Propofol Versus Remimazolam in Gastrointestinal Endoscopy: A Comprehensive Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Tourette's disorder and persistent (chronic) tic disorder – collectively referred to as Tourette syndrome (TS) – are childhood‐onset neuropsychiatric conditions characterized by motor and/or vocal tics that are present for longer than 1 year (American Psychiatric Association, ). TS affects about 1% of the population, with symptoms typically emerging in early childhood and peaking in severity in early adolescence (Bloch et al., ; Hirschtritt et al., ). Alongside tics, 86% of individuals with TS experience comorbid psychiatric conditions that include attention‐deficit/hyperactivity disorder (ADHD), obsessive‐compulsive disorder (OCD), or anxiety disorders (Hirschtritt et al., ; Wolicki et al., ). Together, TS and accompanying psychiatric comorbidities cause significant distress, executive dysfunction (i.e., reduced cognitive control; Morand‐Beaulieu, Stark, & Murphy, ), and functional impairment (Cloes et al., ; Storch et al., ) – all of which contribute to a reduced quality of life (Eapen, Cavanna, & Robertson, ). For over 60% of youth with TS, tics continue into late adolescence and early adulthood (Bloch & Leckman, ; Reagan, Myers, & McGuire, ). Although evidence‐based treatments exist to reduce tic severity (e.g., behavior therapy, pharmacotherapy; Pringsheim et al., ), these interventions infrequently produce tic remission. Importantly, even for those individuals who experience tic remission, functional difficulties can persist. Many adults with TS report ongoing challenges across academic, occupational, and social domains, with some attributing school or work disruptions (e.g., dropping out, avoiding career advancement) to their childhood history of tics (Coffey et al., ; Conelea et al., ; Pérez‐Vigil et al., ; Shady, Broder, Staley, Furer, & Brezden Papadopolos, ). Indeed, population‐based studies show that individuals with TS are less likely to complete secondary or postsecondary education, are more likely to be underemployed, and report lower income levels than unaffected counterparts (Pérez‐Vigil et al., ; Yang et al., ). Overall, these findings highlight the enduring challenges associated with TS and underscore the importance of identifying factors that influence long‐term outcomes. Although the lasting clinical and functional consequences of TS are well documented, few studies have examined predictors of these trajectories using prospective designs (Reagan et al., ; Ricketts et al., ), and the limited available evidence is inconsistent. For instance, some reports suggest that comorbid ADHD and OCD in childhood are associated with reduced likelihood of tic remission in adulthood (Byler et al., ; Groth, Debes, & Skov, ; Lowe, Capriotti, & McBurnett, ), whereas other studies have not supported this relationship (Bloch et al., ; Groth, Skov, Lange, & Debes, ). Meanwhile, no research has directly examined childhood predictors of later functioning or quality of life in TS. Addressing this gap is essential to clarify sources of variability in both clinical course and functioning, which could provide mechanistic insights and inform interventions that promote more favorable long‐term outcomes.