Paulus Theresa, Schappert Ronja, Bluschke Annet, Alvarez-Fischer Daniel, Naumann Kim Ezra Robin, Roessner Veit, Bäumer Tobias, Beste Christian, Münchau Alexander
Institute of Systems Motor Science, University of Lübeck, 23562 Lübeck, Germany.
Department of Neurology, University of Lübeck, 23538 Lübeck, Germany.
Brain Commun. 2021 Dec 2;3(4):fcab282. doi: 10.1093/braincomms/fcab282. eCollection 2021.
Tics in Tourette syndrome are often difficult to discern from single spontaneous movements or vocalizations in healthy people. In this study, videos of patients with Tourette syndrome and healthy controls were taken and independently scored according to the Modified Rush Videotape Rating Scale. We included = 101 patients with Tourette syndrome (71 males, 30 females, mean age 17.36 years ± 10.46 standard deviation) and = 109 healthy controls (57 males, 52 females, mean age 17.62 years ± 8.78 standard deviation) in a machine learning-based analysis. The results showed that the severity of motor tics, but not vocal phenomena, is the best predictor to separate and classify patients with Tourette syndrome and healthy controls. This finding questions the validity of current diagnostic criteria for Tourette syndrome requiring the presence of both motor and vocal tics. In addition, the negligible importance of vocalizations has implications for medical practice, because current recommendations for Tourette syndrome probably also apply to the large group with chronic motor tic disorders.
抽动秽语综合征中的抽动症状往往难以与健康人的单个自发动作或发声区分开来。在本研究中，拍摄了抽动秽语综合征患者和健康对照者的视频，并根据改良的拉什录像评分量表进行独立评分。在基于机器学习的分析中，我们纳入了101例抽动秽语综合征患者（71例男性，30例女性，平均年龄17.36岁±10.46标准差）和109例健康对照者（57例男性，52例女性，平均年龄17.62岁±8.78标准差）。结果表明，运动性抽动的严重程度而非发声现象是区分和分类抽动秽语综合征患者与健康对照者的最佳预测指标。这一发现对当前抽动秽语综合征诊断标准（要求同时存在运动性和发声性抽动）的有效性提出了质疑。此外，发声的重要性可忽略不计这一点对医学实践具有启示意义，因为目前针对抽动秽语综合征的建议可能也适用于患有慢性运动性抽动障碍的一大群体。
