• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.30 no.3
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• pp.109-115
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• 2019

Objectives: This study investigates lay beliefs about the etiology and treatments of tic disorder and Tourette's syndrome, as well as identifying sociodemographic and personality variables affecting these beliefs among South Koreans. Methods: In total, 673 participants (mean age $41.77{\pm}12.03$ years) completed an online survey regarding their beliefs about tic disorder and Tourette's syndrome. The factors related to their lay beliefs about the disorders were analyzed, and the correlates were investigated. Results: Results indicated that lay people in South Korea held strong beliefs that the causes of tic disorder and Tourette's syndrome lie within the parenting/psychological and neurological/biological categories, compared to the dietary/environmental one. Among the sociodemographic variables, sex, age, and levels of subjective mental health knowledge were primarily associated with the aforementioned beliefs. Familiarity with tic disorder and Tourette's syndrome was also associated with these beliefs. Among the personality traits investigated, extraversion and conscientiousness had significant influences on the beliefs people had about tic disorder and Tourette's syndrome. Conclusion: The results suggest that both policy makers and mental health service providers should adopt a strategic approach for developing and implementing health education interventions about tic disorder and Tourette's syndrome because individual sociodemographic variables, familiarity with the disorders, and personality traits are all associated with the beliefs about these disorders.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.17 no.1
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• pp.21-33
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• 2022

Objectives To assess the effectiveness of Chuna manual therapy in patients with Tourette's syndrome. Methods We queried nine electronic databases using the keywords "Tourette's Syndrome" and "tuina OR chuna" to identify RCTs that investigated the effectiveness of Chuna manual therapy in patients with Tourette's syndrome. Results Thirteen RCTs were selected according to the inclusion criteria. A systematic review showed that Chuna manual therapy can have a curative effect on patients with Tourette's syndrome. Conclusions In this study, 13 RCTs reported that Chuna manual therapy was effective for Tourette's syndrome. These findings provide a basis for its clinical use. However, all studies involved populations belonging to the same country. Many studies lacked details of the research methodology. Therefore, further studies are required to produce high-quality evidence.

• 대한상한금궤의학회지
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• v.12 no.1
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• pp.171-182
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• 2020

Objective : The purpose of this study is to report the improvement in a patient who had Tourette syndrome treated with Hoeyeoksan based on Shanghanlun provisions. Methods: The symptoms of the patient were checked on days 14, 34, 62, 82, 103, and 119 after administration of Hoeyeoksan. Tourette syndrome was evaluated using Yale Global Tic Severity Scale (YGTSS), and oversleep and constipation were evaluated using visual analog scale (VAS). In addition, new clinical implications for the interpretation of Shanghanlun provision 318 were reviewed. Results: Daily tics occurred ten times a day for 14 days after the initial diagnosis but decreased to eight times a day after 34 days, six times a day after 62 days, five times a day after 82 days, twice a day after 103 days, and once a day after 119 days after administration of Hoeyeoksan. Oversleep and constipation improved together with Tourette syndrome. Conclusions: In this study, we observed that Hoeyeoksan had a therapeutic effect by improving the chief complaint of the patient. Hence, the interpretation of Shanghanlun provision 318 must include a patient's behavioral and sleep patterns as predisposing factors of Tourette syndrome.

• Korean Journal of Biological Psychiatry
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• v.5 no.1
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• pp.134-137
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• 1998

Authors report a case of separation anxiety disorder, which developed as a side effect during haloperidol treatment of Tourette syndrome(TS). In this case, 14 years old boy developed attention deficit symptoms during his infancy. At 4th grade of primary school, he developed vocal tic, motor tic, and coprolalia. With 5mg/day of haloperidol treatment his symptoms of TS were subsided. During the treatment, he developed features of separation anxiety disorder, including dependence, pleading, clinging, and sadness. Symptoms of attention deficit and separation anxiety disorder were improved by 25mg/day of imipramine treatment. During haloperidol treatment of TS, careful observation may be needed whether separation anxiety disorder-like symptom develops.

• The Journal of the Korea Contents Association
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• v.22 no.10
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• pp.861-869
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• 2022

In patients with Tourette's syndrome, a tic occurs when Mu wave synchronization is broken. Conversely, when Mu wave synchronization is achieved, a tick does not occur. When the tic is suppressed, the cognitive control response process is changed, and if the neurofeedback training that adjusts the EEG frequency power is performed with the changed, the patient will be treated autonomously without artificially suppressing the tic. The results of the research test suggest that if the tic patient does not artificially synchronize mu waves in the premotor cortex (Frontal Cortical 3 site), and if EEG control is performed autonomously like neurofeedback training, as a result, tics do not occur. Cognitive control response processes are altered when a subject is inhibited from tics. By training the altered cognitive control with neurofeedback that modulates EEG frequency power, the patient can be treated autonomously without artificially suppressing the tic.Mu-wave synchronizationcan now be added to existing neurofeedback treatment protocols such as SMR reinforcement, theta-beta-wave imbalance correction, and alpha-wave reinforcement. This study will be used in follow-up studies and clinical trials to more scientifically verify the neurofeedback treatment protocol, a treatment for patients with Tourette's syndrome.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.34 no.4
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• pp.236-241
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• 2023

Objectives: According to the 10th revision of the International Classification of Diseases, the main categories of tic disorders (F95.0, F95.1, and F95.2) follow a diagnostic hierarchy based on the duration and diversity of tic symptoms. The present study investigated the use of this diagnostic hierarchy in real-world clinical practice. Methods: Based on the National Health Insurance Service-National Health Information Database, the diagnosis of transient tic disorder (F95.0) made after a diagnosis of chronic motor or vocal tic disorder (F95.1) or Tourette's syndrome (F95.2) and diagnosis of chronic motor or vocal tic disorder (F95.1) made after a diagnosis of Tourette's syndrome (F95.2) were referred to as type A errors. The diagnosis of transient tic disorder (F95.0) repeated after a period of >12 months was referred to as type B error. Demographic and clinical differences according to the diagnostic error types were analyzed using analysis of variance, Student's t-tests, and chi-squared tests. Results: Most participants (96.5%) were without errors in the diagnosis of tic disorders. Higher proportions of males (p=0.005) and antipsychotic prescriptions (p<0.001) were observed in patients with type A or B diagnostic errors. A higher proportion of health insurance holders was observed among those with type A errors (p=0.027). Conclusion: Errors were absent in majority of the tic diagnoses in real-world clinical practice in terms of the diagnostic hierarchy.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.17 no.1
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• pp.27-31
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• 2006

Objectives : We examined whether D8/17 expression in Tourette syndrome children who suggested PANDAS were higher than comparison group, and there was my clinical difference by D8/l7 expression. Methods : Nine Tourette's syndrome children suggested PANDAS and two ADHD children without tic disorder were evaluated far percentage of D8/17 expression-positive B cells by immunofluorescence flow cytometric assay and anti-streptolysin O titer. Results : The frequency of D8/17 positive B lymphocyte rate was significantly higher in Tourette's syndrome than ADHD, whose average rate were 77.9 and 24.8, respectively. Among 9 TD patients,4 patients showed above 90% D8/l7 expression. There was high concordance expression rate between mother (98.4%) and daughter (99.0%) The significant relation between percentage of D8/17 expression and tic severity were not detected. The significant relation between percentage of D8/17 expression and anti-streptolysin O titer were not detected, however in 66.7% TD patients showed above 100IU/ml. Conclusion : We concluded that subgroup of TD children are streptococcal infected tic disorder, so called PANDAS.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.23 no.2
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• pp.63-68
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• 2012

Objectives : The purpose of this study was to examine the association of exposures to heavy metals with positive diagnosis for attention-deficit hyperactivity disorder (ADHD) and Tourette's syndrome (TS). Methods : Study participants included 27 children diagnosed with ADHD ($9.9{\pm}2.9$ years of age), 21 diagnosed with Tourette's disorder ($10.7{\pm}2.2$ years of age), and 45 normal control children ($9.6{\pm}0.5$ years of age). A Perkin-Elmer mass spectrometer was used to measure the concentrations of 5 heavy metals (Pb, Cd, U, Be, Hg) in hair samples obtained from each participant. Each heavy metal concentration was compared among the groups by use of a Kruskal-Wallis test. Results : The levels of lead (p=.006) and cadmium (p=.037) observed in the hair of children diagnosed with ADHD were significantly higher than those found in the control subjects. There were no significant differences observed for heavy metal levels when comparing TS and control subjects. Conclusion : We confirmed that lead exposure is a risk factor for ADHD. We also identified that cadmium may be a new candidate risk factor for manifestation of ADHD. We did not find an association between heavy metals and manifestation of TS.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.25 no.2
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• pp.53-64
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• 2014

Tic disorder is a childhood neuropsychological disorder characterized by abrupt, involuntary, and repetitive stereotyped muscle movement or vocal sound. Tourette's disorder shows a chronic prognosis, and can last for life if no treatment is applied. Although tic disorder has been known for ages, the underlying cause is still not well known. Non-pharmacological treatments have long been used for the tic disorder, but few clinical studies were conducted. However, the European Society for the Study of Tourette's Syndrome recently issued non-pharmacologic guidelines for treatment of tic disorders based on the research findings obtained so far. In addition, guidelines for non-pharmacologic evidence-based treatment were reported in Canada, North America. By synthesizing the newly reported foreign guidelines for treatment and review articles, the aim of this study is to investigate the non-pharmacologic therapies used for treatment of tic disorder or Tourette's disorder.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.24 no.2
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• pp.90-95
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• 2013

Botulinum toxin, a neurotoxin, is known to be an inhibitor of cholinergic neuromuscular transmission. Recently, it was reported that the administration of botulinum toxin is effective for the treatment of focal neurological motor disorders such as cervical dystonia, blepharospasm, hemifacial spasm, spasmodic dysphonia, and writer's cramp. Several case studies reported that the botulinum toxin was administered for the treatment of motor tic or vocal tic. It was found that this toxin reduces the frequency and severity of the tic as well as the premonitory urge and symptoms. In our case study, a noticeable decrease of motor tic symptom was observed after an intramuscular injection of 300mg of botulinum toxin in an 18-year-old patient with Tourette's disorder who showed only a little improvement of motor tic and vocal tic symptoms after treatment with antipsychotic drugs for several years. This case is reported in our study and literature survey was undertaken for reviewing similar cases. In our study, an 18-year-old boy diagnosed with Tourette's disorder based on Diagnostic and Statistical Manual of Mental Disorders, fourth edition presented with the following scores : the Clinical Global Impression scale, Yale Global Tic Severity Scale (motor/vocal/severity), Premonitory Urge Score, Korean Attention-Deficit Hyperactivity Disorder Rating scale, and Kovac Depression scale which were performed prior to the treatment were 5, 21/5/50, 100, 17, and 18 points, respectively. Two weeks after the injection of botulinum toxin, the scores were 4, 17/5/40, 50, 16, and 19 points, respectively. Eight weeks after the injection of botulinum toxin, they had become 3, 15/5/30, 25, 16, and 20 points, respectively, which clearly indicates a noticeable decrease of motor tic symptom.