Leckman James F
Child Study Center, Children's Clinical Research Center, and Department of Pediatrics, Yale University, New Haven, CT 06520, USA.
Brain Dev. 2003 Dec;25 Suppl 1:S24-8. doi: 10.1016/s0387-7604(03)90004-0.
Tic symptoms, the hallmark of Tourette's syndrome (TS), may simply be fragments of innate behavior. As such, the sensory urges that precede tics may illuminate some of the normal internal cues that are intimately involved in the assembly of behavioral sequences. The occurrence of tics in time appears to have fractal characteristics that may help to explain the waxing and waning course of tic disorders. Longitudinal studies are currently underway that should permit a close examination of the natural fluctuations in tic severity using valid and reliable clinician-rated scales of tic severity. The natural history of tics typically shows a marked decline during the course of adolescence. However, TS can also be associated with social, emotional, and academic difficulties in early adulthood. Comorbid attention deficit/hyperactivity disorder and obsessive-compulsive disorder are likely to influence the long-term adaptive outcomes of individuals with TS. Future progress may also be expected as endophenotypes, and possibly genetic markers, are identified that are associated with specific comorbid conditions and etiologically distinct forms of TS.
抽动症状是妥瑞氏症（TS）的标志，可能仅仅是先天行为的片段。因此，抽动之前的感觉冲动可能会揭示一些与行为序列组装密切相关的正常内部线索。抽动在时间上的发生似乎具有分形特征，这可能有助于解释抽动障碍的消长过程。目前正在进行纵向研究，这些研究应能使用有效且可靠的临床医生评定的抽动严重程度量表，对抽动严重程度的自然波动进行仔细检查。抽动的自然病程通常在青春期会显著下降。然而，TS在成年早期也可能与社交、情感和学业困难相关。共病的注意力缺陷/多动障碍和强迫症可能会影响TS患者的长期适应结果。随着与特定共病状况和病因不同形式的TS相关的内表型以及可能的基因标记被识别出来，未来有望取得进展。
