Tic Disorders and Tourette Syndrome: Current Concepts of Etiology and Treatment in Children and Adolescents

Gloor, Friederike Tagwerker; Walitza, Susanne

doi:10.1055/s-0035-1570492

Cited by 39 publications

(16 citation statements)

References 103 publications

(113 reference statements)

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“…TS is reported worldwide in all cultures and is more common in males than females (M/F ratio ranging from 1.6:1 to 9:1) [ 2 , 3 ]. The aetiopathogenesis of TS is still unclear and more complex than previously perceived, and it involves environmental (infections, perinatal problems, and autoimmunity) and genetic factors that result in a dysfunction of cortico-striato-thalamo-cortical-circuits [ 4 – 8 ].…”

Section: Introductionmentioning

confidence: 99%

Tourette syndrome and other neurodevelopmental disorders: a comprehensive review

Cravedi

Deniau

Giannitelli

et al. 2017

Child Adolesc Psychiatry Ment Health

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Gilles de la Tourette syndrome (TS) is a complex developmental neuropsychiatric condition in which motor manifestations are often accompanied by comorbid conditions that impact the patient’s quality of life. In the DSM-5, TS belongs to the “neurodevelopmental disorders” group, together with other neurodevelopmental conditions, frequently co-occurring. In this study, we searched the PubMed database using a combination of keywords associating TS and all neurodevelopmental diagnoses. From 1009 original reports, we identified 36 studies addressing TS and neurodevelopmental comorbidities. The available evidence suggests the following: (1) neurodevelopmental comorbidities in TS are the rule, rather than the exception; (2) attention deficit/hyperactivity disorder (ADHD) is the most frequent; (3) there is a continuum from a simple (TS + ADHD or/and learning disorder) to a more complex phenotype (TS + autism spectrum disorder). We conclude that a prompt diagnosis and a detailed description of TS comorbidities are necessary not only to understand the aetiological basis of neurodevelopmental disorders but also to address specific rehabilitative and therapeutic approaches.

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Section: Introductionmentioning

confidence: 99%

Tourette syndrome and other neurodevelopmental disorders: a comprehensive review

Cravedi

Deniau

Giannitelli

et al. 2017

Child Adolesc Psychiatry Ment Health

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“…It is recommend that clinicians who evaluate allergies in children take TD into account. 28 Therefore, it is necessary to obtain detailed medical history and physical examination, including mental assessments and necessary auxiliary examinations, before diagnosing TD. The purpose of such an inspection is to rule out other diseases, especially allergic disease.…”

Section: Discussionmentioning

confidence: 99%

Allergic diseases influence symptom severity and T lymphocyte subgroups of children with tic disorders

Liu

Wang

Cao

2021

Journal of Investigative Medicine

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Tic disorders (TD) are childhood-onset neurological disorders. Immune system dysregulation has been postulated to play a role in TD, and its mechanisms likely involve dysfunctional neural-immune cross-talk, which ultimately leads to altered maturation of the brain pathways that control different TD clinical manifestations and behavioral and emotional damages. Clinical studies have demonstrated an association between TD and allergies and overactive immune responses at a systemic level. In this study, the Yale Global Tic Severity Scale was taken as a global measure of tic severity. Compared with the control group, the group of children with TD plus allergic diseases displayed significantly increased Yale total scores (p<0.05), which suggests that children with TD plus allergic diseases have heavier tic symptoms. Both motor and vocal tic scores are higher in the group of children with TD plus allergy compared with the control group. We counted immune cell subpopulations using FACS. T lymphocyte subset comparison of CD3, CD4, CD8, and CD4:CD8 expression ratios revealed that the level of CD3, CD4, and CD4:CD8 in children with TD plus allergic diseases was significantly lower than those of children with TD without allergic diseases. These differences were statistically significant (p<0.05) and suggest that children with TD plus allergic diseases have imbalanced T lymphocyte subsets. We concluded that allergy increased the severity of TD through an imbalance in cellular immunity. Studies need to be done to show whether treatment of allergic symptoms leads to a decrease in TD manifestations.

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“…Tics can only be expressed as simple actions such as blinking, nose twitching, or complex movements such as jumping, uttering words, etc. Its severity usually peaks at around 12 years, with reducing frequency and severity at the end of adolescence (18). Epidemiological studies have shown that males account for the majority of TD patients (ratio 4:1) (19).…”

Section: Discussionmentioning

confidence: 99%

“…TD is currently recognized as a polygenic genetic disorder and is affected by a variety of environmental factors such as prenatal and perinatal noxious events, infections, and so on (18,21). In the past few years, TD's genetic research has made great progress, however, more and more studies have shown that environmental factors contribute not only to the gene-environment interaction but also at least to the disorders' severity and course.…”

Section: Discussionmentioning

confidence: 99%

The Blood Levels of Trace Elements Are Lower in Children With Tic Disorder: Results From a Retrospective Study

Qian

You

et al. 2019

Front. Neurol.

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Background: Tic disorders (TD) are common neuropsychiatric disorders among children and adolescents. It is controversial that trace elements may participate in the pathogenesis of TD. Our study aimed to investigate the trace elements status of zinc (Zn), copper (Cu), iron (Fe), and magnesium (Mg) in children with TD, in comparison to healthy controls. Methods: The medical records of eligible TD children and normal healthy children from January 1 to December 31, 2018 in the outpatient clinic were retrospectively reviewed. The clinical information of all subjects were collected including age, gender, diagnosis, previous health records, and serum trace elements level (Cu, Zn, Fe, Mg) at the time of diagnosis before initiating treatment. Results: In total, 1204 TD children (7.63 ± 2.45 years) and 1,220 healthy children (7.27 ± 3.15 years) who were divided into two gender and three age groups (2-4years, 5-9years, ≥10 years) were reviewed in our study. Our study showed that TD children generally had lower whole blood levels of Zn, Cu, Fe than the normal controls (P < 0.01). No significant difference was observed in whole blood levels of Mg. After adjusting for gender, the trends still remained. Further analysis was performed according to age, the trends still remained in Zn and Fe in all age groups (P < 0.05). However, we observed an almost significantly (P = 0.055) lower level of Cu in TD of 2-4 years group while significant differences in other two groups (P < 0.01). Further multiple linear regression and point biserial correlation showed that the lower blood levels of Zn, Cu, and Fe were correlated with the incidence of TD. Conclusion: The present results indicated that lower blood levels of zinc, iron, copper were associated with TD. Trace elements may be used as an auxiliary treatment for TD and need to be further explored.

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Tic Disorders and Tourette Syndrome: Current Concepts of Etiology and Treatment in Children and Adolescents

Cited by 39 publications

References 103 publications

Tourette syndrome and other neurodevelopmental disorders: a comprehensive review

Tourette syndrome and other neurodevelopmental disorders: a comprehensive review

Allergic diseases influence symptom severity and T lymphocyte subgroups of children with tic disorders

The Blood Levels of Trace Elements Are Lower in Children With Tic Disorder: Results From a Retrospective Study

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