deletions | additions       diff --git a/Phenomenology.md b/Phenomenology.md  index 2289d3a..acffc9f 100644  --- a/Phenomenology.md  +++ b/Phenomenology.md 
...
### Tic suppression  Since tic suppression is part of Comprehensive Behavioral Intervention for Tics (CBIT) and Exposure and Response Prevention (ERP), there has been increased interest in investigating the characteristics of tic suppression and the factors that affect it. A study of 26 TS adolescents compared free ticcing with a tic suppression condition \citep{25786675}. During the free ticcing condition tic distribution across body parts locations  was consistent with the general view that most tics occur at the level of the shoulders and above. Eye tics were the most frequent followed by facial/cervical tics. Limb tics and tics involving the trunk were the least common. During the tic suppression condition, an increase in eye tics were seen in 10 subjects along with an increase in hand tics in 3 subjects. Subjects were more Tic suppression was most  successful inhibiting when it involved suppression of  tics associated with in  the body parts locations  thatgenerally  are generally  involved in the fewest tics (such as the legs and the trunk). The authors make the case that tic suppression involves specific inhibition inhibition,  rather than global inhibition inhibition,  since tic suppression does not result in a general reduction in tics regardless since some types  of which body part they involve. tics are easier to suppress than others.  By definition, children with Tourette syndrome (TS) have had tics for over a year. They can often suppress their tics briefly, briefly  and they  do so better more effectively  when rewarded for successful suppression. It has not been known whether the ability to suppress tics develops only with practice over the years, years  or whetherit was there from  the outset. ability to suppress tics is present when tics initially occur.  \citet{Greene_2015_NTsuppress} addressed this question in children whose tics had developed within the past few months. When children received tokens with monetary value for tic-free intervals, they had significantly more of these intervals compared to a baseline, unrewarded condition. This result suggests the possibility that behavior therapy for tics may work, at least for some children, even before TS can be diagnosed. ### Sensory phenomena   Total tic severity and vocal tic scores were significantly correlated with scores on the Premonitory Urge for Tics Scale (PUTS)  and the University of São Paulo Sensory Phenomena Scale for TS adults \citep{Kano_2015}. The PUTS scores and the USP-SPS scores were correlated with the scores on the Dimensional Yale-Brown Obsessive-Compulsive Scale. In addition, PUTS scores and USP-SPS total scores were both significantly correlated with tic complexity and YGTSS vocal tic scores.Another study examined the association between premonitory urges and interoceptive awareness \cite{25879819}.Interoceptive awareness was measured by how well subjects could be aware of many times their hearts beat during a specific period of time. Interoceptive awareness, tic severity, and severity of obsessive-compulsive symptoms were used in a multiple regression to predict scores on Premonitory Urge for Tics Scale. Interoceptive awareness was a highly significant predictor of premonitory urges with greater interoceptive awareness being associated with higher PUTS scores. Higher PUTS scores were also associated with greater tic severity but to a lesser extent than interoceptive awareness. The authors suggest that high interoceptive awareness might result in people setting a low threshold for perception of their own internal physiological sensations as an urge to tic. This study, however, also showed that TS subjects generally had lower interoceptive awareness than controls and this result was interpreted as possibly related to downregulation of interoception, perhaps reflecting a compensatory process over the period of time that the person had tics. However, the authors also point out that the reduced interoceptive awareness could reflect the effect of the comorbidities associated with TS.  Another study examined the association between premonitory urges and interoceptive awareness \cite{25879819}.Interoceptive awareness was measured by how well subjects could count their heartbeats during a specific period of time. Interoceptive awareness, tic severity, and severity of obsessive-compulsive symptoms were used in a multiple regression to predict PUTS scores. Interoceptive awareness was a highly significant predictor of premonitory urges with greater interoceptive awareness being associated with higher PUTS scores. Higher PUTS scores were also associated with greater tic severity but to a lesser extent than interoceptive awareness. The authors suggest that high interoceptive awareness might result in people setting a low threshold for perception of their own internal physiological sensations and therefore interpreting these sensations as an urge to tic. This study, however, also showed that TS subjects generally had lower interoceptive awareness than controls and this result was interpreted as possibly related to downregulation of interoception, perhaps reflecting a compensatory process that developed over time. However, the authors also point out that the reduced interoceptive awareness could reflect the effect of the comorbidities associated with TS.  ### Symptoms and comorbidity 
...
More research is also being conducted on personality differences associated with TS. A small study of 17 male adolescents \cite{26078419} found that the only difference between the TS subjects and 51 age- and gender-matched controls on the Minnesota Multiphasic Personality Inventory-Adolescent was that the TS subjects scored significantly higher on the Obsessiveness Content Scale. In contrast a study of 50 TS adults in Germany used a variety of instruments to measure psychological symptoms and personality traits \cite{26112450}. Comorbidities were common with 41% having OCD, 28% being depressed and 26% having ADHD. Patients with OCD had more severe tics and there was a trend for those with ADHD to have more severe tics. Only 29% of the patients had no pathological personality traits. The demand-anxious trait was the most common personality trait (measured with the Inventory of Clinical Personality Accentuations) seen in patients and was present in 39% while histrionic personality traits were not found in any of these patients. Personality traits in patients with "pure" TS were comparable to those of the control group. Interestingly, ADHD did not contribute to increased probability of pathological personality traits. Although quality of life was affected by both personality traits and comorbidities, personality traits had a larger impact on quality of life.  ### Course  Baby videos provide a clue \cite{26246137} 34 children in Italy were identified as having autistic behaviors in their second year of life. Families reported that development during the first year of life had been normal and they donated videos that had been recorded before the age of 6 months. Videos of 18 boys were examined in detail. Abnormal general movements, which are spontaneously generated by central pattern generators and modulated by more rostral brain regions, were seen in 10 of the 11 boys who were eventually diagnosed with autism spectrum disorder. In contrast, normal general movements were seen in the 8 boys who had autistic features and 7 of these boys were later diagnosed with Tourette syndrome. 4 of the boys who were eventually diagnosed with autism spectrum disorder had TS as a comorbidity. These results, combined with the recent nearly ubiquitous availability of home baby videos in some cultures, suggest a pseudo-prospective study design could be used to identify features predicting later development of TS. 
...
A follow-up study averaging 9 years of 75 TS patients previously seen at a University-based clinic found that reported TS impairment was more likely to decrease over time in males and increase in females \citep{25193042}. In addition, women were more likely than men to have more body regions, primarily the upper extremities, affected by tics in adulthood. This result suggests that sex continues to influence TS symptoms beyond adolescence.  Since anecdotal evidence has suggested that tics decrease when people are involved in musical activity, the effects of music were systematically studied. Questionnaires completed by 29 patients supported the idea that listening to music and performing music were thought to decrease tic frequency \citep{Bodeck_2015}. In the second study tics almost completely stopped when subjects were performing music. Listening to music and mental imagery of musical performance also resulted in a decrease in tic frequency. It was suggested that focused attention, along with fine motor control and goal-directed behavior, produced the decrease in tics.