Several areas cry out for new research. The nosology of tic disorders has been driven by historical separations such as whether tics involve muscles of respiration and phonation, or whether tics have been present for 12 months. One can hope for development and acceptance of a more science-based nosology. Acceptance and Commitment Therapy, or other newer behavior therapies that avoid focusing on tic suppression, may be better accepted by patients. Tic disorder therapies have thus far been primarily focused on symptom reduction, but with safe behavior therapies, it is time to consider tic prevention.
Where will the answers come from? Increasing large-scale collaborative studies, including prospective tic surveillance studies, may help bring answers to the clinical mysteries, genetic factors, and treatment development. Novel techniques, such as ex vivo organoids from induced pluripotent stem cells, may clarify pathophysiology. We are enthusiastic to see what the next decade brings.
Competing interests
AH is a consultant for Noema Pharma.
PA has received royalties from the Tourette OCD Alberta Network.
CD is a consultant for Medtronic.
NMD has no conflicts of interest. VC has no conflict of interest. KU participated in a clinical trial sponsored by Emalex Biosciences. PP has no conflict of interest. AT has no conflict of interest. CAC has no conflict of interest.