Objective: To evaluate 1) the types of tics undergoing CBIT at an expert movement disorders center and 2) to evaluate the response of each tic phenotype to CBIT by utilizing a tic hierarchy questionnaire.

Background: CBIT has been shown in multiple RCTs to significantly improve motor and vocal tic control in patients with Tourette syndrome. A possible differential response to CBIT by tic phenotype has not been extensively investigated.

Methods: We conducted a retrospective analysis of our tertiary referral center’s Tourette syndrome population undergoing CBIT. We excluded patients with two or less treatment visits. The patient and/or the parent completed a tic hierarchy questionnaire at the initial visit and the final visit during a CBIT session. Each patient had a 10-session CBIT goal.

Results: There were 30 patients with a mean age of 19.4 (SD 12.5) years and a mean number of visits of 6.4 (SD 1.9). All tic phenotypes were assessed but only the following tics revealed a statistically significant improvement with CBIT: darting eyes, facial grimace, head forward, throwing head back, shrugging shoulders, quick flexion/extension of arms and stimulus dependent tics. There was no correlation between the age or number of visits and the treatment response.

Conclusions: Our data suggest that CBIT may have a differential effect and more positive effect on tics with head and proximal upper extremity involvement. Larger and prospective studies will be needed as well as a more careful characterization of the pre-monitory urge component.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/do-different-tic-phenotypes-have-different-responses-to-comprehensive-behavioral-intervention-for-tics-cbit/