Hair cortisol-a stress marker in children and adolescents with chronic tic disorders? A large European cross-sectional study

Abstract

Background There is clear evidence that tic disorders (TDs) are associated with psychosocial stress as well as emotional and behavioral problems. Studies have shown that individuals with TDs have higher acute physiological stress responses to external, single stressors (as reflected by saliva cortisol). The aim of the present study was to examine a physiological marker of longer-term stress (as reflected by hair cortisol concentration) in children and adolescents with TDs and unaffected siblings of individuals with TDs. Methods Two samples of a European cohort were included in this study. In the COURSE sample, 412 children and adolescents aged 3–16 years with a chronic TD including Tourette syndrome according to DSM IV-TR criteria were included. The ONSET sample included 131 3–10 years old siblings of individuals with TDs, who themselves had no tics. Differences in hair cortisol concentration (HCC) between the two samples were examined. Within the COURSE sample, relations of HCC with tic severity and perceived psychosocial stress as well as potential effects and interaction effects of comorbid emotional and behavioral problems and psychotropic medication on HCC were investigated. Results There were no differences in HCC between the two samples. In participants with TDs, there were no associations between HCC and tic severity or perceived psychosocial stress. No main effects of sex, psychotropic medication status and comorbid emotional and behavioral problems on HCC were found in participants with TDs. Conclusion A link between HCC and TDs is not supported by the present results.

Hair androgen concentrations and depressive disorders in adolescents from the general population

“…In addition, high quality studies with hair hormone measurement are currently evolving with associations between hair hormones and mental disorders (exemplarily: [15,54,76,94,95] or considering methodological issues [9,31,47]. Regarding the methodological challenges, diurnal steroid hormone levels (e.g., measured via saliva or urine samples) and longer-term steroid hormone levels (measured via hair samples) should be investigated congruently in longitudinal studies to compare the characteristics of the sampling methods [18]. An alternative explanation for the weak associations in the present study relates to the genetic background, particularly the androgen receptor CAG repeat.…”

Mycoplasma pneumoniae IgG positivity is associated with tic severity in chronic tic disorders

“…A prospective longitudinal study described that a multiplicative interaction between GABHS infections and psychosocial stress can enhance tic and OC symptom severity (Lin et al, 2010). Psychosocial stress, a strong predictor of greater tic severity, may also influence immune responses to infection via activation of the hypothalamic-pituitaryadrenal axis (Martino et al, 2020), although this mechanism is yet not fully understood (Buse et al, 2021). Finally, behavioural patterns, which may be accentuated in young people with greater tic severity and/or a higher comorbid neuropsychiatric burden, could increase the risk of exposure to infectious pathogens (Martino et al, 2020) and, thus, also indirectly contribute the association observed in thus study.…”

Recent progress on Tourette syndrome

“…The study authors concluded that GAS exposure was less likely to be a risk factor for tic exacerbations; therefore, the evaluation and treatment of GAS infections are not warranted in the context of worsening of tics. The authors also attempted to identify biomarkers of tics, examining hair cortisol concentration as a physiological marker of long-term stress in patients with tics, and found no association between hair cortisol concentration and tic severity 61 .…”