Fractality as a quantitative assessment tool for tic disorders and functional tic-like behaviors

分形作为抽动障碍和功能性抽动样行为的定量评估工具

基本信息

批准号：
10728174
负责人：
KEVIN J BLACK
金额：
$ 42.76万
依托单位：
WASHINGTON UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-08-15 至 2025-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10728174
关键词：
6 year old Affect Age Assessment tool Behavior Black Populations Characteristics Child Childhood Chronic Clinical Clinical Research Clinical Treatment Complex Data Set Deep Brain Stimulation Development Diagnosis Dimensions Disease Epidemiology Etiology Face Fractals Frequencies Functional disorder Future Gilles de la Tourette syndrome Goals Head High Prevalence Individual International Lead Measures Methods Modeling Motor Tics Movement Movement Disorders Natural History Neck Neurologic Symptoms Patient Care Patients Pattern Periodicity Persons Pharyngeal structure Physics Procedures Publications Research Resistance Resolution Risk Factors Sampling Schools Series Severities Students Symptoms Teenagers Testing Therapeutic Tic disorder Time Training Video Recording Visit Vocal Tics Waxes blind boys clinical diagnosis clinical encounter clinical practice comorbidity demographics emerging adult experience follow-up improved patient subsets phenomenological models risk sharing tic suppression tic-like movements vocalization young adult

项目摘要

Project summary The natural history of tics is characterized by a high prevalence in boys, with onset around around 4‒6 years of age. The initial tic symptoms are usually simple motor tics affecting the face, head, and neck. The first vocal tic occurs on average a few years later, and is usually a simple vocal tic such as throat clearing or sniffing. If the tics persist more than a year, the severity usually peaks around the age of 8 to 12 years. Most individuals with tics undergo significant improvement or complete resolution before early adulthood. Recently, while tics in patients with Tourette syndrome (TS) have been increasing rapidly, a different pattern has also been observed. Some teenagers and young adults have experienced sudden onset of complex tic-like movements and vocalizations. These patients differ significantly on several other features as well, and such distinct tic-like behavior is now referred to as functional neurological symptom disorder with tics, or functional tic-like behavior (FTLB). However, differentiating FTLB from typical tics is still challenging, and diagnosis and treatment are important issues under active study in numerous centers worldwide. Tic disorders are distinguished from other movement disorders not only by the phenomenology of individual tics, but also by the timing of tics: they are neither rhythmic nor completely unpredictable. Rather, tics tend to occur in clusters (several tic attacks within a few seconds, followed by an extended period of tic-free time). On longer time scales, several bouts of tics may be followed by a relatively tic-free period with repeated episodes grouped over minutes, and patients often describe a similar pattern over days or weeks. Based on this self- similarity over different time scales, fractal timing of tics in TS was demonstrated over 20 years ago, and we recently extended those results to both Provisional Tic Disorder and TS, applying a model from physics to measure fractal dimension (Df) in relatively brief data sets (5 minutes). The Df of the tic time series correlates with the tic severity, suggesting that Df may be useful as an objective indicator of tic severity. We hypothesized that the fractal dimension Df of tics may distinguish FTLB from typical tics. Specifically, FTLB may not show a fractal pattern, or the quantitatively measured fractal dimension may differ from that of typical tics. The objective of this proposal is to investigate Df with the following specific aim: Df will be computed from video samples of tics or FTLB, blind to diagnosis, contributed locally and from collaborators worldwide, and compared to test this hypothesis. The long-term goal is to find an objective measure that distinguishes FLTB from tic disorders, and if Df can be successfully demonstrated to differ between the two, future studies could look at comorbidities, treatment, and how they change when healthy individuals mimic tics.

项目概要抽动症自然史的特点是男孩发病率高，发病时间约为 4-6 岁。最初的抽动症状通常是影响面部、头部和颈部的简单运动抽动。平均发生在几年后，通常是简单的声音抽动，例如清喉咙或抽鼻子。抽动持续一年以上，严重程度通常在 8 至 12 岁左右达到顶峰。最近，抽动症在成年早期之前经历了显着改善或完全缓解。抽动秽语综合征（TS）患者数量迅速增加，但也观察到了不同的模式。一些青少年和年轻人突然出现复杂的抽动样运动，并且这些患者的发声在其他几个特征上也存在显着差异，并且具有明显的抽动样特征。行为现在被称为伴有抽动的神经症状障碍，或功能性抽动样行为 (FTLB) 然而，区分 FTLB 和典型抽动仍然具有挑战性，诊断和治疗也很困难。世界各地许多中心正在积极研究的重要问题。抽动障碍与其他运动障碍的区别不仅在于个体的现象学抽动，还取决于抽动的时间：抽动既不是有节奏的，也不是完全不可预测的。成群发生（几秒钟内几次抽动发作，随后是较长一段无抽动时间）。在更长的时间范围内，几次抽动之后可能会出现一段相对无抽动的时期，但会反复发作在几分钟内进行分组，并且患者经常根据这种自我描述在几天或几周内描述类似的模式。不同时间尺度上的相似性，20 多年前就已经证明了 TS 中抽动的分形时间，并且我们最近将这些结果扩展到临时抽动障碍和 TS，应用物理学模型在相对简短的数据集中（5 分钟）测量分形维数 (Df)。抽动时间序列的 Df 相关。与抽动严重程度的关系，表明 Df 可作为抽动严重程度的客观指标。我们发现抽动的分形维数 Df 可以将 FTLB 与典型抽动区分开来。可能不显示分形图案，或者定量测量的分形维数可能与典型的分形维数不同该提案的目标是研究 Df，其具体目标如下：Df 将根据以下公式计算。抽动症或 FTLB 的视频样本，无视诊断，由本地和世界各地的合作者提供，以及长期目标是找到区分 FLTB 的客观衡量标准。抽动障碍，如果 Df 能够成功证明两者之间存在差异，未来的研究可能研究合并症、治疗方法，以及当健康人模仿抽动时它们如何变化。