- Premonitory Urges Reconsidered: Urge Location Corresponds to Tic Location in Patients With Primary Tic Disorders
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Jana Essing, Ewgeni Jakubovski, Nikolas Psathakis, Sinan N Cevirme, James F Leckman, Kirsten R Müller-Vahl
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J Mov Disord. 2022;15(1):43-52. Published online January 25, 2022
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DOI: https://doi.org/10.14802/jmd.21045
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 Abstract
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- Objective
In patients with Tourette syndrome and other primary tic disorders (PTDs), tics are typically preceded by premonitory urges (PUs). To date, only a few studies have investigated the location and frequency of PUs, and contrary to clinical experience, the results suggest that PUs are not located in the same anatomic region as the tics. This study aimed to further explore PU location and frequency in detail, differentiating the kind and complexity of the corresponding tics, in a large sample of patients with PTD.
Methods
A total of 291 adult (≥ 18 years) patients with a confirmed diagnosis of chronic PTD were included. The study was conducted online, assement included tics and the general characterization of PUs and a sophisticated body drawing for locating PUs.
Results
We found that PUs were located in the same body area as, or in direct proximity to, the corresponding tic. Most frequently, PUs were located in the face and at the head (62.1%). Compared with simple tics, complex (motor and vocal) tics were more often preceded by a PU; but there was no difference in PU frequency observed between motor tics and vocal tics. PUs were more often experienced at the front than at the back of the body (73% vs. 27%), while there was no difference between the right and left sides (41.6% vs. 41.3%).
Conclusion
The strong association between PU and tic location further supports the hypothesis that PUs represent the core of PTD. Accordingly, future therapies should focus on treating PUs to achieve greater tic reduction.
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Citations
Citations to this article as recorded by  - Functional Tic‐Like Behaviors: A Common Comorbidity in Patients with Tourette Syndrome
Kirsten R. Müller‐Vahl, Anna Pisarenko, Carolin Fremer, Martina Haas, Ewgeni Jakubovski, Natalia Szejko
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Lisa Keenan, Jessica Bramham, Michelle Downes
Developmental Neuropsychology.2024; 49(1): 39. CrossRef - Premonitory Urge in Patients with Tics and Functional Tic‐like Behaviors
Natalia Szejko, Julian Fletcher, Davide Martino, Tamara Pringsheim
Movement Disorders Clinical Practice.2024; 11(3): 276. CrossRef - A meta-analysis of transcranial magnetic stimulation in Tourette syndrome
Elizabeth R. Steuber, Joseph F. McGuire
Journal of Psychiatric Research.2024; 173: 34. CrossRef - Premonitory Urge and Tic Severity, Comorbidities, and Quality of Life in Chronic Tic Disorders
Valerie Brandt, Jana Essing, Ewgeni Jakubovski, Kirsten Müller‐Vahl
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Aysegul Gunduz, Christos Ganos
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Andreas Hartmann, Per Andrén, Cyril Atkinson-Clément, Virginie Czernecki, Cécile Delorme, Nanette Marinette Monique Debes, Kirsten Müller-Vahl, Peristera Paschou, Natalia Szejko, Apostolia Topaloudi, Keisuke Ueda, Kevin J. Black
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Catherine Striley, Kevin J. Black, Natalie E. Chichetto, Lauren Vagelakos
Evidence-Based Practice in Child and Adolescent Mental Health.2023; : 1. CrossRef - Clinical evaluation of premonitory urges in children and adolescents using the Chinese version of Individualized Premonitory Urge for Tics Scale
Guanghua Che, Wenjing Ren, Joseph F. McGuire, Ping Li, Zhiruo Zhao, Jing Tian, Jinyuan Zhang, Yue Zhang
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Carolin Fremer, Natalia Szejko, Anna Pisarenko, Martina Haas, Luise Laudenbach, Claudia Wegener, Kirsten R. Müller-Vahl
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