Tamara Pringsheim

The University of Calgary | HBI · Department of Medicine

Background: In 2020, health professionals witnessed a dramatic increase in referrals of young people with rapid onset of severe tic-like behaviours. We assembled a working group to develop criteria for the clinical diagnosis of functional tic-like behaviours (FTLB) to help neurologists, pediatricians, psychiatrists and psychologists recognize and...

There has been an increasing recognition among both medical and psychological professionals, as well as the public media, of a concerning trend for child and adolescent users of audiovisual-based, algorithmic social media platforms (e.g., TikTok) to present with or claim functional psychiatric impairment that is inconsistent with or distinct from c...

The incidence and prevalence of Huntington's disease (HD) based on a systematic review and meta‐analysis of 20 studies published from 1985 to 2010 was estimated at 0.38 per 100,000 person‐years (95% confidence interval [CI], 0.16–0.94) and 2.71 per 100,000 persons (95% CI, 1.55–4.72), respectively. Since 2010, there have been many new epidemiologic...

Background: There is currently very limited data related to transition services for movement disorders. Objectives: Movement Disorders Society (MDS) Task Force on Pediatrics conducted a survey of current provision of transition for young adults with movement disorders. Methods: The survey questionnaire was based on review of available evidence...

During the COVID-19 pandemic, several countries have observed an unexpected increase in the number of adolescents and young adults presenting with rapid onset functional tic-like behaviours after being exposed to social media content of others displaying a similar pattern of functional tics. Many of these patients have been referred to Movement Dis...

Background: A systematic review of epidemiological studies of primary dystonia from 1985 and 2010 found an overall prevalence of 16.43 per 100,000 (95% CI = 12.09-22.32). Methods: We performed a systematic review of studies from 2010 and 2022 to determine if there are important differences in epidemiology between these time periods. Results: N...

Background and Purpose The prognosis of rapid onset functional tic‐like behaviors (FTLBs) is unknown. This prospective cohort study describes the course and treatment of rapid onset FTLBs in adolescents (n = 20) and adults (n = 9) previously reported in two case series. Methods Yale Global Tic Severity Scale (YGTSS) scores were compared between fi...

Introduction Les tics sont moins fréquents chez les adultes que chez les enfants. Leur répartition et spécificité selon le sexe, et les comorbidités associées sont peu connues dans cette tranche d’âge. Objectifs Caractériser la relation entre la sévérité des tics et la gêne ressentie chez les femmes par rapport aux hommes; évaluer et standardiser...

This chapter discusses the use of the alpha-2 adrenergic agonists, clonidine and guanfacine, for the treatment of Tourette syndrome. A review of the pharmacology of alpha agonists and their possible mechanism of action in Tourette syndrome is provided, as well as discussion of the pharmacoepidemiological data on their use for this disorder. A criti...

Introduction Tourette’s syndrome (TS) affects approximately 1% of children. This study will determine the efficacy and safety of paired comprehensive behavioural intervention for tics (CBIT) plus repetitive transcranial magnetic stimulation (rTMS) treatment in children with Tourette’s syndrome. We hypothesise that CBIT and active rTMS to the supple...

Background and aim Clinical centres have seen an increase in tic-like movements during the COVID-19 pandemic. A series of children and adolescents are described. Methods A retrospective chart review of 34 consecutive paediatric patients presenting with sudden onset tic-like movements, seen over 6 months. Results 94% of patients were female, with...

Background and Objectives To review the current evidence on the options available for initiating dopaminergic treatment of motor symptoms in early-stage Parkinson disease and provide recommendations to clinicians. Methods A multidisciplinary panel developed practice recommendations, integrating findings from a systematic review and following an In...

Background: Tic disorders belong to the broad spectrum of pediatric and adult movement disorders. The wide variability in clinical presentations, applied assessment tools, and treatments are poorly understood. Objectives: To map practices and knowledge base of movement disorder clinicians concerning clinical features, pathophysiology, and treatm...

Aim To investigate sex-related differences in tic severity, tic-related impairments, and psychiatric comorbidities in childhood. Method In this cross-sectional study, tic severity/impairment and demographic factors were collected from 270 children and young people (aged 5–17y, mean 10y 6mo, SD 3y 4mo; 212 males and 58 females) with a tic disorder...

Background: Tic disorders may reflect impaired inhibitory control. This has been evaluated using different behavioural tasks, yielding mixed results. Our objective was to test inhibitory control in children with tics through simultaneous presentation of multiple, mobile stimuli. Methods: Sixty-four children with tics (mean age 12.4 years; 7.5-18...

Background: Clinicians have reported an increase in functional tic-like behaviours in children and youth during the COVID-19 pandemic. We describe adults developing rapid onset of functional tic-like behaviours between May 2020 and June 2021. Methods: Data were analysed from the Adult Tic Disorders Registry, a single-site,12-month prospective co...

Background Tourette syndrome and OCD are disorders that frequently occur in children and cause a high level of disability. In Alberta there is a huge delivery gap in providing healthcare services for children with TS and OCD. A stakeholder consultation was performed to ascertain how service delivery could be improved across the province and to info...

The purpose of this study was to examine associations between physical activity, sleep and symptom severity in children with tic disorders. Children with tic disorders wore the GeneActiv device, a wrist-worn accelerometer that measures physical activity intensity and sleep/wake parameters continuously for seven days, and completed questionnaires on...

Introduction There is a diverse body of evidence investigating non-pharmacological treatment options for apathy in Parkinson’s disease (PD). We aimed to better understand the context and mechanisms by which non-pharmacological interventions may improve apathy in persons with PD. Methods We conducted a realist review of the body of evidence investi...

Disruptive behaviour disorders (DBDs)—which can include or be comorbid with disorders such as attention-deficit hyperactivity disorder, oppositional defiant disorder, conduct disorder and disruptive mood dysregulation disorder—are commonly seen in paediatric practice. Given increases in the prescribing of atypical antipsychotics for children and yo...

Adult onset idiopathic dystonia (AOID) is the third most common movement disorder in adults. Co-existing depressive symptoms and disorders represent major contributors of disability and quality of life in these patients, but their prevalence remains unclear. We investigated the point prevalence of supra-clinical threshold depressive symptoms/depres...

Aim To explore the feasibility and possible effects of low‐frequency repetitive transcranial magnetic stimulation (rTMS) delivered to the supplementary motor area (SMA) on tic severity and motor system neurophysiology in children with Tourette syndrome. Method Ten children with Tourette syndrome (eight males, two females; 9–15y) participated in th...

Sensory phenomena (premonitory sensations/urges) are associated with tics. Noisier afferent signals may underlie tic disorders, possibly affecting proprioception. We compared 64 children with Tourette syndrome or chronic motor tic disorder with 155 typically developing controls in arm‐position matching using a robotic exoskeleton (Kinarm). Passive...

Purpose of the Review The need to develop novel pharmacological approaches for TS is balanced by the necessity for interventions to be safe and tolerable. This review provides an overview of studies of medications for TS over the last 3 years. Recent Findings Four studies of deutetrabenazine and valbenazine in TS failed in their primary outcomes....

Purpose of Review Tourette’s syndrome (TS), a neurodevelopmental disorder characterized by persistent motor and vocal tics, is understood to be a genetic disorder with a complex pattern of inheritance and a high degree of heritability. Nonetheless, adversity during pregnancy and early life has been associated with the onset of TS. Understanding the...

Childhood‐onset movement disorders represent a heterogenous group of conditions. Given the complexity of these disorders, the transition of care from pediatric to adult medicine is an important consideration. We performed a scoping review of the literature on transitional care in chronic neurological disease, exploring key transitional issues and p...

Objective: To conduct a scoping review of the literature on apathy in Parkinson's disease (PD), to better understand how apathy in Parkinson's disease is diagnosed, treated and managed. Methods: MEDLINE, Embase, PsycINFO, CINAHL, Cochrane Central Register of Control Trials and Cochrane Database of Systematic Reviews were searched to 17 May 2017....

Background: Anxiety and depression are common, disabling comorbidities in CD, and may predispose to social withdrawal and social cognitive impairments. The relationship between social cognition and depressive/anxiety symptoms in CD is under-investigated. Methods: Forty-six CD patients (40 women; mean±SD age, 55.57±10.84 years) were administered...

Background: Aggressive and disruptive behaviours are frequently observed in children. Short-term use of antipsychotics with monitoring for adverse effects is recommended when first-line interventions fail (e.g. psychosocial therapies and psychostimulants for ADHD). This study aimed to understand the barriers and facilitators to behavioural change...

Self-injurious behaviours (SIBs) are defined as deliberate, repetitive and persistent behaviours that are directed towards the body and lead to physical injury and are not associated with sexual arousal and without suicidal intent. In movement disorders, SIBs are typically associated with tic disorders, most commonly Tourette syndrome, and neuromet...

Introduction: Converging evidence from both clinical and experimental studies has shown that Tourette syndrome (TS) is not a unitary condition, but a cluster of multiple phenotypes, which encompass both tics and specific behavioural and cognitive symptoms (mainly attention-deficit and hyperactivity disorder and obsessive-compulsive disorder). Metho...

Introduction: Though many unanswered questions about the pathophysiology of Tourette Syndrome remain, several pharmacotherapies for tics have been studied, with varying results in terms of efficacy and the strength of evidence. Areas covered: This literature review encompasses pharmacotherapies for tics. The pharmacotherapies discussed in this revi...

A cross sectional study was performed in a tertiary pediatric movement disorders clinic. Ten consecutive patients with essential tremor(ET) were assessed. Clinical evaluation was performed utilizing the Tremor Rating Scale (TRS). Subsequently, triaxial accelerometers were placed equidistantly at the dorsum of the hands and arms, the recording was d...

Objective: To review pharmacologic and nonpharmacologic strategies for treating sleep disturbances in children and adolescents with autism spectrum disorder (ASD) and to develop recommendations for addressing sleep disturbance in this population. Methods: The guideline panel followed the American Academy of Neurology 2011 guideline development p...

Purpose With the recent legalization of cannabis for nonmedicinal purposes in Canada, it is becoming increasingly important to understand the potential mental health risks that cannabis may present. The objective of this study was to estimate associations between the frequency of cannabis use and the presence of elevated internalizing (e.g., anxiet...

Objective: Few studies have longitudinally followed trends in antidepressant prescribing for Canadian children following the Black Box warning issued in 2004. Using a national data source, we aim to describe trends in antidepressant recommendations for Canadian children ages 1-18 during 2012 to 2016. Methods: A database called the Canadian Disease...

Abstract available at: https://www.mdsabstracts.org/abstract/cerebellar-brain-inhibition-and-cervical-dystonia-exploring-clinico-electrophysiological-associations/

Objective: To provide evidence-based recommendations for the acute symptomatic treatment of children and adolescents with migraine. Methods: We performed a systematic review of the literature and rated risk of bias of included studies according to the American Academy of Neurology classification of evidence criteria. A multidisciplinary panel de...

Objective: To provide updated evidence-based recommendations for migraine prevention using pharmacologic treatment with or without cognitive behavioral therapy in the pediatric population. Methods: The authors systematically reviewed literature from January 2003 to August 2017 and developed practice recommendations using the American Academy of...

Objective: To provide evidence-based recommendations for the acute symptomatic treatment of children and adolescents with migraine. Methods: We performed a systematic review of the literature and rated risk of bias of included studies according to the American Academy of Neurology classification of evidence criteria. A multidisciplinary panel de...

Objective: To provide updated evidence-based recommendations for migraine prevention using pharmacologic treatment with or without cognitive behavioral therapy in the pediatric population. Methods: The authors systematically reviewed literature from January 2003 to August 2017 and developed practice recommendations using the American Academy of...

Objective: The goal of this study was to characterize the frequency and trends of psychotropic drug prescribing in Canadian children from 2010 to 2016 and to compare these results with a previous study conducted between 2005 and 2009. Methods: Using a national physician panel survey database from IQVIA Canada, aggregated frequencies of written pre...

Background: Trends in the use of antipsychotics and alpha agonists for the treatment of tic disorders in Canadian children, and how closely these trends align with evidence-based guidelines on the pharmacotherapy of tic disorders, have not been explored. Methods: IQVIA's Canadian Disease and Therapeutic Index, a survey-based data set, was used t...

Introduction Tourette syndrome is a common childhood-onset neuropsychiatric disorder, with tics that wax and wane in frequency and severity over time. The purpose of the proposed scoping review is to map the types of evidence available pertaining to the effect of diet, sleep and exercise on tic severity and identify key concepts and gaps in researc...

Objective: To make recommendations on the assessment and management of tics in people with Tourette syndrome and chronic tic disorders. Methods: A multidisciplinary panel consisting of 9 physicians, 2 psychologists, and 2 patient representatives developed practice recommendations, integrating findings from a systematic review and following an In...

Objective: To systematically evaluate the efficacy of treatments for tics and the risks associated with their use. Methods: This project followed the methodologies outlined in the 2011 edition of the American Academy of Neurology's guideline development process manual. We included systematic reviews and randomized controlled trials on the treatm...

Introduction Anxiety is a common symptom for those experiencing dementia and is associated with worse outcomes. The aim of the study was to examine which anxiety tools have been validated compared with a gold standard diagnostic criterion in persons with dementia. Methods We completed a systematic review of the literature, which was registered a p...

Objective: The aim of this qualitative study was to explore the decisional needs of parents of children with ADHD and disruptive and aggressive behaviour to inform the creation of a patient decision aid. Method: A one-day meeting of researchers, community advocacy partners, and 11 parents of children (age range eight to 21) with aggressive and d...

Background:: Tardive dyskinesia is a movement disorder characterised by irregular, stereotyped, and choreiform movements associated with the use of antipsychotic medication. We aim to provide recommendations on the treatment of tardive dyskinesia. Methods:: We performed a systematic review of studies of the treatment of tardive dyskinesia. Studi...

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Background Hydrocephalus is a debilitating disorder, affecting all age groups. Evaluation of its global epidemiology is required for healthcare planning and resource allocation. Objectives To define age-specific global prevalence and incidence of hydrocephalus. Methods Population-based studies reporting prevalence of hydrocephalus were identified...

Checklist items with corresponding page numbers for the PRISMA (2009) guidelines. (DOC)

Citations in non-English or French language that were excluded during abstract reviews. (DOCX)

Search criteria for MEDLINE, EMBASE, Cochrane and Google Scholar databases. (PDF)

Data extraction form for systematic review. (PDF)

R script for generating world map shaded by continent with the prevalence of hydrocephalus in the pediatric and elderly populations[66]. (PDF)

Introduction: Antipsychotic use in children has increased over the past two decades. Randomized controlled trials have evaluated the efficacy of antipsychotics in autism spectrum disorder (ASD) and disruptive behavior disorders (DBD). Areas covered: The authors systematically analyze the results of randomized controlled trials of second and third g...

The objective of this study was to provide epidemiological data regarding obsessive compulsive disorder (OCD) in Canada, and examine related conditions, childhood experiences and healthcare utilization. A Statistics Canada population-based health survey was utilized (N = 25,097). The prevalence of diagnosed OCD in Canada was 0.93% (95% CI 0.75-1.11...

Background: Use of second-generation antipsychotics (SGA) has increased in recent years; however, their use and effect on metabolic outcomes has been poorly characterised in population-level studies.AimsThis study aimed to determine the associations between SGA use and metabolic indicators in a general population. Method: We used data from the C...

Background: This is an update of the original Cochrane Review published in Issue 4, 2011.Attention deficit hyperactivity disorder (ADHD) is the most prevalent of the comorbid psychiatric disorders that complicate tic disorders. Medications commonly used to treat ADHD symptoms include stimulants such as methylphenidate and amphetamine; non-stimulan...

Basic examination and diagnostic skills in neurology are important for every graduating medical student. However, a majority of medical students consider neurology as complex and difficult to master. We evaluate the impact a learner-friendly, innovative simulation-based training programme has on long-term retention and delayed recall of neurologica...

Movement disorders associated with antipsychotic medications are relatively common, stigmatising, and potentially disabling. Their prevalence in people with psychosis who are prescribed second-generation antipsychotics (SGAs) is uncertain, as is their level of recognition by clinicinas. We conducted meta-analyses of randomised controlled trials inc...

Background: Quetiapine is an antipsychotic that is widely prescribed off-label by family physicians despite evidence that safer alternatives exist. The aim of this research was to explore, in-depth, family physicians' reasons for this behaviour. Methods: We conducted qualitative interviews with 15 urban family physicians in Alberta between Octob...

Objective: To develop recommendations for disease-modifying therapy (DMT) for multiple sclerosis (MS). Methods: A multidisciplinary panel developed DMT recommendations, integrating findings from a systematic review; followed an Institute of Medicine-compliant process to ensure transparency and patient engagement; and developed modified Delphi co...

Objective: To review evidence on starting, switching, and stopping disease-modifying therapies (DMTs) for multiple sclerosis (MS) in clinically isolated syndrome (CIS), relapsing-remitting MS (RRMS), and progressive MS forms. Methods: Relevant, peer-reviewed research articles, systematic reviews, and abstracts were identified (MEDLINE, CENTRAL,...

Background: Akathisia is a common and distressing neuropsychiatric syndrome associated with antipsychotic medication, characterised by subjective and objective psychomotor restlessness. The goal of this guideline is to provide clinicians with recommendations on the assessment and treatment of akathisia. Methods: We performed a systematic review...