Department of Clinical Neurosciences, University of Calgary, Alberta Children's Hospital, 2888 Shaganappi Trail NW, Calgary, AB, T3B 6A8, Canada.
Curr Treat Options Neurol. 2013 Aug;15(4):385-95. doi: 10.1007/s11940-013-0238-5.
When tics caused by Tourette Syndrome cause meaningful impairment for patients, a comprehensive treatment approach includes education of patients, peers, and family, treatment of comorbid behavioral disorders if present, and consideration of behavior therapy and pharmacotherapy for tics themselves. This systematic review and meta-analysis demonstrates that behavior therapies based on Habit Reversal Therapy, including the Comprehensive Behavioral Intervention for Tics are effective in reducing tic severity when compared with supportive psychotherapy. When these behavior therapies are unavailable, Exposure with Response Prevention may also be effective. Both face-to-face and telehealth delivery methods for behavior therapy improve tic severity, and broader distribution of behavior therapy through increased training or telehealth methods is encouraged. High-quality randomized trials comparing behavior therapies for tics with pharmacotherapy are needed.
当妥瑞氏症引起的抽搐对患者造成显著影响时,全面的治疗方法包括对患者、同伴和家属进行教育,治疗存在的共病行为障碍,以及考虑针对抽搐本身的行为疗法和药物治疗。本系统评价和荟萃分析表明,基于习惯逆转疗法的行为疗法,包括妥瑞氏症综合行为干预,在降低抽搐严重程度方面比支持性心理疗法更有效。当这些行为疗法不可用时,暴露与反应预防也可能有效。行为疗法的面对面和远程医疗两种实施方式都能改善抽搐严重程度,鼓励通过增加培训或远程医疗方法更广泛地推广行为疗法。需要高质量的随机试验比较抽搐的行为疗法与药物治疗。