Dursun S M, Reveley M A
Department of Psychiatry, Faculty of Medicine, University of Leicester.
Psychol Med. 1997 Mar;27(2):483-7. doi: 10.1017/s0033291796003984.
The treatment of Tourette's syndrome (TS) is often unsatisfactory. However, there is some evidence that transdermal nicotine patch (TNP) application may improve tics of nonsmoking TS patients who are refractory to haloperidol treatment.
In this open study we applied two 10 mg TNP for 2 consecutive days to four TS patients whose symptoms were not controlled by haloperidol and to a never-medicated TS patient, all of whom are non-smokers. The Yale Global Tic Severity Scale (YGTSS) and a quantified video-taped micro-structured analysis of tics (head-shake tics, eye-blinks, vocal tics, facial grimace and other body tics) were both carried out to assess the change after the application of TNP.
TNP application significantly reduced the YGTSS by an average of 50%, with no reported side-effects, for up to 4 weeks but not 16 weeks, as compared with TNP-free period. Consistent with these results, the total counts of tics also showed a significant decrease for up to 4 weeks after the TNP application.
TNP application differentially affected individually quantified tics, which may suggest a differential role of nicotinic receptors in the generation of different tics.
抽动秽语综合征（TS）的治疗效果往往不尽人意。然而，有证据表明，对于对氟哌啶醇治疗无效的非吸烟TS患者，应用经皮尼古丁贴片（TNP）可能改善抽动症状。
在这项开放性研究中，我们连续两天给4名症状未被氟哌啶醇控制的TS患者以及1名从未接受过药物治疗的TS患者（均为非吸烟者）使用两片10毫克的TNP。采用耶鲁综合抽动严重程度量表（YGTSS）以及对抽动（摇头抽动、眨眼、发声抽动、面部 grimace 和其他身体抽动）进行量化的录像微观结构分析，来评估应用TNP后的变化。
与未使用TNP的时期相比，应用TNP后，YGTSS平均显著降低了50%，且在长达4周而非16周的时间内未报告有副作用。与这些结果一致，在应用TNP后的长达4周内，抽动的总数也显著减少。
应用TNP对个体量化的抽动有不同影响，这可能表明烟碱受体在不同抽动产生中具有不同作用。
