TEMPORARY TIC SUPPRESSION ABILITY IN INDIVIDUALS WITH TOURETTE SYNDROME AND TIC DISORDERS- IS IT A CLINICAL SIGNIFICANT?
Pilowsky Peleg T.1,3,Goldhagen H.3, Levy L.3, Mastorov, E.3, Apter A.2, & Steinberg T.2
פילובסקי פלג, ת.1,3, גולדהגן, ח.3, לוי, ל.3, מסטורוב, א.3, אפטר, א.2, שטיינברג, ת.2
The Neuropsychological Unit1, Matta and Harry Freund Neuropsychiatric Tourette Syndrome and Tic Disorders Clinic2, Schneider Children’s Medical Center, Tel Aviv-Yaffo Academic College3
Introduction: Tics in Tourette syndrome (TS) are considered involuntary but, in fact, can be partially suppressed. There is a paucity of information regarding tics suppressibility through lifespan, and its' clinical and prognostic values are unclear. Since the ability to temporarily suppress tics might bear important clinical and emotional implications, it is essential to explore this ability and its’ relation to participants’ phenotype.
Methods: 32 children with TS and tic disorders were examined. YGTSS and DSM criteria were administered to confirm diagnosis. Assessment of neuropsychological functioning, comorbid conditions and emotional difficulties characteristic to TS, were employed. Following Himle & Woods (2005), participants were videorecorded to assess tics during baseline, tics suppression, and recovery periods. Also, participants were recorded during performance of a computerized attention task: while suppressing tics compared to natural condition, to assess the effect of tic suppression on performance.
Results: More than half (59%) of the participants succeeded in suppressing their tics. Tics frequency was significantly lower during tics suppression than baseline level. No rebound effect was found after suppression. Children with inattention were less able to suppress their tics: Tics suppression ability negatively correlated with the number of commission errors in the attention task, and parental report of inattention in everyday life. Moreover, individuals with above clinical cutoff for depression had significantly higher percentage of tics during suppression, indicating a lower ability to suppress tics.
Conclusion: Patients' characteristics, specifically inattention and depression, might be important when tic suppression based interventions are considered.