Objective: The aim of this study was to compare characteristics and severity of tics in patients with Gilles de la Tourette Syndrome (GTS) and comorbid Autism Spectrum Disorder (ASD) to patients without ASD diagnosis.

Background: ASD is one of comorbidities in patients with GTS. It is characterized by persistent deficits in social communication and social interaction with restricted and repetitive patterns of behaviour, interests or activities. The prevalence of ASD in patients with GTS ranges from about 3% to 20%.

Method: We performed a one-time registration study in a cohort of 390 consecutive patients with GTS aged 5–66 years (mean age 16.0±9.5, 292 males, 255 children). Duration of GTS was 8.7±7.6 years. All patients were personally interviewed and examined. The diagnosis of ASD was in each case made prior to our evaluation in specialized centers dedicated to ASD diagnosis by psychiatrists experienced in the field of ASD. All patients were assessed using Yale Global Tic Severity Scale (YGTSS) and the statistical analysis of obtained results was performed.

Results: Statistical analysis of 5 dimensions of YGTSS (number, frequency, intensity, complexity, and interference) related to motor and phonic tics showed a significantly higher score for complexity of motor tics (p=0.002) and frequency (p=0.036), intensity (p=0.013), complexity (p=0.011), and interference (p=0.022) of vocal tics in patients with GTS and comorbid ASD compared to patients with GTS only. A statistical analysis of total scores on YGTSS was also performed. Patients with a dual diagnosis of GTS and ASD had a significantly higher total scores on YGTSS compared to patients with GTS without comorbid ASD: total motor tic score (Me 18 vs 14; Q1-Q3 14-19 vs 11-18; p=0.003), total phonic tic score (Me 13.5 vs 10; Q1-Q3 9-19 vs 6-14; p=0.002), impairment score (Me 30 vs 20; Q1-Q3 20-35 vs 10-30; p=0.001), total Yale Global Tic Severity Score (Me 57.5 vs 42; Q1-Q3 45-75 vs 26-61; p<0.001).

Conclusion: Patients with dual diagnosis of GTS and ASD have more severe tics which cause significant impairment of daily living. Such GTS patients require clinicians’ special attention not only due to the presence of ASD symptoms but also because of the more severe course of GTS itself.

Previously presented at: 13th European Conference on Tourette Syndrome & Tic Disorders; 01.-02.10.2021; ePoster

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-severity-of-tics-in-patients-with-gilles-de-la-tourette-syndrome-and-comorbid-autism-spectrum-disorder/