Clinical Course and Adulthood Outcome in Tourette Syndrome

Abstract

Abstract This chapter summarizes theexisting literature on the long-term course of Tourette syndrome (TS). Ticsymptoms typically reach their worst-ever severity between ages 10–12 years.Children with tics tend to become more aware of premonitory urges and displaymore complex tics as they grow older. One-half to two-thirds of children withTS experience a significant decline of tic symptoms that roughly coincides withadolescence. There is no evidence to suggest that pharmacological or behavioraltreatments for tics affect long-term prognosis, although research examining thequestion is lacking. Comorbid attention-deficit/hyperactivity disorder symptoms,when they occur, typically precede the onset of tics, and comorbid obsessive–compulsivesymptoms (OCS) usually follow the onset of tics. The presence of OCS inadulthood is highly correlated with the persistence of tic symptoms intoadulthood and not strongly related to the presence of OCS in childhood. Poorfine motor skills are associated with the persistence of tic symptoms intoadulthood. Smaller caudate volumes are associated with the persistence of ticsymptoms into adulthood.