Li Ying, Wang Fang, Liu Jingran, Wen Fang, Yan Chunmei, Zhang Jishui, Lu Xiaoyan, Cui Yonghua
National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China.
J Child Adolesc Psychopharmacol. 2019 Nov;29(9):652-658. doi: 10.1089/cap.2019.0048. Epub 2019 Jul 25.
Premonitory urges (PUs) are defined as sensory experiences of pre-tic inner tension. Evidence suggests that most patients with Tourette syndrome experience PUs, which are transiently relived by the expression of tics. However, recent studies have revealed inconsistent results regarding the correlation between the severity of PUs and the severity of tic symptoms. A meta-analysis was performed to confirm the correlation between the severity of the urge and the severity of the expression of the tic. In total, 10 studies involving 626 patients with tic disorders were included in this meta-analysis. The correlation coefficient () was extracted from each selected study, and a pooled correlation coefficient () and its 95% confidence intervals (CIs) were calculated. Sensitivity and subgroup analyses were performed to identify the potential sources of heterogeneity. The pooled correlation coefficient () of the relationship between the severity of PUs and tic symptoms was 0.296 (95% CI: 0.215-0.376) with an of 15.2% (95% CI: 0.00-56.5) based on a fixed effects model. The correlation was stronger in adults than in children ( = 0.03). A slight to moderate positive correlation was observed between the severity of PUs and tic symptoms. This correlation may be affected by the age of the patients. Further research should seek to elucidate the relationships among PUs, tic suppression, and tic expression to support the development of behavioral intervention therapies to reduce tic symptoms.
先兆冲动（PUs）被定义为抽动前内心紧张的感觉体验。有证据表明，大多数抽动秽语综合征患者会经历先兆冲动，这些冲动会通过抽动的表现而短暂缓解。然而，最近的研究在先兆冲动的严重程度与抽动症状的严重程度之间的相关性方面得出了不一致的结果。进行了一项荟萃分析以确认冲动严重程度与抽动表现严重程度之间的相关性。本荟萃分析共纳入了10项涉及626例抽动障碍患者的研究。从每项选定的研究中提取相关系数（），并计算合并相关系数（）及其95%置信区间（CIs）。进行敏感性和亚组分析以确定异质性的潜在来源。基于固定效应模型，先兆冲动严重程度与抽动症状之间关系的合并相关系数（）为0.296（95%CI：0.215 - 0.376），异质性检验值为15.2%（95%CI：0.00 - 56.5）。这种相关性在成年人中比在儿童中更强（ = 0.03）。先兆冲动的严重程度与抽动症状之间观察到轻微至中度的正相关。这种相关性可能受患者年龄的影响。进一步的研究应致力于阐明先兆冲动、抽动抑制和抽动表现之间的关系，以支持开发减少抽动症状的行为干预疗法。
