在大流行时代，诊断功能性抽动样行为的关键现象学线索有哪些？

What are the Key Phenomenological Clues to Diagnose Functional Tic-Like Behaviors in the Pandemic Era?

机构信息

Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences, University of Calgary, Calgary, AB, Canada.

Neurology Department, Hôpital Fondation Adolphe de Rothschild, Paris, France.

出版信息

Mov Disord Clin Pract. 2024 Apr;11(4):398-402. doi: 10.1002/mdc3.13977. Epub 2024 Jan 25.

DOI:10.1002/mdc3.13977

PMID:38269641

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10982605/

Abstract

BACKGROUND

Functional tic-like behaviors (FTLBs) can be difficult to distinguish from tics.

OBJECTIVES

To describe the phenomenology of FTLBs in youth and assess the movements and vocalizations most suggestive of the diagnosis.

METHODS

We compared the phenomenology of tics between youth (<20 yr) with FTLBs and with primary tics from our Registry in Calgary, Canada.

RESULTS

Two hundred and thirty-six youths were included: 195 with primary tics (75% males; mean age: 10.8 yr) and 41 with FTLBs (98% females; 16.1 yr). In the bivariate models, FTLBs were most associated with copropraxia (OR = 15.5), saying words (OR = 14.5), coprolalia (OR = 13.1), popping (OR = 11.0), whistling (OR = 9.8), simple head movements (OR = 8.6), and self-injurious behaviors (OR = 6.9). In the multivariable model, FTLBs were still associated with saying words (OR = 13.5) and simple head movements (OR = 6.3). Only 12.2% of youth with FTLBs had throat clearing tics (OR = 0.2).

CONCLUSIONS

This study shall help physicians diagnose youth with FTLBs according to the presence/association of specific movements and vocalizations.

摘要

背景

功能性抽动样行为（FTLBs）与抽动难以区分。

目的

描述青少年 FTLBs 的表现，并评估最有助于诊断的运动和发声。

方法

我们比较了加拿大卡尔加里登记处的青少年 FTLB 与原发性抽动的抽动表现。

结果

共纳入 236 名青少年：195 名原发性抽动（75%为男性；平均年龄：10.8 岁）和 41 名 FTLB（98%为女性；16.1 岁）。在双变量模型中，FTLB 与 Copropraxia（OR=15.5）、说单词（OR=14.5）、Coprolalia（OR=13.1）、爆裂声（OR=11.0）、口哨声（OR=9.8）、简单头部运动（OR=8.6）和自残行为（OR=6.9）最相关。在多变量模型中，FTLB 仍与说单词（OR=13.5）和简单头部运动（OR=6.3）相关。只有 12.2%的 FTLB 青少年有清嗓子抽动（OR=0.2）。