• 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.133-141
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• 1993

Present study investigated the differences in psychological tests responses between chronic motor tic disorder and tourette's disorder to clarify whether chronic motor tic and tourette's disorder constitute a single disorder on a continuum or not. Based on the diagnosis by child psychiatrists 29 chronic motor tic disorder and 10 tourette's disorder children between the age of 6 to 13 were selected, and the psychological tests responses of two diagnostic groups were compared. The results showed that tourette's disorder is more related to neulological problems than chronic motor tic disorder. Also it was found that children with tourette's disorder have more difficulties in social-emotional adjustment than children with chronic motor tic disorder. These results suggested that interactions among neurological factor, emotional factor and temperamental characristics might be more involved in tourette's disorder than in chronic motor tic disorder. The limitations of present study and the need for futher research on the comorbidity of tourette's disorder and ADHD were discussed.

• 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.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.

• Korean Journal of Psychosomatic Medicine
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• v.31 no.2
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• pp.142-148
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• 2023

Objectives : The purpose of this study is to investigate the relationships between premonitory urge, tic severity, and comorbidities in children and adolescents with chronic tic disorders. Methods : In this study, scales for tic symptoms, premonitory urge, obsessive-compulsive symptoms, and ADHD symptoms were repeatedly measured twice in 26 children and adolescents aged 10 to 18 years with chronic tic disorders. Correlations between scales were confirmed through repeated measures correlation analysis, and causal relationships between scales were confirmed through regression analysis using a linear mixed model. Results : The degree of premonitory urges showed a significant positive correlation with the severity of tic symptoms, the severity of obsessive-compulsive symptoms, and the severity of ADHD symptoms. The ADHD symptoms showed a significant positive correlation with the severity of tic symptoms. These results were the same even in children and adolescents with tic disorders who were not diagnosed with obsessive-compulsive disorder. Additionally, premonitory urges were found to have a significant positive effect on the severity of tic symptoms. Conclusions : These results may be helpful in treating tic disorders and can be used in future tic disorder research considering developmental trajectory.

• 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.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 Oriental Neuropsychiatry
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• v.14 no.2
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• pp.213-218
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• 2003

This is a case report of a patient with Tourett's disorder treated by Ukgan-san. We evaluated the patient Tourett's disorder by behavior and sound. His tic behaviors like eye blinking, shoulder shrugging, head jerking, facial frimace have been shown frequently, and His phonic tic symptoms like coughing, throat clearing, sniffing have been presented frequently, too. We diagnosed his condition as Wind-syndrome Caused by Hyperactivity of Liver-yang by patient's redish face, taut pulse, Left umbilical throb. So we treated the patient with Ukgan-san. and the score of Yale Global Tic Severity Scale(YGTSS) was 30 at the start of treatment. and the score of YGTSS was 3 at the end. We found that Ukgan-san was effective for the patient with Tourett's disorder.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.5 no.1
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• pp.150-161
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• 1994

Clinical Characteristics of 83 tic patients referred to child psychiatric clinics were studied including the patients' sexes, birth orders and onset ages. We compared the differences between patients and normal control regarding the co-morbidity, and mothering attitude using CBCL(Child Behavioral Check List) and MBRI(Mothering Behavior Rating Instrument). And we also evaluated the influence of types of tic disorder and the presence of behavioral characteristics of the tic patients. The following results were obtained. 1) The sex ration was 5.9:1, male dominant. 2) The eldest children were being twice as many as the youngest children(eldest : youngest : single=4.7 : 1.7 : 1). 3) The eldest children tended to have earlier onset than others. 4) The tic children as a whole had more accompanying behavioral problems than the normal children according to the CBCL scales' scores. 5) The mothers of tic children had more negative view of their children, more rejecting and more hostile attitude toward their children. 6) The types of tic disorder(the Tourette disorder vs chronic moter tic disorder) did not make a difference in the incidence of behavior problems. 7) Those who had attentional problems regardless the types of tic had more behavioral problems than those who had not. 8) Those who had familial loadings of tic disorder tended to have more likely Tourette disorders than chronic tic disorders.

• The Journal of Pediatrics of Korean Medicine
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• v.21 no.3
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• pp.71-84
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• 2007

Objectives The purpose of this study is to report a case of transient tic disorder, chronic motor tic disorder, and Tourette's disorder of the children who treated by herbal medicine. Methods We treated the tic-disorder children with herbal medicine (Samchulgeonbitang, Oyaksun- gisankamibang, Cheonggan-soyosan), and we evaluated tic disorder cases by Yale Global Tic Severity Scale (YGTSS). Results We treated a tic-disorder patients with herbal medicine and we had some good effects on a patients who had transient tic disorder, chronic motor tic disorder, and Tourette's disorder. The patients' symptomswere improved and the YGTSS also decreased. Conclusions Herbal medicine works well especially for tic-disorder, and active medical treatments are the most important thing for Transient tic disorder.