Neurocognitive predictors of treatment response to randomized treatment in adults with tic disorders.
Neurocognitive predictors of treatment response to randomized treatment in adults with tic disorders.
复制标题
患有抽动障碍的成人对随机治疗的治疗反应的神经认知预测因子。
DOI：
10.1016/j.pnpbp.2016.11.002
复制
发表时间：
2017-03-06
影响因子：
5.6
通讯作者：
Wilhelm S
中科院分区：
文献类型：
--
作者：
Abramovitch A;Hallion LS;Reese HE;Woods DW;Peterson A;Walkup JT;Piacentini J;Scahill L;Deckersbach T;Wilhelm S
抽动秽语障碍（TS）和慢性抽动障碍（CTD）是以不自主发声和运动抽动为特征的神经发育障碍。因此，TS/CTD已被概念化为认知和运动抑制控制障碍。然而，大多数神经认知研究发现TS/CTD个体的抑制能力与健康对照相当或上级。这些发现导致了这样的假设，即TS/CTD患者由于持续需要抑制抽搐而产生了更强的抑制控制。然而，认知控制在TS/CTD中的作用尚不清楚，特别是在成年人中。为了研究抑制控制在TS/CTD中的作用，本研究通过评估TS/CTD成人大样本中抑制控制和治疗反应之间的关系来研究这种关联。作为一项比较行为疗法与支持性心理疗法治疗TS/CTD的大型随机试验的一部分，对122名基线期TS/CTD成人进行了一系列测试，包括抑制控制测试。我们评估了神经心理学测试表现与症状严重程度变化之间的相关性，并比较了临床总体印象量表定义的治疗应答者和无应答者的表现。结果表明，无论治疗类型如何，症状和治疗反应的变化与抑制控制、智力或运动功能测试的神经心理学表现无关。TS/CTD患者症状严重程度的显著变化与抑制控制的损害或变化无关，无论治疗类型如何，这一发现表明抑制控制可能不是成人这些疾病的临床相关方面。
Tourette’s disorder (TS) and chronic tic disorder (CTD) are neurodevelopmental disorders characterized by involuntary vocal and motor tics. Consequently, TS/CTD have been conceptualized as disorders of cognitive and motor inhibitory control. However, most neurocognitive studies have found comparable or superior inhibitory capacity among individuals with TS/CTD relative to healthy controls. These findings have led to the hypothesis that individuals with TS/CTD develop increased inhibitory control due to the constant need to inhibit tics. However, the role of cognitive control in TS/CTD is not yet understood, particularly in adults. To examine the role of inhibitory control in TS/CTD, the present study investigated this association by assessing the relationship between inhibitory control and treatment response in a large sample of adults with TS/CTD. As part of a large randomized trial comparing behavior therapy versus supportive psychotherapy for TS/CTD, a battery of tests, including tests of inhibitory control was administered to 122 adults with TS/CTD at baseline. We assessed the association between neuropsychological test performance and change in symptom severity, as well as compared the performance of treatment responders and non-responders as defined by the Clinical Global Impression Scale. Results indicated that change in symptoms, and treatment response were not associated with neuropsychological performance on tests of inhibitory control, intellectual ability, or motor function, regardless of type of treatment. The finding that significant change in symptom severity of TS/CTD patients is not associated with impairment or change in inhibitory control regardless of treatment type suggests that inhibitory control may not be a clinically relevant facet of these disorders in adults.