Objective: To compare premonitory urges (PU) in patients with tics and functional tic-like behaviors (FTB).

Background: Previous case series have suggested that patients with functional tics, unlike patients with tics, do not experience premonitory urges, and that this may be a clinical characteristic which allows clinicians to distinguish between these two conditions.

Method: We compared the results of the Premonitory Urge for Tics Scale (PUTS) in patients with tics and FTB gathered in the Adult Tic Registry, a prospective cohort study at the University of Calgary. The sample of patients with tics comprised individuals with a confirmed diagnosis of Tourette syndrome, or persistent motor or vocal tic disorder. Patients with FTB included those with FTB without a childhood history of tics (“new onset FTB”) and those with FTB with a childhood history of tics (FTBCh). We used a t-test and ANOVA to compare mean scores on each PUTS item and the final PUTS score. Analyses were conducted in STATA .

Results: We included 84 patients with tics, 27 patients with new onset FTB and 15 with FTBCh. The mean age of the entire cohort was 29.37+/-1.26 years, 58 (46.4%) patients were male. There were significant differences in age and sex between patients with tics and FTB. When comparing patients with tics and FTB, there were no significant differences in the final PUTS score (26.31+/-0.77 in patients with tics, vs 25.54+/-1.24 in patients with FTB, p=0.58), or in any of the individual PUTS items. Comparison of PUTS scores in patients with tics, new onset FTB and FTBCh did not show any significant differences between these three groups, however, patients with FTBCh had the highest PUTS scores.

Conclusion: In this cohort study of patients with FTBs, premonitory urges as reported on the PUTS did not differ from patients with tics. The presence of premonitory urge should not be used as a clinical characteristic to differentiate patients with tics from patients with FTBs.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/premonitory-urge-in-patients-with-tics-and-functional-tic-like-behaviors/