoogle ScholarPubMed
Swain, JE, Scahill, L, Lombroso, PJ, et al. Tourette syndrome and tic disorders: a decade of progress. J Am Acad Child Adolesc Psychiatry 2007;46:947–968.CrossRefGoogle ScholarPubMed
Martino, D, Johnson, I, Leckman, JF. What does immunology have to do with normal brain development and the pathophysiology underlying Tourette syndrome and related neuropsychiatric disorders? Front Neurol 2020;11:567407.CrossRefGoogle Scholar
Gilbert, DL. Inflammation in tic disorders and obsessive-compulsive disorder: are PANS and PANDAS a path forward? J Child Neurol 2019;34:598–611.CrossRefGoogle ScholarPubMed
Pauls, DL, Raymond, CL, Stevenson, JM, et al. A family study of Gilles de la Tourette syndrome. Am J Hum Genet 1991;48:154–163.Google ScholarPubMed
Paschou, P. The genetic basis of Gilles de la Tourette Syndrome. Neurosci Biobehav Rev 2013;37:1026–1039.CrossRefGoogle ScholarPubMed
Ercan-Sencicek, AG, Stillman, AA, Ghosh, AK, et al. l-Histidine decarboxylase and Tourette’s syndrome. N Engl J Med 2010;362:1901–1908.CrossRefGoogle ScholarPubMed
Fernandez, TV, Sanders, SJ, Yurkiewicz, IR, et al. Rare copy number variants in tourette syndrome disrupt genes in histaminergic pathways and overlap with autism. Biol Psychiatry 2012;71:392–402.CrossRefGoogle ScholarPubMed
Abelson, JF, Kwan, KY, O’Roak, BJ, et al. Sequence variants in SLITRK1 are associated with Tourette’s syndrome. Science 2005;310:317–320.CrossRefGoogle ScholarPubMed
Abdulkadir, M, Mathews, CA, Scharf, JM, et al. Polygenic risk scores derived from a Tourette syndrome genome-wide association study predict presence of tics in the Avon Longitudinal Study of Parents and Children cohort. Biol Psychiatry 2019;85:298-304.CrossRefGoogle ScholarPubMed
Yu, D, Sul, JH, Tsetsos, F, et al. Interrogating the genetic determinants of Tourette’s syndrome and other tic disorders through genome-wide association studies. Am J Psychiatry 2019;176:217–227.CrossRefGoogle ScholarPubMed
Tsetsos, F, Yu, D, Sul, JH, et al. Synaptic processes and immune-related pathways implicated in Tourette syndrome. Transl Psychiatry 2021;11:56.CrossRefGoogle ScholarPubMed
Banaschewski, T, Woerner, W, Rothenberger, A. Premonitory sensory phenomena and suppressibility of tics in Tourette syndrome: developmental aspects in children and adolescents. Dev Med Child Neurol 2003;45:700–703.CrossRefGoogle ScholarPubMed
Kushner, HI. A Cursing Brain? The Histories of Tourette Syndrome. Cambridge, MA: Harvard University Press; 2000.Google Scholar
Pringsheim, T, Okun, MS, Müller-Vahl, K, et al. Practice guideline recommendations summary: treatment of tics in people with Tourette syndrome and chronic tic disorders. Neurology 2019;92:896–906.CrossRefGoogle ScholarPubMed
Müller-Vahl, KR, Szejko, N, Verdellen, C, et al. European clinical guidelines for Tourette syndrome and other tic disorders: summary statement. Eur Child Adolesc Psychiatry 2022;31:377–382.CrossRefGoogle ScholarPubMed
Cheung, MY, Shahed, J, Jankovic, J. Malignant Tourette syndrome. Mov Disord 2007;22:1743–1750.CrossRefGoogle ScholarPubMed
Hirschtritt, ME, Lee, PC, Pauls, DL, et al. Lifetime prevalence, age of risk, and genetic relationships of comorbid psychiatric disorders in Tourette syndrome. JAMA Psychiatry 2015;72:325–333.CrossRefGoogle ScholarPubMed
Jobson, KO, Potter, WZ. International Psychopharmacology Algorithm Project Report. Psychopharmacol Bull 1995;31:457–459.Google ScholarPubMed
Pringsheim, T, Marras, C. Pimozide for tics in Tourette’s syndrome. Cochrane Database Syst Rev 2009;2:CD006996.Google Scholar
Müller-Vahl, KR, Krueger, D. Does Tourette syndrome prevent tardive dyskinesia? Mov Disord 2011;26:2442–2443.CrossRefGoogle ScholarPubMed
Sallee, F, Kohegyi, E, Zhao, J, et al. Randomized, double-blind, placebo-controlled trial demonstrates the efficacy and safety of oral aripiprazole for the treatment of Tourette’s disorder in children and adolescents. J Child Adolesc Psychopharmacol 2017;27:771–781.CrossRefGoogle ScholarPubMed
Yoo, HK, Joung, YS, Lee, JS, et al. A multicenter, randomized, double-blind, placebo-controlled study of aripiprazole in children and adolescents with Tourette’s disorder. J Clin Psychiatry 2013;74:e772–780.CrossRefGoogle ScholarPubMed
Jankovic, J, Jimenez-Shahed, J, Brown, LW. A randomised, double-blind, placebo-controlled study of topiramate in the treatment of Tourette syndrome. J Neurol Neurosurg Psychiatry 2010;81:70–73.CrossRefGoogle ScholarPubMed
Cavanna, AE, Nani, A. Antiepileptic drugs and Tourette syndrome. Int Rev Neurobiol 2013;112:373–389.CrossRefGoogle ScholarPubMed
Müller-Vahl, KR. Treatment of Tourette syndrome with cannabinoids. Behav Neurol 2013;27:119–124.CrossRefGoogle Scholar
Pandey, S, Srivanitchapoom, P, Kirubakaran, R, Berman, BD. Botulinum toxin for motor and phonic tics in Tourette’s syndrome. Cochrane Database Syst Rev 2018;1:CD012285.Google ScholarPubMed
Azrin, NH, Nunn, RG. Habit-reversal: a method of eliminating nervous habits and tics. Behav Res Ther 1973;11:619–628.CrossRefGoogle ScholarPubMed
Piacentini, J, Woods, DW, Scahill, L, et al. Behavior therapy for children with Tourette disorder: a randomized controlled trial. JAMA 2010;303:1929–1937.CrossRefGoogle ScholarPubMed
Wilhelm, S, Peterson, AL, Piacentini, J, et al. Randomized trial of behavior therapy for adults with Tourette syndrome. Arch Gen Psychiatry 2012;69:795–803.CrossRefGoogle ScholarPubMed
Verdellen, CW, Keijsers, GP, Cath, DC, Hoogduin, CA. Exposure with response prevention versus habit reversal in Tourettes’s syndrome: a controlled study. Behav Res Ther 2004;42:501–511.CrossRefGoogle ScholarPubMed
van de Griendt, JM, Verdellen, CW, van Dijk, MK, Verbraak, MJ. Behavioural treatment of tics: habit reversal and exposure with response prevention. Neurosci Biobehav Rev 2013;37:1172–1177.CrossRefGoogle ScholarPubMed
Martino, D, Deeb, W, Jimenez-Shahed, J, et al. The 5 pillars in Tourette syndrome deep brain stimulation patient selection: present and future. Neurology 2021;96:664–676.CrossRefGoogle ScholarPubMed
Muller-Vahl, KR. Deep brain stimulation in Tourette syndrome: the known and the unknown. J Neurol Neurosurg Psychiatry 2019;90:1076–1077.CrossRefGoogle ScholarPubMed
Hartmann, A. Tics. In: Wolters, ECh, Baumann, CR, eds. Parkinson Disease and Other Movement Disorders. Motor Behavioural Disorders and Behavioural Motor Disorders. Amsterdam: VU University Press; 2014: 561–576.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×