Tourette Syndrome: A Mini-Review

Novotný, Miroslav; Vališ, Martin; Klímová, Blanka

doi:10.3389/fneur.2018.00139

Cited by 38 publications

(31 citation statements)

References 24 publications

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“…However, they require the patient to invest time and energy in practicing demanding behavioral techniques, such as tic control or habit reversal. Despite the benefits and evidence-based effectiveness of behavioral therapies for tic disorders [7][8][9], there is great difficulty in patients accessing behavioral treatments because of a shortage of trained therapists [10]. A promising development in increasing accessibility to behavioral treatments is the use of digital health interventions (DHIs) [11].…”

Section: Introductionmentioning

confidence: 99%

Fidelity of Delivery and Contextual Factors Influencing Children’s Level of Engagement: Process Evaluation of the Online Remote Behavioral Intervention for Tics Trial

Khan¹,

Hollis²,

Hall³

et al. 2021

J Med Internet Res

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Background The Online Remote Behavioral Intervention for Tics (ORBIT) study was a multicenter randomized controlled trial of a complex intervention that consisted of a web-based behavioral intervention for children and young people with tic disorders. In the first part of a two-stage process evaluation, we conducted a mixed methods study exploring the reach, dose, and fidelity of the intervention and contextual factors influencing engagement. Objective This study aims to explore the fidelity of delivery and contextual factors underpinning the ORBIT trial. Methods Baseline study data and intervention usage metrics from participants in the intervention arm were used as quantitative implementation data (N=112). The experiences of being in the intervention were explored through semistructured interviews with children (n=20) and parent participants (n=20), therapists (n=4), and referring clinicians (n=6). A principal component analysis was used to create a comprehensive, composite measure of children and young people’s engagement with the intervention. Engagement factor scores reflected relative uptake as assessed by a range of usage indices, including chapters accessed, number of pages visited, and number of log-ins. The engagement factor score was used as the dependent variable in a multiple linear regression analysis with various contextual variables as independent variables to assess if there were any significant predictors of engagement. Results The intervention was implemented with high fidelity, and participants deemed the intervention acceptable and satisfactory. The engagement was high, with child participants completing an average of 7.5 of 10 (SD 2.7) chapters, and 88.4% (99/112) of participants completed the minimum of the first four chapters—the predefined threshold effective dose. Compared with the total population of children with tic disorders, participants in the sample tended to have more educated parents and lived in more economically advantaged areas; however, socioeconomic factors were not related to engagement factor scores. Factors associated with higher engagement factor scores included participants enrolled at the London site versus the Nottingham site (P=.01), self-referred versus clinic referred (P=.04), higher parental engagement as evidenced by the number of parental chapters completed (n=111; ρ=0.73; P<.001), and more therapist time for parents (n=111; ρ=0.46; P<.001). A multiple linear regression indicated that parents’ chapter completion (β=.69; t110=10.18; P<.001) and therapist time for parents (β=.19; t110=2.95; P=.004) were the only significant independent predictors of child engagement factor scores. Conclusions Overall, the intervention had high fidelity of delivery and was evaluated positively by participants, although reach may have been constrained by the nature of the randomized controlled trial. Parental engagement and therapist time for parents were strong predictors of intervention implementation, which has important implications for designing and implementing digital therapeutic interventions in child and adolescent mental health services. International Registered Report Identifier (IRRID) RR2-10.1186/s13063-019-3974-3

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Section: Introductionmentioning

confidence: 99%

Fidelity of Delivery and Contextual Factors Influencing Children’s Level of Engagement: Process Evaluation of the Online Remote Behavioral Intervention for Tics Trial

Khan¹,

Hollis²,

Hall³

et al. 2021

J Med Internet Res

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“…The most commonly prescribed medications include α-adrenergic agonists, benzodiazepines, antipsychotics, and botulinum toxins [2-4]. Although some studies suggest that certain drugs may be more effective, such as antipsychotics, clonidine, guanfacine, and baclofen, there is no universally accepted standard therapy [5] and new trials of drug candidates are frequent [6]. Currently, 3 medications (haloperidol, pimozide, and aripiprazole) have FDA approval to treat TS; they have limited efficacy in severe forms of TS and can be associated with undesirable side effects [3].…”

Section: Introductionmentioning

confidence: 99%

Deep Brain Stimulation Results in Greater Symptomatic Improvement in Tourette Syndrome than Conservative Measures: A Meta-Analysis

Mahajan

Purger

Mantovani

et al. 2020

Stereotact Funct Neurosurg

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Introduction: Deep brain stimulation (DBS) has emerged as a safe and effective therapy for refractory Tourette syndrome (TS). Recent studies have identified several neural targets as effective in reducing TS symptoms with DBS, but, to our knowledge, none has compared the effectiveness of DBS with conservative therapy. Methods: A literature review was performed to identify studies investigating adult patient outcomes reported as Yale Global Tic Severity Scale (YGTSS) scores after DBS surgery, pharmacotherapy, and psychotherapy. Data were pooled using a random-effects model of inverse variance-weighted meta-analysis (n = 168 for DBS, n = 131 for medications, and n = 154 for behavioral therapy). Results: DBS resulted in a significantly greater reduction in YGTSS total score (49.9 ± 17.5%) than pharmacotherapy (22.5 ± 15.2%, p = 0.001) or psychotherapy (20.0 ± 11.3%, p < 0.001), with a complication (adverse effect) rate of 0.15/ case, 1.13/case, and 0.60/case, respectively. Conclusion: Our data suggest that adult patients with refractory TS undergoing DBS experience greater symptomatic improvement with surprisingly low morbidity than can be obtained with pharmacotherapy or psychotherapy.

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“…This disease affects approximately 1% of the population, and men are affected by the disease three-to-four times more often than women. The therapy of Tourette’s syndrome may consist of neuropsychological interventions; pharmacotherapy: (i) drugs that block or lessen dopamine—haloperidol and risperidone, (ii) botulinum injections, (iii) attention-deficit hyperactivity disorder medications—methylphenidate and dextroamphetamine, (iv) central adrenergic inhibitors—clonidine and guanfacine, (v) antidepressants—fluoxetine, and (vi) antiseizure medications: topiramate; and deep brain stimulation [ 128 ].…”

Section: Pharmacological Applicationmentioning

confidence: 99%

Cannabis sativa L. as a Natural Drug Meeting the Criteria of a Multitarget Approach to Treatment

Stasiłowicz

Tomala

Podolak

et al. 2021

IJMS

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Cannabis sativa L. turned out to be a valuable source of chemical compounds of various structures, showing pharmacological activity. The most important groups of compounds include phytocannabinoids and terpenes. The pharmacological activity of Cannabis (in epilepsy, sclerosis multiplex (SM), vomiting and nausea, pain, appetite loss, inflammatory bowel diseases (IBDs), Parkinson’s disease, Tourette’s syndrome, schizophrenia, glaucoma, and coronavirus disease 2019 (COVID-19)), which has been proven so far, results from the affinity of these compounds predominantly for the receptors of the endocannabinoid system (the cannabinoid receptor type 1 (CB1), type two (CB2), and the G protein-coupled receptor 55 (GPR55)) but, also, for peroxisome proliferator-activated receptor (PPAR), glycine receptors, serotonin receptors (5-HT), transient receptor potential channels (TRP), and GPR, opioid receptors. The synergism of action of phytochemicals present in Cannabis sp. raw material is also expressed in their increased bioavailability and penetration through the blood–brain barrier. This review provides an overview of phytochemistry and pharmacology of compounds present in Cannabis extracts in the context of the current knowledge about their synergistic actions and the implications of clinical use in the treatment of selected diseases.

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Tourette Syndrome: A Mini-Review

Cited by 38 publications

References 24 publications

Fidelity of Delivery and Contextual Factors Influencing Children’s Level of Engagement: Process Evaluation of the Online Remote Behavioral Intervention for Tics Trial

Fidelity of Delivery and Contextual Factors Influencing Children’s Level of Engagement: Process Evaluation of the Online Remote Behavioral Intervention for Tics Trial

Deep Brain Stimulation Results in Greater Symptomatic Improvement in Tourette Syndrome than Conservative Measures: A Meta-Analysis

Cannabis sativa L. as a Natural Drug Meeting the Criteria of a Multitarget Approach to Treatment

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