Highlights within the highlights
Highlights within the highlights include new treatments for tics that have not yet made it into the clinic but offer hope they will. One includes median nerve stimulation using a portable device (wristband) which would also be the first on-demand treatment of tics \citep{Morera_Maiquez_2023}. On the pharmacological aisle, we see the dopamine D1 antagonist ecopipam emerging as the first drug developed specifically for the treatment of tics, with a favorable side effect profile compared to D2 receptor antagonists when it comes to metabolic side effects \citep{36628546a}. Then, we see studies refining the neuroanatomy and connectivity of TS based on sophisticated neuroimaging approaches and deep brain stimulation treatments \citep{Zouki_2023}. Finally, there is still a substantial literature on FTLB with interesting relations to classic, neurodevelopmental tics that can frequently co-occur, complicating diagnosis and treatment to a certain extent \citep{Müller-Vahl2024}.
Scrying the future with a crystal ball
The field seems ripe for additional work in several areas. A number of important questions about tic disorders remain mysterious, and future work may clarify them: Why do tics start around age 5-10 years? Why are boys more likely to develop tics? How accurately can we predict outcomes for individual patients? Why do tics improve during sleep, or with the transition to adolescence and adulthood? Can we identify a natural non-human animal model? Do neurosteroids reduce tics in humans? Which patients need which treatments?