Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States.
Department of Radiology, Washington University School of Medicine, St. Louis, MO, United States.
Sci Rep. 2019 Mar 8;9(1):3951. doi: 10.1038/s41598-019-40133-4.
Motor and vocal tics are common in childhood. The received wisdom among clinicians is that for most children the tics are temporary, disappearing within a few months. However, that common clinical teaching is based largely on biased and incomplete data. The present study was designed to prospectively assess outcome of children with what the current nomenclature calls Provisional Tic Disorder. We identified 43 children with recent onset tics (mean 3.3 months since tic onset) and re-examined 39 of them on the 12-month anniversary of their first tic. Tic symptoms improved on a group level at the 12-month follow-up, and only two children had more than minimal impairment due to tics. Remarkably, however, tics were present in all children at follow-up, although in several cases tics were apparent only when the child was observed remotely by video. Our results suggest that remission of Provisional Tic Disorder is the exception rather than the rule. We also identified several clinical features present at the first examination that predict one-year outcome; these include baseline tic severity, subsyndromal autism spectrum symptoms, and the presence of an anxiety disorder.
运动性抽动和发声性抽动在儿童中很常见。临床医生的普遍看法是，大多数儿童的抽动是暂时的，会在几个月内消失。然而，这种常见的临床教学主要基于有偏见和不完整的数据。本研究旨在前瞻性评估目前命名为暂定抽动障碍的儿童的预后。我们确定了 43 名近期出现抽动的儿童（从抽动发作开始平均 3.3 个月），并在他们首次出现抽动 12 个月后对其中 39 名儿童进行了重新检查。在 12 个月的随访中，抽动症状在群体水平上有所改善，只有两名儿童因抽动而出现明显的功能障碍。然而，值得注意的是，在随访时所有儿童都存在抽动，尽管在某些情况下，只有通过视频远程观察儿童时才能发现抽动。我们的研究结果表明，暂定抽动障碍的缓解是例外而非常规。我们还在首次检查时发现了一些可预测一年结局的临床特征；这些特征包括基线抽动严重程度、亚综合征自闭症谱系症状和焦虑障碍的存在。
