title: Temporal course of the tourette syndrome clinical triad.
abstract: BACKGROUND
  Tourette syndrome (TS) is a disorder characterized by childhood onset of motor and phonic tics, often with improvement of tic symptoms by young adult years. The temporal course of tics and commonly comorbid behavioral symptoms is still not well characterized.
  
  
  METHODS
  In order to clarify the time course of tics and comorbid attention deficit hyperactivity disorder (ADHD) or obsessive compulsive disorder (OCD) in TS, we administered a brief survey regarding the course of symptoms at a single point in time to 53 TS patients aged 13-31 years.
  
  
  RESULTS
  Mean age (±SD) at symptom onset was 7.9 (±3.6) years for tics, 7.9 (±3.5) for ADHD, and 9.2 (±5.0) for OCD. Age at peak symptom severity was 12.3 (±4.6) years for tics, 10.8 (±3.8) for ADHD, and 12.6 (±5.5) for OCD. Tics, ADHD, and OCD were reported to be no longer present in 32.0%, 22.8%, and 21.0% of subjects, respectively. Decline in symptom severity began at age 14.7 (±3.7) years for tics, 13.9 (±2.9) for ADHD, and 15.1 (±5.0) for OCD. Remission of symptoms occurred at age 17.4 (±3.8) years for tics, 17.4 (±1.3) for ADHD, and 15.6 (±2.3) for OCD.
  
  
  CONCLUSIONS
  Our data confirm and expand previously reported TS spectrum symptom milestones and may guide design of future research aimed at improving the course of TS.
authors.affiliation: Department of Neurology, University of Utah, Salt Lake City, UT, USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Shprecher
authors.affiliation: Department of Anesthesiology, Harvard School of Medicine, Boston, MA, USA.
authors.forename: Lindsay A
authors.initials: LA
authors.lastname: Rubenstein
authors.affiliation: Department of Neurology, University of Utah, Salt Lake City, UT, USA.
authors.forename: Keenan
authors.initials: K
authors.lastname: Gannon
authors.affiliation: Department of Neurology, Boston University, Boston, MA, USA.
authors.forename: Samuel A
authors.initials: SA
authors.lastname: Frank
authors.affiliation: Atlantic Neuroscience Institute, Overlook Medical Center, Summit, NJ, USA.
authors.forename: Roger
authors.initials: R
authors.lastname: Kurlan
keywords: Tourette; attention deficit hyperactivity disorder; obsessive compulsive disorder; tic