Arbuzova and colleagues examined tactile and visual metacognitive ability in patients with GTS and it's association with PUs. The authors did not find impairment of metacognition in individuals with GTS and no association between PU and metacognition was also found \citep{Arbuzova2022}.
Tic assessment
European Society for the Study of Tourette Syndrome (ESSTS) \citep{Szejko2022} published revised version of their guidelines for assessment of tics. As the golden standard for assessment of tics, the Yale Global Tic Severity Scale (YGTSS) was listed. Along with recomendations about assessment of tics and psychiatric comorbidities, the authors also provided assessments that facilitate the differential diagnosis and assessment of cognitive abilities, emotional functions and motor skills.
\citep{Beeler2022} investigated tic fractality by examining two tic time series datasets collected 6-12 months apart in children with tics using random walk models and directional statistics. The authors showed that tics are fractal in nature and tools examining this characteristic could be used to estimate tic severity and treatment effectiviness as well as possible marker for differentiating tics from functional tic-like behaviors.
\citep{Cernera2022} proposed a new sensor-based approach for assessment of tics. The authors used a combination of electromyography and acceleration data and machine learning techniques to capture differences between tics and voluntary actions and compare those with ratings done by the experts during the modified Rush Video Rating Protocol. The accuracy of new technique was comparable with the expert consensus.
Phenomenology
Baizabal-Carvalho and Jankovic compared phenomenology of tics and comorbidities in males and females with GTS \citep{Baizabal-Carvallo2022b}. Males represented 77.6% of the cohort comprising 201 GTS patients. No differences regarding frequency, distribution and complexity of tics were detected. Males with GTS had higher frequency of ADHD. In children with TS, males not only had higher rate of ADHD than females, but also had higher frequency of complex motor tics and earlier age at onset than females. These differences were not detected in adults with GTS, since tic complexity increases in females with aging.
Males and females with tics were also compared as part of the EMTICS study \citep{Garcia-Delgar2022}. Males had more severe symptoms than females, except for emotional problems. There was also a statistically significant interaction between sex and age on the severity of tics and compulsions, with females showing higher symptom severity with increasing age than males.
Group from the University of Calgary examined clinical phenomenology in males and females with tics based on the Pediatric Tic Registry \citep{Girgis2022}. When comparing both groups, females had more severe motor tics, had higher global severity on the Yale Global Tic Severity Scale. While males were more frequently diagnosed with ADHD, females had significantly higher scores on the Children's Depression Inventory.
Video-recordings of 156 patients with TS were assessed for tic duration \citep{Baizabal-Carvallo2022}. Dystonic tics were longer lasting than tonic tics. Furthermore, patients with dystonic tics has older age of onset, older age at evaluation, greater tic severity, more complex tics, and increased risk for being considered for deep brain stimuation than patients with tonic tics.The same group of authors evaluated clinical phenomenology and correlations of oculogyric tics \citep{Baizabal-Carvallo2022a}. In order to examine this clinical problem the authors reviewed video-recordings and clinical history of 201 patients with tics. Oculogyric tics were found in 22.4% of patients. When it comes to phenomenology of simple oculogyric tics, the most common manifestation was transcient upward gaze, while eye-closure followed by upward and lateral deviations was the most frequent complex oculogyric tic. Patients with oculogyric tics were younger and had higher frequency of cranial tics. No differences were found in tic severity, the profile of psychiatric comorbidities and the use of antipsychotics was found.
Evolution of tic severity over time \citep{Iverson2022}
Functional tic-like behaviors
A seminal paper \citep{Müller-Vahl2022}
\citet{Arbuckle_2022} present new data from the Washington University New Tics study on clinical features in children examined, on average, 4 months after tic onset, who would go on to be diagnosed with TS / CTD. They compare these characteristics to those described in 17 reports on functional tic-like symptoms (FND-tic), who also tend to be evaluated first a few months of symptoms begin. "Stark differences in presentation distinguish the FND-tic patients from typical PTD." Symptoms that best distinguished the groups included movements or vocalizations that were dramatically worse in the presence of others, vs. alone, coprophenomena at presentation, symptoms that dramatically and persistently disrupt the person’s intended actions or communications, and "tic attacks."