• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.12 no.1
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• pp.103-114
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• 2001

Tourette's disorder is a disease which manifests one or more motor tics and vocal tics for more than a year. Chronic motor tic or vocal tic disorders are characterized by only one kind of tics for more than a year. We intended to investigate the clinical characteristics of the patients with chronic motor tic disorders or Tourette's disorders who had admitted from May 1, 1998 to May 1, 1999 to Seoul National University Hospital Child and Adolescent Psychiatry ward. In addition, we compared the clinical characteristics of the patients in order to elucidate the relationship between the two disorders. The patients with learning disabilities were selected as controls. There was no statistically significant difference between the onsets of the patients with chronic motor tic disorders(n=13, $7.3{\pm}2.5$ years), and Tourette's disorder(n=39, $7.2{\pm}2.2$ years), but with learning disability($4.2{\pm}1.9$ years). Also, the patients with chronic motor tic disorder and Tourette's disorder showed similar age at admission($11.7{\pm}2.7$ versus $11.5{\pm}2.6$ years), duration of admission($5.7{\pm}5.4$ versus $11.0{\pm}8.7$ weeks), mothers' ages at child birth($27.3{\pm}2.9$ versus $28.3{\pm}6.7$ years old),and fathers' age at child birth($32.2{\pm}3.2$ versus $33.3{\pm}5.2$ years old). We observed that those who had learning disabilities were alike in those aspects, except for age at visit to clinic($9.8{\pm}3.2$ years old). Family history of psychiatric illnesses(24.1% versus 46.2%), recognized precipitating factors(11.1% versus 35.7%) and response to pharmacological treatments(77.8% versus 76.9%) of the patients with chronic motor tic disorders and Tourette's disorders were observed and no differences were found. Comorbid patterns of diseases were noted. Intrafamilial conflicts were more common in the patients with learning disabilities than those with chronic tic disorders or Tourette's disorders. Precipitating factors were observed more frequent in chronic tic disorder and Tourette's disorder than learning disability. Neurocognitive profiles were investigated, and verbal IQs of the patients with chronic motor tic disorder, Tourette's disorder and learning disability were $92.3{\pm}10.7$, $94.7{\pm}14.9$, $94.3{\pm}13.8$, performance IQs $93.0{\pm}20.5$, $97.5{\pm}13.0$, $95.0{\pm}16.9$ and full-scale IQs $91.9{\pm}20.1$, $95.8{\pm}14.5$, $93.9{\pm}15.1$, respectively, which were found to be not significantly different. No difference was found in structural neurological abnormalities and EEG profiles. The patients with learning disabilities showed more common Bender-Gestalt test abnormalities. In conclusion, we have not found any affirmative clues for the division of chronic motor tic disorder and Tourette's disorder in clinical perspective.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.9 no.2
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• pp.209-217
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• 1998

Object：The purpose of this study was to investigate that infection with group $A[{\beta}]$ hemolytic streptococcus may associate the mechanisms that cause or exacerbate the tic symptoms in some cases of Tourette's disorder Method：Fourteen cases with abrupt worsening of tics participated in this study：10 males,4 females. The subjects were divided into two groups composing of the group with increasing level of ASO titer and the group with normal level of ASO titer. The subjects were administered Yale Global Tic Severity Scale(YGTSS). Result：The global severity scores and overall TS impairment rating scores of YGTSS in the group with increasing level of ASO titer were more higher than in the group with normal level of ASO titer Conclusion：These results suggest that increasing level of ASO titer, resulting from group $A[{\beta}]$ hemolytic streptococcal infection has affected worsening the tic symptoms in Touette's disorder.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.6 no.1
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• pp.47-55
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• 1995

To elucidate the biochemical etiology. 1) plasma dopemine-beta-hydroxylase activity was measured and 2) the correlation between age and DBH activity was examined in 30 Tourette's disorder, 19 chronic motor tic disorder, and 24 controls. The results are summarized as follows : 1) The mean plasma DBH activity in Tourette's disorder was significantly elevated compared to normal groups, but significant differences in DBH activity between Tourette's disorder and chronic motor tic disorder, and between chronic motor tic disorder and normal control group were not found. 2) In all three groups, the significant positive correlations between age and plasma DBH activity found. These findings support the hypothesis of a possible involvement of brain catecholamine dysfunction in the production of Tourette's disorders, and this dysfunction might be due to the increased dopaminergic and decreased noradrenergic function. Future research should be focused on the mechanism of functional abnormalities of DBH.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.4 no.1
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• pp.68-78
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• 1993

The pathophysiology and neural mechanism involved in Tourette's and chronic motor tic disorder are highly controversial. In order to investigate the functional abnormalities of brain. In Tourette's and chronic motor tic disorder, 42 children with Tourette's and chronic motor disorder underwent single photon emission computed tomography(SPECT) using Tc-99m-HM-PAO. The results are summarized as follows : 1) 31.0% (13/42) of this series revealed perfusion defect in cerebral cortex. 2) 4.8% (2/42) revealed perfusion defect in basal ganglia. 3) 4.8(2/42) revealed perfusion defect in thalamus. 4) 16.7%(7/42) showed perfusion defect in cerebellum. 5) The frequency of abnormal perfusion showed no significant difference between tic with and without attention deficit hyperactivity disorder. 6) The frequency of abnormal perfusion showed no significant difference between Tourette's and chronic motor tic disorder. These findings support the hypothesis of a possible involvement of brain dysfunction in the production of Tourette's and chronic motor tic disorder, and quantification of blood flow and co-registration with magnetic resonance imaging will increase the validity of this study.