Mini-Child Tourette Syndrome Impairment Scale Scoresin Functional versus Primary Tic Disorders

ABSTRACT

Objective: To investigate differences in Mini-Child Tourette Syndrome Impairment Scale (Mini-CTIM) scores rated by parents and patients with functional tics versus primary tic disorders. Background: The mini-CTIM is a validated clinical tool for assessing tic and non-tic related impairment in children with tic disorders. Recently, in the context of the COVID-19 pandemic, there has been a dramatic increase in the number of patients presenting with new onset functional tic-like behaviors. There is limited clinical data on how quality of life is impaired in these patients. Design/Methods: We reviewed parent and patient mini-CTIM scores in patients with a final diagnosis of functional tics for new patient encounters between 3/24/2021 and 6/29/2021, identifying 18 patients. Mini-CTIM scores are completed by both the parent and patient as part of a standard pre-visit intake in our Tourette's clinics. The mini-CTIM has two parts motor/vocal tic impairment(mini-CTIM motor/vocal) and impairment related to ADHD/OCD/anxiety/rages/other(mini-CTIM other). The maximum score of each part is 42;higher scores suggest more impairment. Twenty patients with initial visits for primary tic disorders, matched for age and sex, were randomly selected during the same corresponding time period for comparison. Parametric(unpaired t-test) and non-parametric(Wilcoxon Rank Sum Test) statistical analysis were performed when appropriate. Results: The average age of patients with functional tics was 15.8 years at initial visit and 94% were female. Average(median) mini-CTIM tic scores in functional tic disorders families were patient 6.5(5.5);parent 6.9(5.0). In primary tic disorder families, scores were patient 7.6(5.0);parent 7.4(5.0). Mini-CTIM other scores in functional tic disorders families were patient 10.1(9.5);parent 11.4(10.0). In primary tic disorder families, scores were patient 10.7(13.0) and parent 10.3(10.0). No differences in mini-CTIM measures rose to the level of statistical significance Conclusions: Despite dramatic symptoms, impairment ratings at home, school and social environment do not appear to be elevated compared with primary tic disorders.