• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제30권3호
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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.

• 척추신경추나의학회지
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• 제17권1호
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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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• 제12권1호
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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.

• 생물정신의학
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• 제5권1호
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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.

• 한국콘텐츠학회논문지
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• 제22권10호
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• pp.861-869
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• 2022

투렛증후군 환자에게서 뮤파(Mu wave) 동기화가 깨졌을 때 틱이 발생하고, 그 반대로 뮤파 동기화를 이루면 틱이 발생하지 않는다. 연구시험 결과는 전운동피질(Frontal Cortical 3 사이트)에서 뮤파 동기화를 틱 환자가 인위적으로 하지 않고 뉴로피드백 훈련처럼 자율적으로 뇌파 조절이 이뤄진다면 마찬가지 결과로 틱이 발생하지 않는다는 사실을 시사한다. 피시험자에게 틱을 억제시켰을 때 인지 제어 반응 프로세스가 변경된다. 변경된 인지 제어를 뇌파 주파수 파워를 조절하는 뉴로피드백으로 훈련하면 환자가 인위적으로 틱을 억제하지 않아도 자율적으로 치료가 된다. 연구시험 결과는 뇌 운동영역의 뮤파 통제를 통해 틱이 발생하지 않는 생체신호 지표가 뉴로피드백 훈련의 치료프로토콜이 될 수 있는 단초를 마련하였다. 기존 뉴로피드백 치료 프로토콜인 SMR강화, 세타파-베타파 불균형 수정, 알파파 강화 등에 뮤파 강화를 추가할 수 있게 되었다. 본 연구가 투렛증후군 환자 치료법인 뉴로피드백 치료 프로토콜을 보다 과학적으로 검증하는 후속 연구와 임상시험에 활용될 것이다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제34권4호
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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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• 제17권1호
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• pp.27-31
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• 2006

연구목적 : Streptococcus 감염에 취약한 생물학적 지표라고 알려진 D8/17 항체가 PANDAS로 의심되는 뚜렛장애 환자에서 높은지를 알아보고, 뚜렛장애군 중 D8/17 양성반응 여부에 따라 임상경과에 차이가 있는지를 알아보고자 본 연구를 시행하였다. 방 법 : PANDAS가 의심되는 뚜렛장애 소아환자 9명과 비교 대상으로 틱증상이 없이 일관되게 지속적으로 주의력결핍 과잉 행동장애를 보이는 2명의 소아를 택하여 B 임파구 D8/17 항원 양성반응 비율과 혈청 ASO 농도를 비교분석하였다. 결 과 : PANDAS가 의심되는 9명의 뚜렛장애 소아의 경우 평균 77.9%($50.9{\sim}100%$) D8/17 B임파구 양성 비율을 보여 비교대상인 2명의 ADHD(24.8%, 53.7%) 보다 의미 있게 높았다. 뚜렛장애 중 90% 이상의 높은 양성비율을 보이는 경우가 4예 (44..4%)였다. 특히 모녀 뚜렛장애인 경우 각각 98.4%, 99.0%라는 높은 수치를 보였다. 뚜렛장애의 심한 정도와 D8/17 양성 임파구 비율간에 의미있는 상관관계는 없었다. ASO titer와D8/17양성 임파구 비율간에 통계적으로 의미 있는 상관관계는 없었지만 뚜렛장애 66.7%에서 100IU/ml 이상을 보였다. 결 론 : 상기결과를 종합하여 볼 때 일부 뚜렛장애 환자의 경우 streptocooccus 감염과 연관된 PANDAS일 가능성이 충분히 있다고 판단되었다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제23권2호
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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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• 제25권2호
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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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• 제24권2호
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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.