• Journal of Oriental Neuropsychiatry
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• v.19 no.3
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• pp.277-288
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• 2008

We have cared for a 13years old boy, who has Tourette Syndrome and symptoms of vocal tic and motor tic for 5years, since 9months ago. We have treated him with korean herb medicine, 8-constitution acupuncture, Chimsband, Neurofeedback, EFT therapy. After taking treatment, his YGTSS score was down to 38 from 119, and his tic symtoms altered for the better. We think korean herb medicine had a powerful effect and Neurofeedback was effective. Especially, SMR Beta Training of all programs of Neurofeedback was effective and well-directed. The EFT program helped him improved also, but it need much of time to apply. When we evaluated the condition of patient who was under the Cans 3000, we could not find any relationship between tic symtoms and Cans 3000. When we treat Tourette Syndrome, having the patience is important at a distance of time. Because Tourette Syndrome is a kind of unstable symptoms, so we would not care to predict what the result will be in a brief space of time.

• Journal of Oriental Neuropsychiatry
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• v.34 no.2
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• pp.61-69
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• 2023

Objectives: To examine the effect of complex Korean medical treatment on tic disorder in children who visited the neuropsychiatric clinic of Korean medicine. Methods: Medical records of 35 patients diagnosed with tic disorder based on DSM-V who received complex Korean medical treatment (herbal medicine, acupuncture and Korean psychotherapy) were reviewed. Tic disorder was then evaluated by Yale Global Tic Severity Scale (YGTSS) before and at 4, 8, and 12 weeks after treatment to determine whether their symptoms were improved. Results: 1) After the treatment, mean YGTSS was reduced from 35.54±14.77 to 23.20±12.65. There were statistically significant changes between scores according to the time of treatment (p< 0.05). 2) At the time of visit, symptoms of motor tics were in the order of eyes, neck and shoulders, mouth, head and arms & hands, nose, face, upper body and other parts, and legs and symptoms of vocal tics were in the order of sniffing, dry coughing and MMM, AA and whistling, and other sounds. 3) For 35 patients, herbal medicine was prescribed every two weeks. The frequency of prescriptions used was in the order of Shihogayonggolmoryo-tang, Gami-ondam-tang, and others. 4) The frequency of herbs used in 35 patients was in the order of Poria, Zingiberis Rhizoma Recens, Pinelliae Rhizoma and Scutellariae Radix, Bupleuri Radix, Ostreae Concha and Bovis Ossis Fossilia, and others. Conclusions: Complex Korean medical treatment including herbal medicine, acupuncture, and Korean psychotherapy is effective for reducing tic symptoms in children.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.12 no.1
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• pp.115-124
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• 2001

Objective：The purpose of this study was to compare the clinical features of children with three subdiagnoses of tic disorder(transient tic disorder(TTD), chronic tic disorder(CTD) and Tourette’s disorder (TD)) and to exam the factors related with illness severity of them. Method：Subjects were 69 children who met DSM-IV criteria for tic disorder and 43 control children. All subjects were investigated demographic and clinical factors related to tic. The severity of tic was assessed with the Yale Global Tic Severity Scale(YGTSS) in tic disorder children. The Child Behavior Checklist(CBCL) was accomplished by parents of all subjects. Results：Children with TTD had not only shorter duration of tic symtoms but also milder tic severity and impairment than those with CTD and TD. They also had significantly lower scores on most CBCL subscales than children with CTD and TD, while they were similar with controls in all the CBCL subcale scores except aggressive behavior. Children with CTD and those with TD were similar to each other in clinical variables except number of tic symptom and scores on CBCL social problem subscale. The interference and intensity of motor tic symptoms and duration of tic symptoms were significant predictors of global impairment score on YGTSS, while the presence of comorbid ADHD was a preictor of the total behavior problem score of CBCL. Conclusion：These findings indicate that duration of tic symptoms and the presence of comorbid ADHD as well as the severity of tic symptoms strongly associated with the illness severity of children with tic disorder. These results also suggest that those clinical factors may be more important for assessing the severity of illness and determining the treatment strategy than the sub-diagnosis itself in children with tic disorder.

• Journal of TMJ Balancing Medicine
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• v.5 no.sup
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• pp.6-10
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• 2015

A 8 year-old male patient with tic disorder was managed by appliance of Functional Cerebrospinal Therapy (FCST) for 7 months, combined with acupuncture. After being treated for 7 months, the patient's symptoms were improved. Assessment was made by Yale Global Tic Severity Scale (YGTSS) and clinical observation. A positive effect was observed and further clinical and biological research on FCST is expected.

• Journal of TMJ Balancing Medicine
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• v.13 no.1
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• pp.21-26
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• 2023

Objectives: The purpose of this study is to report the effect of Korean medical treatment with Temporomandibular Joint Balancing Therapy (TBT) on Tic disorder patient who often glancing up when feels nerves, frightened or tired. Methods: In this study, Tic disorder patient was treated to △△ Korean medicine Hospital from June 12nd, 2022 to July 26th, 2023 by outpatient way. During the clinic period, the patient was treated by Korean medical treatment (acupuncture, cupping, herb medicine), especially using TBT. YGTSS (Yale Global Tic Severity Scale), NDI (Neck Disability Index) and VAS were used for measuring the Tic disorder and neck pain. Results: After treatment for 46 days, the YGTSS showed a decrease from 17 to 3, the VAS associated with Tic disorder also decreased from 6 to 1 and NDI associated with neck pain decreased from 7 to 4. Conclusions: These results showed that Korean medical treatment especially using TBT may have an effect on reducing symptoms of Tic disorder and neck pain. But the further researches are needed.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.16 no.2
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• pp.183-191
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• 2005

Tic disorder including Tourette's disorder is a neurodevelopmental disorder that appears in childhood and characterized by the presence of motor and vocal tics. Childhood-onset obsessive-compulsive disorder (OCD) is suggested to be a phenomenologically and etiologically distinct subtype of OCD, bearing a close genetic relationship to tic-disorders. Tourette's disorder and OCD are comorbid in $40-75\%$ of patients initially diagnosed with either disorder. Basal ganglia and cortico-striato-thalamic circuits are implicated in the pathophysiology of both disorders and these disorders have similar clinical features. Over the past decades, the progress in research on Tourette's disorder and OCD has been extraordinary. This review describes some of important insights from these work, involving these areas : 1) clinical implication 2) genetics and epidemiology 3) brain imaging study 4) neuroche-mistry 5) pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS).

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.7 no.1
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• pp.77-91
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• 1996

In order to elucidate the biological etiology and the effects of comorbidity on biological variables in tic disorders, plasma serotonin (5-hydroxlfryptamine, 5-HT) and 5-hydroxy- indoleacetic acid (5-HIAA) we.e measured in 87 tic disorders and 30 control subjects. The 87 tic disorder were composed of 45 Tourette's disorder(TS), 22 chronic motor tic disorders (CMT) and 20 transient tic disorders (TTD). Among these patients,43 patients were pure tic disorder (PT), 28 subject also had attention deficit hyperactivity disorder (T+ADHD) and 16 subjects had obsessive compulsive disorders (T+ OCD) as comorbid disorders. The results are summarized as follows : 1) Plasma 5-HT levels showed significant positive correlations with plasma 5-HIAA levels (Pennon r=0.77, p<0.05). 2) Plasma 5-HT and 5-HIAA levels showed no significant correlation with age in tic disorders. 3) Plasma 5-HIAA and 5-HT levels showed no significant correlations with age in control subjects. 4) There was significant difference in plasma 5-HT levels among TS, CMT, TTD and control groups (ANOVA F=34.48, df=3, 113, p<0.01), and post-hoc test using Scheffe method showed significant differences between control and TS, control and CMT, control and ITD groups. But, post-hoc test showed no significant differences between TS and CMT, TS and TTD, CMT and TTD groups. 5) There was significant difference in plasma 5-HIAA levels among TS, CMT, TTD and control groups (ANOVA F=26.48, df=3, 113, p<0.01), and post-hoc test using Scheffe method showed significant differences between control and TS, control and CMT, control and TTD groups. But, post-hoc test showed no significant differences between TS and CMT, TS and TTD, CMT and TID groups.f) There was significant difference in plasma 5-HT and 5-HIAA levels among PT, T+ADHD, T+OCD and contol groups (ANOVA 5-HT, F=37.59, df=3, 113, p<0.01, 5-HIAA, F=27.37, df=3, 113, p<0.01), and post-hoc test using Scheffe method showed signiscant differences between control and PT, control and T+ADHD and control and T+OCB. But, post-hoc test showed no significant differences between PT and T+ADHD, PT and T+ OCD and T+ADHD and T+ OCD. These results show that decreased 5-HT and 5-HIAA levels may play a role in the genesis of tic disorders, but these findings have no significant correlations with the severity of tic disorders. And the comorbid disorders of tics may have minimal effects on the biochemical abnormalities. Future studies must be focused on the effects of serotonin agonists and antagonists on tic disorders and molecular biological methodology may enhance to elucidate the mechanisms of these abnormal findings.

• 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.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.34 no.1
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• pp.37-44
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• 2023

Objectives: Tic disorders are highly heritable; however, growing evidence suggests that environmental factors play a significant role in their pathogenesis. Studies on these factors have been inconsistent, with conflicting results. Therefore, this study aimed to examine the associations of pre- and perinatal exposure to Tourette syndrome (TS) or chronic tic disorders (CTD) in Korean school-aged children. Methods: This case-control study used data from a large prospective cohort study. The primary outcome was TS/CTD diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria and Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version-Korean Version. Demographic, pre-, and perinatal information was obtained from the maternal questionnaires. Data between the TS/CTD and control groups were compared using the chi-squared or Student's t-test, as appropriate. Two-step logistic regression analyses were used to test the association between TS/CTD and pre- and perinatal risk factors. Results: We included of 223 children (78 with TS/CTD and 145 controls). Significant differences in the demographic data between the two groups were observed. The male sex ratio, mean parental age, parental final education level, and family history of tics were included as confounders. In the final adjusted multivariable model, TS/CTD was significantly associated with antiemetic exposure during pregnancy (odds ratio [OR]=16.61, 95% confidence interval [CI] 1.49-185.22, p=0.02) and medically assisted reproduction (OR=7.89, 95% CI 2.28-27.28, p=0.01). Conclusion: Antiemetic exposure and medically assisted reproduction are significantly associated with the risk of TS/CTD. These results should be replicated in future prospective and gene-by-environment studies.

• Korean Journal of Psychosomatic Medicine
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• v.18 no.1
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• pp.3-10
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• 2010

Gilles de la Tourette syndrome is a chronic motor and vocal tic disorder of childhood onset. Abnornmalities in basal ganglia-thalamo-cortical circuits may play an important role in the pathophysiology underlying the involuntary tics. It is often complicated by comorbid attention-deficit/hyperactivity disorder or obsessive-compulsive disorder. Transcranial magnetic stimulation(TMS) is a neurophysiologic technique with research ap-plication. As there is good evidence that this technique can modify cortical activity, repetitive TMS is also used for treatment to change the cortical excitability and therefore affect underlying interconnected cortical-sub-cortical loop. We reviewed the neurophysiologic parameters and the clinical applicability of TMS and rTMS.