Advances in Clustering and Classification of Tic Disorders: A Systematic Review

Kai Yang,1,2 Tianyuan Lei,1,2 JinHyun Jun,1,2 Qinghao Yang,1,2 Jingyi Li,1,2 Mengjiao Wang,1,2 Yonghua Cui1,2 1Department of Psychiatry, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, 100045, People’s Republic of China; 2Laboratory for Clinical Medicine, Capital Medical University, Beijing, 100045, People’s Republic of ChinaCorrespondence: Tianyuan Lei; Yonghua Cui, Email [email protected]; [email protected]: Tic disorders (TD) are common neurodevelopmental disorders characterized by heterogeneous tic symptoms in children, making diagnostic classification difficult. This complexity requires accurate subtyping using data-driven computational methods to identify patterns within clinical data. This systematic review primarily summarizes the current evidence for the classification of TD using a data-driven approach.Patients and Methods: We conducted a systematic literature search on PubMed and Web of Science up to December 2023 and identified 16 publications analyzing 14 unique samples, totaling approximately 6000 subjects.Results: Nine studies classified different subtypes of TD based on symptoms and behavior. Seven studies identified novel factor structures based on TD and its complex comorbidity patterns. Seven studies highlighted associations between TD symptom patterns and genetics, reflecting the diversity of underlying genetic mechanisms underlying TD.Conclusion: This systematic review reveals significant variability in research on the classification of TD, which limits the application of findings for accurate diagnosis and guiding treatment strategies in pediatric psychiatry. Further research incorporating multidimensional information (such as genetic, neuroimaging, and environmental and social factors) is essential to improve the understanding of TD subtypes.Keywords: tic disorders, Tourette syndrome, subtype classification, cluster analysis