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Related Experiment Video

Updated: Jun 22, 2025

Generating Acute and Chronic Experimental Models of Motor Tic Expression in Rats
07:38

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Published on: May 27, 2021

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We've all been wrong about provisional tic disorder.

Sarah C Grossen1, Amanda L Arbuckle2, Emily C Bihun2

  • 1Departments of Psychiatry and Neurology, Washington University in St. Louis, St. Louis, MO, United States of America.

Comprehensive Psychiatry
|June 28, 2024
PubMed
Summary
This summary is machine-generated.

Provisional Tic Disorder (PTD) in children is often more persistent and complex than previously thought, challenging the traditional distinction between short-lived and chronic tic disorders.

Keywords:
Provisional Tic DisorderTic disorders/classification (MeSH)Tic disorders/psychology (MeSH)Tourette syndrome (MeSH)

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Area of Science:

  • Child neurology
  • Neurodevelopmental disorders
  • Pediatric psychiatry

Background:

  • Provisional Tic Disorder (PTD) is common in childhood.
  • Clinical experience suggests PTD is mild and short-lived, with few tics and low comorbidity.
  • This perception may stem from biased ascertainment and limited follow-up in previous observations.

Purpose of the Study:

  • To investigate the natural history and clinical characteristics of childhood Provisional Tic Disorder.
  • To challenge the traditional clinical distinction between recent-onset and chronic tic disorders.

Main Methods:

  • Prospective study of 89 children with tics onset within 9 months.
  • Follow-up assessments at 12, 24, 36, and 48 months post-first tic.
  • Included children with diverse tic presentations and comorbidities, with data collection from clinical and non-clinical sources.

Main Results:

  • At onset, many children had comorbidities like ADHD (39%), anxiety (27%), and OCD (9%).
  • Most children presented with multiple tics (mean 6.9 motor, 2.0 phonic), complex tics (41%), and suppressible tics (69%).
  • At 12 months, 78/79 children still had tics, often persistent but with low medical impact; many tics were only observed via monitoring.

Conclusions:

  • The study findings challenge the clinical lore that PTD is typically mild and transient.
  • Data support discontinuing the arbitrary separation of tic disorders into recent-onset versus chronic categories.
  • PTD may represent a more persistent neurodevelopmental condition than traditionally assumed.