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16-04-2025 | Original Article

Network Analysis of Premonitory Urges, Tic Symptoms, Obsessive-Compulsive Symptoms, and Quality of Life in Drug-Naïve Children and Adolescents with Tic Disorder

Auteurs: Xianbin Wang, Xu Hong, Yihan Ma, Hui Xu, Liping Yu, Wenyan Zhang, Zhongliang Jiang, Yonghua Cui, Ying Li

Gepubliceerd in: Child Psychiatry & Human Development

Abstract

Premonitory urges (PU) in tic disorder (TD) are recognized as a crucial factor influencing tic symptoms and overall well-being. This study employs network analysis to explore the intricate relationships among PU, tic symptoms, obsessive-compulsive symptoms (OCS), and quality of life (QoL) in drug-naïve children and adolescents with TD. Participants were drug-naïve TD patients aged 6 to 16 years. All participants consented to undergo multiple accessments, including the Yale Global Tic Severity Scale (YGTSS), Premonitory Urge to Tic Scale (PUTS), Gilles de la Tourette-Quality of Life Scale (GTS-QOL), Children’s Yale-Brown Obsessive-Compulsive Scale (CY-BOCS), and Obsessive-Compulsive Inventory-Revised (OCI-R). Network analysis was conducted using the R-package qgraph. Based on a sample of 344 TD patients, robust associations were identified between PU and tic symptoms, OCS, and QoL deficits. Centrality analysis identified ordering symptoms and obsessive thoughts as key nodes. Notable cross-scale associations were observed, such as the connections between PU and checking symptoms, as well as PU and obsessive thoughts. Bridge centrality analysis revealed that obsessive thoughts were identified as the strongest bridge symptom. PU was indirectly related to QoL in individuals with TD, while OCS exerted a direct association. Our study underscores the role of OCS in tic-related symptoms among individuals with TD. Highlighting the significant associations between PU and OCS, it emphasizes the necessity for targeted interventions to improve overall well-being.

Alleen toegankelijk voor geautoriseerde gebruikers

Bernard BA, Stebbins GT, Siegel S, Schultz TM, Hays C, Morrissey MJ, Goetz CG (2009) Determinants of quality of life in children with Gilles de La tourette syndrome. Mov Disord 24(7):1070–1073. https://doi.org/10.1002/mds.22487CrossRefPubMed

Bhikram T, Arnold P, Crawley A, Abi-Jaoude E, Sandor P (2020) The functional connectivity profile of tics and obsessive-compulsive symptoms in tourette syndrome. J Psychiatr Res 123:128–135. https://doi.org/10.1016/j.jpsychires.2020.01.019CrossRefPubMed

Brandt V, Essing J, Jakubovski E, Muller-Vahl K (2023) Premonitory urge and tic severity, comorbidities, and quality of life in chronic tic disorders. Mov Disord Clin Pract 10(6):922–932. https://doi.org/10.1002/mdc3.13742CrossRefPubMedPubMedCentral

Brown C, Shahab R, Collins K, Fleysher L, Goodman WK, Burdick KE, Stern ER (2019) Functional neural mechanisms of sensory phenomena in obsessive-compulsive disorder. J Psychiatr Res 109:68–75. https://doi.org/10.1016/j.jpsychires.2018.11.018CrossRefPubMed

Cavanna AE, Schrag A, Morley D, Orth M, Robertson MM, Joyce E, Selai C (2008) The Gilles de La tourette syndrome-quality of life scale (GTS-QOL): development and validation. Neurology 71(18):1410–1416CrossRefPubMed

Cervin M (2023) Sensory processing difficulties in children and adolescents with Obsessive-Compulsive and anxiety disorders. Res Child Adolesc Psychopathol 51:223–232. https://doi.org/10.1007/s10802-022-00962-wCrossRefPubMed

Cervin M, Miguel EC, Güler AS, Ferrão YA, Erdoğdu AB, Lazaro L, Mataix-Cols D (2021) Towards a definitive symptom structure of obsessive– compulsive disorder: a factor and network analysis of 87 distinct symptoms in 1366 individuals. Psychol Med 52(14):3267–3279. https://doi.org/10.1017/s0033291720005437CrossRefPubMedPubMedCentral

Cheng S, Li X, Liu J (2024) Self-consciousness mediated the role of the Insula in self-disclosure: evidence from rs-fMRI data. Acta Psychol. https://doi.org/10.1016/j.actpsy.2024.104133CrossRef

Craig AD (2009) How do you feel — now? The anterior Insula and human awareness. Nat Rev Neurosci 10(1):59–70. https://doi.org/10.1038/nrn2555CrossRefPubMed

10.

de Vries FE, Cath DC, Hoogendoorn AW, van Oppen P, Glas G, Veltman DJ, van Balkom AJL M (2016) Tic-Related versus Tic-Free Obsessive-Compulsive disorder. J Clin Psychiatry 77(10):e1240–e1247. https://doi.org/10.4088/JCP.14m09736CrossRefPubMed

11.

Eddy CM, Cavanna AE (2014) Premonitory urges in adults with complicated and uncomplicated tourette syndrome. Behav Modif 38(2):264–275. https://doi.org/10.1177/0145445513504432CrossRefPubMed

12.

Eddy CM, Cavanna AE, Gulisano M, Agodi A, Barchitta M, Cali P, Rizzo R (2011) Clinical correlates of quality of life in tourette syndrome. Mov Disord 26(4):735–738. https://doi.org/10.1002/mds.23434CrossRefPubMed

13.

Eddy CM, Rizzo R, Gulisano M, Agodi A, Barchitta M, Cali P, Cavanna AE (2011) Quality of life in young people with tourette syndrome: a controlled study. J Neurol 258(2):291–301. https://doi.org/10.1007/s00415-010-5754-6CrossRefPubMed

14.

Epskamp S, Borsboom D, Fried EI (2018) Estimating psychological networks and their accuracy: A tutorial paper. Behav Res Methods 50(1):195–212. https://doi.org/10.3758/s13428-017-0862-1CrossRefPubMed

15.

Epskamp S, Cramer AOJ, Waldorp LJ, Schmittmann VD, Borsboom D (2012) Qgraph: network visualizations of relationships in psychometric data. J Stat Softw 48(4):1–18. https://doi.org/10.18637/jss.v048.i04CrossRef

16.

Farhat LC, Brentani H, de Toledo VHC, Shephard E, Mattos P, Baron-Cohen S, Polanczyk GV (2022) ADHD and autism symptoms in youth: a network analysis. J Child Psychol Psychiatry 63(2):143–151. https://doi.org/10.1111/jcpp.13436CrossRefPubMed

17.

Ferrão YA, Shavitt RG, Prado H, Fontenelle LF, Malavazzi DM, de Mathis MA, do Rosário MC (2012) Sensory phenomena associated with repetitive behaviors in obsessive-compulsive disorder: An exploratory study of 1001 patients. Psychiatry Research 197(3):253–258. https://doi.org/10.1016/j.psychres.2011.09.017CrossRefPubMed

18.

Forlim CG, Brandt V, Jakubovski E, Ganos C, Kühn S, Müller-Vahl K (2024) Symptom network analysis in a large sample of children and adults with a chronic tic disorder. Mov Disorders Clin Pract. https://doi.org/10.1002/mdc3.14167CrossRef

19.

Girone N, Benatti B, Bucca C, Cassina N, Vismara M, Dell’Osso B (2024) Early-onset obsessive-compulsive disorder: sociodemographic and clinical characterization of a large outpatient cohort. J Psychiatr Res 172:1–8. https://doi.org/10.1016/j.jpsychires.2024.02.009CrossRefPubMed

20.

Gonner S, Leonhart R, Ecker W (2008) The Obsessive-Compulsive Inventory-Revised (OCI-R): validation of the German version in a sample of patients with OCD, anxiety disorders, and depressive disorders. J Anxiety Disord 22(4):734–749. https://doi.org/10.1016/j.janxdis.2007.07.007CrossRefPubMed

21.

Grassi G, Cecchelli C, Mazzocato G, Vignozzi L (2021) Early onset obsessive–compulsive disorder: the biological and clinical phenotype. CNS Spectr. https://doi.org/10.1017/s1092852921000122CrossRefPubMed

22.

Gu Y, Li Y, Cui Y (2020) Correlation between premonitory urges and tic symptoms in a Chinese population with tic disorders. Pediatr Investig 4(2):86–90. https://doi.org/10.1002/ped4.12189CrossRefPubMedPubMedCentral

23.

Guenzi P, Georges L (2010) Interpersonal trust in commercial relationships. Eur J Mark 44(1/2):114–138. https://doi.org/10.1108/03090561011008637CrossRef

24.

Haas M, Jakubovski E, Fremer C, Dietrich A, Hoekstra PJ, Jäger B, Müller-Vahl KR (2021) Yale global tic severity scale (YGTSS): psychometric quality of the gold standard for tic assessment based on the Large-Scale EMTICS study. Front Psychiatry. https://doi.org/10.3389/fpsyt.2021.626459CrossRefPubMedPubMedCentral

25.

Haraldstad K, Wahl A, Andenaes R, Andersen JR, Andersen MH, Beisland E (2019) A systematic review of quality of life research in medicine and health sciences. Qual Life Res 28(10):2641–2650. https://doi.org/10.1007/s11136-019-02214-9. network, L.CrossRefPubMedPubMedCentral

26.

Hesapcioglu ST, Tural MK, Kandil S (2014) Quality of life and self-esteem in children with chronic tic disorder. Turk Pediatri Ars 49(4):323–332. https://doi.org/10.5152/tpa.2014.1947CrossRefPubMedPubMedCentral

27.

Ho CS, Huang JY, Yang CH, Lin YJ, Huang MY, Su YC (2020) Is the Yale global tic severity scale a valid tool for parent-reported assessment in the paediatric population? A prospective observational study in Taiwan. BMJ Open 10(8):e034634. https://doi.org/10.1136/bmjopen-2019-034634CrossRefPubMedPubMedCentral

28.

Huisman-van Dijk HM, Matthijssen S, Stockmann RTS, Fritz AV, Cath DC (2019) Effects of comorbidity on tourette’s tic severity and quality of life. Acta Neurol Scand 140(6):390–398. https://doi.org/10.1111/ane.13155CrossRefPubMedPubMedCentral

29.

Isaacs DA, Riordan HR, Claassen DO (2021) Clinical Correlates of Health-Related Quality of Life in Adults With Chronic Tic Disorder. Front Psychiatry. https://doi.org/10.3389/fpsyt.2021.619854CrossRefPubMedPubMedCentral

30.

Jones PJ, Ma R, McNally RJ (2019) Bridge centrality: A network approach to Understanding comorbidity. Multivar Behav Res 56(2):353–367. https://doi.org/10.1080/00273171.2019.1614898CrossRef

31.

Kano Y, Matsuda N, Nonaka M, Fujio M, Kuwabara H, Kono T (2015) Sensory phenomena related to tics, obsessive-compulsive symptoms, and global functioning in tourette syndrome. Compr Psychiatr 62:141–146. https://doi.org/10.1016/j.comppsych.2015.07.006CrossRef

32.

Kloft L, Steinel T, Kathmann N (2018) Systematic review of co-occurring OCD and TD: evidence for a tic-related OCD subtype? Neurosci Biobehavioral Reviews 95:280–314. https://doi.org/10.1016/j.neubiorev.2018.09.021CrossRef

33.

Kurlan R, Daragjati C, Como PG, McDermott MP, Trinidad KS, Roddy S, Robertson MM (1996) Non-obscene complex socially inappropriate behavior in tourette’s syndrome. J Neuropsychiatry Clin Neurosci 8(3):311–317. https://doi.org/10.1176/jnp.8.3.311CrossRefPubMed

34.

Labad J, Menchon JM, Alonso P, Segalas C, Jimenez S, Jaurrieta N, Vallejo J (2008) Gender differences in obsessive-compulsive symptom dimensions. Depress Anxiety 25(10):832–838. https://doi.org/10.1002/da.20332CrossRefPubMed

35.

Langelage J, Verrel J, Friedrich J, Siekmann A, Schappert R, Bluschke A, Munchau A (2022) Urge-tic associations in children and adolescents with tourette syndrome. Sci Rep 12(1):16008. https://doi.org/10.1038/s41598-022-19685-5CrossRefPubMedPubMedCentral

36.

Leckman JF, Riddle MA, Hardin MT, Ort SI, Swartz KL, Stevenson J, Cohen DJ (1989) The Yale global tic severity scale: initial testing of a clinician-rated scale of tic severity. J Am Acad Child Adolesc Psychiatry 28(4):566–573. https://doi.org/10.1097/00004583-198907000-00015CrossRefPubMed

37.

Li B, Mody M (2016) Cortico-Striato-Thalamo-Cortical circuitry, working memory, and Obsessive–Compulsive disorder. Front Psychiatry. https://doi.org/10.3389/fpsyt.2016.00078CrossRefPubMedPubMedCentral

38.

Li Y, Woods DW, Gu Y, Yu L, Yan J, Wen F, Cui Y (2021) Psychometric properties of the Chinese version of the premonitory urge for tics scale: A preliminary report. Front Psychol 12:573803. https://doi.org/10.3389/fpsyg.2021.573803CrossRefPubMedPubMedCentral

39.

Liu F, Wang G, Yao B, Ye J, Wang J, Wang H, Liu H (2023) Cross-sectional investigation of quality of life determinants among children with tic disorders: the roles of family environmental and clinical factors. Heliyon. https://doi.org/10.1016/j.heliyon.2023.e13228CrossRefPubMedPubMedCentral

40.

MC R-C, MT JFL, RG M, EC SHSPPS, M (2001) Adults with early-onset obsessive-compulsive disorder. Am J Psychiatry 158(11):1899–1903. https://doi.org/10.1176/appi.ajp.158.11.1899CrossRef

41.

McKay D, Piacentini J, Greisberg S, Graae F, Jaffer M, Miller J, Yaryura-Tobias JA (2003) The children’s Yale-Brown Obsessive-Compulsive scale: item structure in an outpatient setting. Psychol Assess 15(4):578–581. https://doi.org/10.1037/1040-3590.15.4.578CrossRefPubMed

42.

Menon V, Uddin LQ (2010) Saliency, switching, attention and control: a network model of Insula function. Brain Struct Function 214(5–6):655–667. https://doi.org/10.1007/s00429-010-0262-0CrossRef

43.

Nilles C, Hartmann A, Roze E, Martino D, Pringsheim T (2023) Tourette syndrome and other tic disorders of childhood. In Motor System Disorders, Part II: Spinal Cord, Neurodegenerative, and Cerebral Disorders and Treatment (pp. 457–474). https://doi.org/10.1016/b978-0-323-98817-9.00002-8

44.

Openneer TJC, Tarnok Z, Bognar E, Benaroya-Milshtein N, Garcia-Delgar B, Morer A, and the Ecg (2020) The premonitory urge for tics scale in a large sample of children and adolescents: psychometric properties in a developmental context. An EMTICS study. Eur Child Adolesc Psychiatry 29(10):1411–1424. https://doi.org/10.1007/s00787-019-01450-1CrossRefPubMed

45.

Peng ZW, Yang WH, Miao GD, Jing J, Chan RC (2011) The Chinese version of the Obsessive-Compulsive Inventory-Revised scale: replication and extension to non-clinical and clinical individuals with OCD symptoms. BMC Psychiatry. https://doi.org/10.1186/1471-244X-11-129CrossRefPubMedPubMedCentral

46.

Peters SK, Dunlop K, Downar J (2016) Cortico-Striatal-Thalamic loop circuits of the salience network: A central pathway in psychiatric disease and treatment. Front Syst Neurosci. https://doi.org/10.3389/fnsys.2016.00104CrossRefPubMedPubMedCentral

47.

Pile V, Lau JYF, Topor M, Hedderly T, Robinson S (2018) Interoceptive accuracy in youth with tic disorders: exploring links with premonitory urge, anxiety and quality of life. J Autism Dev Disord 48(10):3474–3482. https://doi.org/10.1007/s10803-018-3608-8CrossRefPubMedPubMedCentral

48.

Ravindran A, Richter M, Jain T, Ravindran L, Rector N, Farb N (2019) Functional connectivity in obsessive-compulsive disorder and its subtypes. Psychol Med 50(7):1173–1181. https://doi.org/10.1017/s0033291719001090CrossRefPubMed

49.

Reese HE, Scahill L, Peterson AL, Crowe K, Woods DW, Piacentini J, Wilhelm S (2014) The premonitory urge to tic: measurement, characteristics, and correlates in older adolescents and adults. Behav Ther 45(2):177–186. https://doi.org/10.1016/j.beth.2013.09.002CrossRefPubMed

50.

Ren J, Wang H (2023) Chapter 4 - Network analysis. Elsevier. https://doi.org/10.1016/B978-0-44-318679-0.00010-7CrossRef

51.

Rizzo R, Gulisano M, Pellico A, Cali PV, Curatolo P (2014) Tourette syndrome and comorbid conditions: a spectrum of different severities and complexities. J Child Neurol 29(10):1383–1389. https://doi.org/10.1177/0883073814534317CrossRefPubMed

52.

Rothenberger A, Roessner V (2019) Psychopharmacotherapy of Obsessive-Compulsive symptoms within the framework of tourette syndrome. Curr Neuropharmacol 17(8):703–709. https://doi.org/10.2174/1570159x16666180828095131CrossRefPubMedPubMedCentral

53.

Rousseaux GC, Gad CS (2013) Haschek and Rousseaux’s Handbook of Toxicologic Pathology (Third Edition) (Vol. II). Academic Press. https://doi.org/10.1016/B978-0-12-415759-0.00030-3

54.

Rozenman M, Johnson OE, Chang SW, Woods DW, Walkup JT, Wilhelm S, Piacentini J (2015) Relationships between premonitory urge and anxiety in youth with chronic tic disorders. Child Health Care 44(3):235–248. https://doi.org/10.1080/02739615.2014.986328CrossRefPubMed

55.

Sambrani T, Jakubovski E, Muller-Vahl KR (2016) New insights into clinical characteristics of Gilles de La tourette syndrome: findings in 1032 patients from a single German center. Front Neurosci 10:415. https://doi.org/10.3389/fnins.2016.00415CrossRefPubMedPubMedCentral

56.

Scahill LD, Leckman JF, Marek KL (1995) Sensory phenomena in tourette’s syndrome. Adv Neurol 65:273–280PubMed

57.

Shavitt RG, Mathis MA, Oki F (2014) Phenomenology of OCD: lessons from a large multicenter study and implications for ICD-11. J Psychiatr Res 57:141–148. https://doi.org/10.1016/j.jpsychires.2014.06.010CrossRefPubMedPubMedCentral

58.

Steinberg T, Shmuel Baruch S, Harush A, Dar R, Woods D, Piacentini J, Apter A (2009) Tic disorders and the premonitory urge. J Neural Transm 117(2):277–284. https://doi.org/10.1007/s00702-009-0353-3CrossRefPubMed

59.

Storch EA, Murphy TK, Geffken GR, Sajid M, Allen P, Roberti JW, Goodman WK (2005) Reliability and validity of the Yale global tic severity scale. Psychol Assess 17(4):486–491. https://doi.org/10.1037/1040-3590.17.4.486CrossRefPubMed

60.

Storch EA, Murphy TK, Geffken GR, Soto O, Sajid M, Allen P, Goodman WK (2004) Psychometric evaluation of the children’s Yale–Brown Obsessive-Compulsive scale. Psychiatry Res 129(1):91–98. https://doi.org/10.1016/j.psychres.2004.06.009CrossRefPubMed

61.

Su MT, McFarlane F, Cavanna AE, Termine C, Murray I, Heidemeyer L, Murphy T (2017) The english version of the Gilles de La tourette Syndrome-Quality of life scale for children and adolescents (C&A-GTS-QOL). J Child Neurol 32(1):76–83. https://doi.org/10.1177/0883073816670083CrossRefPubMed

62.

Wen F, Gu Y, Yan J, Liu J, Wang F, Yu L, Cui Y (2021) Revisiting the structure of the Yale global tic severity scale (YGTSS) in a sample of Chinese children with tic disorders. BMC Psychiatry. https://doi.org/10.1186/s12888-021-03399-5CrossRefPubMedPubMedCentral

63.

Wickham H (2016) ggplot2: elegant graphics for data analysis. Springer. https://ggplot2.tidyverse.org

64.

Woods DW, Piacentini J, Himle MB, Chang S (2005) Premonitory urge for tics scale (PUTS): initial psychometric results and examination of the premonitory urge phenomenon in youths with tic disorders. J Dev Behav Pediatrics: JDBP 26(6):397–403CrossRef

65.

Yan J, Gu Y, Wang M, Cui Y, Li Y (2022) The Obsessive-Compulsive symptoms in tic disorders and the psychometric properties of children’s Yale-Brown Obsessive-Compulsive scale: an Evidence-Based survey in a Chinese sample. Front Pediatr 10:794188. https://doi.org/10.3389/fped.2022.794188CrossRefPubMedPubMedCentral

66.

Yang K, Wang X, Hu S, Li Y, Lei T, Li Y, Cui Y (2024) The psychometric properties of Chinese version of the Gilles de La tourette syndrome-quality of life scale (GTS-QOL) for children and adolescents. BMC Psychiatry. https://doi.org/10.1186/s12888-024-06149-5CrossRefPubMedPubMedCentral

67.

Zhang P, Wang L, Zhou Q, Dong X, Guo Y, Wang P, Sun C (2023) A network analysis of anxiety and depression symptoms in Chinese disabled elderly. J Affect Disord 333:535–542. https://doi.org/10.1016/j.jad.2023.04.065CrossRefPubMed

68.

Zheng S, He A, Yu Y, Jiang L, Liang J, Wang P (2021) Research trends and hotspots of health-related quality of life: a bibliometric analysis from 2000 to 2019. Health Qual Life Outcomes 19(1):130. https://doi.org/10.1186/s12955-021-01767-zCrossRefPubMedPubMedCentral

Titel: Network Analysis of Premonitory Urges, Tic Symptoms, Obsessive-Compulsive Symptoms, and Quality of Life in Drug-Naïve Children and Adolescents with Tic Disorder
Auteurs: Xianbin Wang
Xu Hong
Yihan Ma
Hui Xu
Liping Yu
Wenyan Zhang
Zhongliang Jiang
Yonghua Cui
Ying Li
Publicatiedatum: 16-04-2025
Uitgeverij: Springer US
Gepubliceerd in: Child Psychiatry & Human Development
Print ISSN: 0009-398X
Elektronisch ISSN: 1573-3327
DOI: https://doi.org/10.1007/s10578-025-01838-y

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Network Analysis of Premonitory Urges, Tic Symptoms, Obsessive-Compulsive Symptoms, and Quality of Life in Drug-Naïve Children and Adolescents with Tic Disorder

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