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Wang CX, Wang B, Sun JJ, Xiao CY, Ma H, Jia FY, Li HH. Circulating retinol and 25(OH)D contents and their association with symptoms in children with chronic tic disorders. Eur Child Adolesc Psychiatry 2024; 33:1017-1028. [PMID: 37166521 PMCID: PMC11032271 DOI: 10.1007/s00787-023-02226-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 05/04/2023] [Indexed: 05/12/2023]
Abstract
The present study measured serum levels of vitamin A (VA) and vitamin D (VD) in children with chronic tic disorders (CTD) and investigated their potential association with CTD and comorbidity of attention deficit hyperactivity disorder (ADHD) and the association of their co-insufficiencies or deficiencies with CTD symptoms. A total of 176 children (131 boys and 45 girls, median age of 9 years) with CTD were recruited as the CTD group. During the same period, 154 healthy children were selected as the healthy control (HC) cohort. Circulating retinol and 25-hydroxyvitamin D (25[OH]D) levels were measured for all participants using high-performance liquid chromatography (HPLC) and tandem mass spectrometry. The Yale Global Tic Severity Scale (YGTSS) was employed for the assessment of tic status and CTD impairment. The Swanson, Nolan, and Pelham Rating Scale (SNAP-IV) and the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) were used to evaluate comorbidity symptoms. CTD pediatric participants exhibited markedly diminished circulating retinol and 25(OH)D levels compared to HCs. Moreover, VA and VD deficiencies and their co-insufficiencies/deficiencies were more prevalent in CTD participants than HCs. Circulating 25(OH)D levels were inversely proportional to the YGTSS motor tic scores. YGTSS scores in CTD children with only VA or VD insufficiency or deficiency or with VA and VD co-insufficiency/deficiency did not differ from those in CTD children with normal VA and VD. CTD children with comorbid ADHD displayed reduced circulating retinol and 25(OH)D concentrations and elevated prevalence of VD deficiency compared to CTD participants without comorbid ADHD. Lower serum retinol content was intricately linked to the presence of elevated CTD and comorbid ADHD. VA and VD deficiencies and their co-insufficiencies/deficiencies were markedly enhanced in CTD pediatric participants compared to HCs. Lower VA concentration was linked to the presence of enhanced CTD and comorbid ADHD. Therefore, children with CTD, especially with comorbid ADHD, may be at a higher risk of VA or VD deficiency, which may prompt the clinicians to consider whether blood tests for VA and VD in CTD children would be helpful for clinical care.
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Affiliation(s)
- Cheng-Xin Wang
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, 130021, Jilin, China
- Department of Laboratory Medicine, The First Hospital of Jilin University, Changchun, 130021, China
| | - Bing Wang
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, 130021, Jilin, China
| | - Jian-Jian Sun
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, 130021, Jilin, China
| | - Chun-Ying Xiao
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, 130021, Jilin, China
| | - Huan Ma
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, 130021, Jilin, China
| | - Fei-Yong Jia
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, 130021, Jilin, China
| | - Hong-Hua Li
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, 130021, Jilin, China.
- School of Public Health, Jilin University, Changchun, Jilin, China.
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Chen Z, Wang X, Teng Z, Liu M, Liu F, Huang J, Liu Z. Modifiable lifestyle factors influencing psychiatric disorders mediated by plasma proteins: A systemic Mendelian randomization study. J Affect Disord 2024; 350:582-589. [PMID: 38246286 DOI: 10.1016/j.jad.2024.01.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 01/13/2024] [Accepted: 01/16/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND Psychiatric disorders are emerging as a serious public health hazard, influencing an increasing number of individuals worldwide. However, the effect of modifiable lifestyle factors on psychiatric disorders remains unclear. METHODS Genome-wide association studies (GWAS) summary statistics were obtained mainly from Psychiatric Genomics Consortium and UK Biobank, with sample sizes varying between 10,000 and 1,200,000. The two-sample Mendelian randomization (MR) method was applied to investigate the causal associations between 45 lifestyle factors and 13 psychiatric disorders, and screen potential mediator proteins from 2992 candidate plasma proteins. We implemented a four-step framework with step-by-step screening incorporating two-step, univariable, and multivariable MR. RESULTS We found causal effects of strenuous sports or other exercise on Tourette's syndrome (OR [95%CI]: 0.0047 [5.24E-04-0.042]); lifelong smoking index on attention-deficit hyperactivity disorder (10.53 [6.96-15.93]), anxiety disorders (3.44 [1.95-6.05]), bipolar disorder (BD) (2.25 [1.64-3.09]), BD II (2.89 [1.81-4.62]), and major depressive disorder (MDD) (2.47 [1.90-3.20]); and educational years on anorexia nervosa (AN) (1.47 [1.22-1.76]), and MDD (0.74 [0.66-0.83]). Five proteins were found to have causal associations with psychiatric disorders, namely ADH1B, GHDC, STOM, CD226, and TP63. STOM, a membrane protein deficient in the erythrocytes of hereditary stomatocytosis patients, may mediate the effect of educational attainment on AN. LIMITATIONS The mechanisms underlying the effects of lifestyle factors on psychiatric disorders require further investigation. CONCLUSIONS These findings could help assess the risk of psychiatric disorders based on lifestyle factors and also support lifestyle interventions as a prevention strategy for mental illness.
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Affiliation(s)
- Zhuohui Chen
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan, China; Hypothalamic Pituitary Research Centre, Xiangya Hospital, Central South University, Changsha, China
| | - Xiang Wang
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan, China; Hypothalamic Pituitary Research Centre, Xiangya Hospital, Central South University, Changsha, China
| | - Ziwei Teng
- National Clinical Research Centre for Mental Disorders, Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Mengdong Liu
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Fangkun Liu
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan, China; Hypothalamic Pituitary Research Centre, Xiangya Hospital, Central South University, Changsha, China
| | - Jing Huang
- National Clinical Research Centre for Mental Disorders, Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Zhixiong Liu
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan, China; Hypothalamic Pituitary Research Centre, Xiangya Hospital, Central South University, Changsha, China.
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Nikolaus S, Mamlins E, Antke C, Dabir M, Müller HW, Giesel FL. Boosted dopamine and blunted serotonin in Tourette syndrome - evidence from in vivo imaging studies. Rev Neurosci 2022; 33:859-876. [PMID: 35575756 DOI: 10.1515/revneuro-2022-0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 04/12/2022] [Indexed: 12/14/2022]
Abstract
The precise cortical and subcortical mechanisms of Tourette syndrome (TS) are still not fully understood. In the present retrospective analysis, adolescent and adult medication-naïve patients showed increased DA transporter (DAT) binding in nucleus caudate (CAUD), putamen (PUT) and/or whole neostriatum (NSTR). D2 receptor (R) binding and DA release were not different from controls throughout the nigrostriatal and mesolimbocortical system. When patients were medication-free (either medication-naïve or under withdrawal), DAT was still increased in PUT, but not different from controls in CAUD, NSTR and ventral striatum (VSTR). SERT was unaltered in midbrain/pons (MP), but decreased in PUT, thalamus (THAL) and hypothalamus. D2R was unaltered throughout the nigrostriatal and mesolimbocortical system, while DA release was not different from controls in PUT, CAUD and NSTR, but elevated in VSTR. 5-HT2AR binding was unaltered in neocortex and cingulate. In acutely medicated adults, DAT was unaltered in PUT, but still increased in CAUD, whereas DA release remained unaltered throughout the nigrostriatal and mesolimbocortical system. When part of the patients was acutely medicated, vesicular monoamine transporter (VMAT2), DAT, SERT and DA synthesis were not different from controls in striatal regions, whereas D2R was decreased in NSTR, THAL, frontal cortex and limbic regions. Conversely, 5-HT2AR binding was unaltered in striatal regions and THAL, but increased in neocortical and limbic areas. It may be hypothesized that both the DA surplus and the 5-HT shortage in key regions of the nigrostriatal and mesolimbic system are relevant for the bouts of motor activity and the deficiencies in inpulse control.
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Affiliation(s)
- Susanne Nikolaus
- Department of Nuclear Medicine, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine University, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Eduards Mamlins
- Department of Nuclear Medicine, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine University, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Christina Antke
- Department of Nuclear Medicine, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine University, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Mardjan Dabir
- Department of Nuclear Medicine, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine University, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Hans-Wilhelm Müller
- Department of Nuclear Medicine, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine University, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Frederik L Giesel
- Department of Nuclear Medicine, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine University, Moorenstr. 5, 40225 Düsseldorf, Germany
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Affiliation(s)
- Huei-Shyong Wang
- Division of Pediatric Neurology, Chang Gung Children's Hospital at Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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Katz TC, Bui TH, Worhach J, Bogut G, Tomczak KK. Tourettic OCD: Current understanding and treatment challenges of a unique endophenotype. Front Psychiatry 2022; 13:929526. [PMID: 35966462 PMCID: PMC9363583 DOI: 10.3389/fpsyt.2022.929526] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
Obsessive compulsive disorder (OCD) and chronic tic disorders (CTD) including Tourette Syndrome (TS) are often comorbid conditions. While some patients present with distinct symptoms of CTD and/or OCD, a subset of patients demonstrate a unique overlap of symptoms, known as Tourettic OCD (TOCD), in which tics, compulsions, and their preceding premonitory urges are overlapping and tightly intertwined. The specific behaviors seen in TOCD are typically complex tic-like behaviors although with a compulsive and partially anxious nature reminiscent of OCD. TOCD is not classified within the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) as an independent diagnostic entity, but mounting evidence suggests that TOCD is an intermediate neuropsychiatric disorder distinct from either TS or OCD alone and as such represents a unique phenomenology. In this review of TOCD we discuss clinical, genetic, environmental, neurodevelopmental, and neurocircuit-based research to better characterize our current understanding of this disorder. TOCD is characterized by earlier age of onset, male predominance, and specific symptom clusters such as lower tendency toward compulsions related to checking, cleaning, and reassurance seeking and higher tendency toward compulsions such as rubbing, tapping, or touching associated with symmetry concerns or thoughts of exactness. Functional magnetic resonance imaging (fMRI) imaging suggests that TOCD symptoms may arise from involvement of an intermediate neurocircuitry distinct from classic OCD or classic CTD. Small cumulative contributions from multiple genetic loci have been implicated, as have environmental factors such as infection and perinatal trauma. In addition, this review addresses the treatment of TOCD which is especially complex and often treatment resistant and requires pharmacology and behavioral therapy in multiple modalities. Given the distressing impact of TOCD on patients' functioning, the goal of this review is to raise awareness of this distinct entity toward the goal of improving standards of care.
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Affiliation(s)
- Tamar C Katz
- Department of Psychiatry, Boston Children's Hospital, Boston, MA, United States
| | - Thanh Hoa Bui
- Tic Disorders and Tourette Syndrome Program, Department of Neurology, Boston Children's Hospital, Boston, MA, United States
| | - Jennifer Worhach
- Tic Disorders and Tourette Syndrome Program, Department of Neurology, Boston Children's Hospital, Boston, MA, United States
| | - Gabrielle Bogut
- Tic Disorders and Tourette Syndrome Program, Department of Neurology, Boston Children's Hospital, Boston, MA, United States
| | - Kinga K Tomczak
- Tic Disorders and Tourette Syndrome Program, Department of Neurology, Boston Children's Hospital, Boston, MA, United States
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Chan YS, Jang JT, Ho CS. Effects of physical exercise in children with attention deficit/hyperactivity disorder. Biomed J 2021; 45:265-270. [PMID: 34856393 PMCID: PMC9250090 DOI: 10.1016/j.bj.2021.11.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/18/2021] [Accepted: 11/23/2021] [Indexed: 11/24/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is one of the most commonly neurodevelopmental disorders with a complex symptomatology in children, and frequently suffer from deficits in executive functions and motor abilities. Although medication-based treatments usually have a positive effect, possible side effects may result in a need for an adjunctive intervention. Present studies show positive effect of physical exercise on cognitive function. Therefore, the purpose of the current study is thoroughly examine the effects of physical exercise in children with ADHD. Preliminary evidence shows both acute and chronic physical exercise are beneficial to ADHD symptoms, executive function, and motor abilities. Benefits of acute exercise may gradually accumulate over time. Such benefits reflect the positive correlation between cognition and physical activity, and these benefits will also lead to changes in executive function after long-term training. Aerobic could induce to increase the neurotransmitter ie. serotonin, dopamine, brain-derived neurotrophic factor (BDNF) and brain blood flow. Perceptual motor and meditation could lead to neuroplasticity in nerve cells and synaptic connections; furthermore, strengthening the sensory-motor base contributes to the improvement of attention. An exercise program for children with ADHD include to moderate to high intensity interval training and cognitive tasks are suitable. The preliminary state of the evidence supports physical exercise as an adjunctive treatment for ADHD at this time.
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Affiliation(s)
- Yuan-Shuo Chan
- Department of Special Education, National Taipei University of Education.
| | - Jia-Tzer Jang
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University
| | - Chin-Shan Ho
- Graduate Institute of Sports Science, National Taiwan Sport University
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Liang JH, Zhang SX, Chen YC, Tan KY, Zhang JS, Zhao Y, Kakaer A, Chen YJ. Role of psychotherapy strategy for the management of patients with Tourette syndrome - A Bayesian network meta-analysis. J Psychiatr Res 2021; 143:451-461. [PMID: 34482986 DOI: 10.1016/j.jpsychires.2021.07.051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 07/16/2021] [Accepted: 07/31/2021] [Indexed: 11/19/2022]
Abstract
Tourette's syndrome (TS) is a complex neurodevelopmental disorder characterized by high comorbidity. Treatment with psychotherapy is highly recommended, however, there exists limited available evidence on the use and the optimal psychotherapeutic outcome is debatable. We performed a systematic search on several bibliographic databases for randomized controlled trials (RCTs) reporting the use of psychotherapy treatment in TS patients, from inception to August 1st, 2020, and without language restrictions. Outcome measures were measured by the Yale global tic severity scale (YGTSS) to determine the efficacy of psychotherapy. Data were pooled as Standard mean difference (SMD) in the Bayesian analysis of the random effect model. A total of 17 RCTs with 9 treatments and 1042 participants were included from an initial 4901 records. The primary outcome including, Comprehensive behavioral intervention (CBIT) [SMD = -1.43, 95%Credible interval (CrI): -2.39, -0.44], Exposure with response prevention (ERP) [SMD = -1.37, 95%CrI: -2.62, -0.13], Habit reversal therapy (HRT) [SMD = -0.93, 95%CrI: 1.83, -0.05], and Behavior therapy (BT) [SMD = -0.85, 95%CrI: 1.51, -0.18], were found to be significantly lower in the TS group compared with the control group (including wait-list, treatment-as-usual or other named control group). Based on the Surface under the cumulative ranking curve (SUCRA), CBIT (SUCRA value = 86.97%, 95%CrI: 44%, 100%) was found to be a suitable psychotherapeutic treatment for TS patients. High-quality RCTs on psychotherapy are needed to perform for establishing the foundation of the generation of evidence-based guidelines.
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Affiliation(s)
- Jing-Hong Liang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, PR China.
| | - Shu-Xin Zhang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, PR China.
| | - Yi-Can Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, PR China.
| | - Kai-Yun Tan
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, PR China.
| | - Jing-Shu Zhang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, PR China.
| | - Yu Zhao
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, PR China.
| | - Aerziguli Kakaer
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, PR China.
| | - Ya-Jun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, PR China.
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Pringsheim T, Nosratmirshekarlou E, Doja A, Martino D. Physical activity, sleep and neuropsychiatric symptom severity in children with tourette syndrome. Eur Child Adolesc Psychiatry 2021; 30:711-719. [PMID: 32372272 DOI: 10.1007/s00787-020-01552-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 04/28/2020] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to examine associations between physical activity, sleep and symptom severity in children with tic disorders. Children with tic disorders wore the GeneActiv device, a wrist-worn accelerometer that measures physical activity intensity and sleep/wake parameters continuously for seven days, and completed questionnaires on sleep quality, exercise and severity of tics, ADHD, obsessive-compulsive behaviours, anxiety and depression. 110 children participated in the study. Children with more severe tics had significantly more frequent comorbid diagnoses, greater impairment in subjective sleep measures, greater sedentary activity time and less light, moderate and vigorous activity time (all p < 0.05). There was a significant negative correlation between light, moderate and vigorous physical activity and the severity of tics (- 0.22, p = 0.04), obsessive compulsive behaviours (- 0.22, p = 0.03), anxiety (- 0.35, p = 0.0005) and depression (- 0.23, p = 0.03). There was no correlation between objective sleep time, sleep efficiency and symptom severity. Subjective sleep quality was positively correlated with all symptom severity measures, with the strongest correlation with ADHD severity (0.42, p < 0.00001). The results of this observational study indicate a small, but significant relationship between activity and sleep measures and the severity of the main symptom domains present in tic disorders.
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Affiliation(s)
- Tamara Pringsheim
- Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences, University of Calgary, Calgary, Canada. .,Mathison Centre for Mental Health Research & Education, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
| | | | - Asif Doja
- Department of Pediatrics, University of Ottawa, Ottawa, Canada
| | - Davide Martino
- Department of Clinical Neurosciences, University of Calgary, Calgary, Canada
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Jackson GM, Nixon E, Jackson SR. Tic frequency and behavioural measures of cognitive control are improved in individuals with Tourette syndrome by aerobic exercise training. Cortex 2020; 129:188-198. [PMID: 32492517 DOI: 10.1016/j.cortex.2020.01.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 10/19/2019] [Accepted: 03/13/2020] [Indexed: 02/05/2023]
Abstract
Previous observations of improvements in cognition in typically developing children following moderate to vigorous exercise (e.g., Budde, Voelcker-Rehage, Pietrabyk-Kendziorra, Ribeiro, & Tidow, 2008; Hillman et al., 2009) have led to increased interest in the potential benefits of exercise for children with neurodevelopmental disorders, involving difficulties in self-regulation (e.g., Halperin & Healey, 2011; Archer & Kostrzewa, 2012). Using a within-sample design, the current study looked at the beneficial effects of non-aerobic movement training (Tai Chi), compared to aerobic movement training (Kick Boxing), on behavioural measures of cognitive control and clinical measures of tic severity in a group of young people with Tourette Syndrome (TS). We demonstrate that Kick Boxing, but not Tai Chi, led to a significant enhancement in cognitive control task performance. Furthermore, while tic frequency (tics per minute) was reduced during both types of exercise, this reduction was significantly greater, and sustained for longer, following Kick Boxing. Importantly, the magnitude of the increase in cognitive control following Kick Boxing predicted the degree of reduction in tic frequency. These findings suggest that aerobic exercise may be a useful intervention for improving self-regulation of tics in young people with TS, probably through enhancements in associated cognitive control circuits.
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Affiliation(s)
- Georgina M Jackson
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, UK
| | - Elena Nixon
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, UK.
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Interventions for tic disorders: An updated overview of systematic reviews and meta analyses. Psychiatry Res 2020; 287:112905. [PMID: 32163785 DOI: 10.1016/j.psychres.2020.112905] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 02/29/2020] [Accepted: 02/29/2020] [Indexed: 01/01/2023]
Abstract
To conduct an updated overview of systematic reviews (SRs) summarizing the efficacy and safety of various strategies used to treat tic disorders (TDs) in children. We searched the Cochrane Library, PubMed, EMBASE, and relevant reference lists for articles published between the search deadline from our last overview and April 2019 and included 16 SRs. The results presented that antipsychotics, a2-adrenergic receptor agonists, and HRT/CBIT still appeared to be the most robust evidence-based options for the treatment of TDs. Compared with our last overview, more robust evidence showed that aripiprazole and acupuncture was effective treatment in treating children TDs, and DBS for medication-refractory and severely affected patients. In addition, physical activity or exercise may be promising treatments, and the clonidine adhesive patch is an effective, safe, and convenient treatment option for TDs. Moreover, methylphenidate, guanfacine, and desipramine appeared to reduce ADHD symptoms in children with tics. However, no research studies have examined HRT/CBIT alone compared with HRT/CBIT in combination with medication. More high-quality clinical trials comparing different interventions for TDs including economic evaluations should be encouraged.
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Update on the Treatment of Tics in Tourette Syndrome and Other Chronic Tic Disorders. Curr Treat Options Neurol 2020. [DOI: 10.1007/s11940-020-0620-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Chen CW, Wang HS, Chang HJ, Hsueh CW. Effectiveness of a modified comprehensive behavioral intervention for tics for children and adolescents with tourette's syndrome: A randomized controlled trial. J Adv Nurs 2020; 76:903-915. [PMID: 31782167 DOI: 10.1111/jan.14279] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 11/05/2019] [Accepted: 11/19/2019] [Indexed: 12/17/2022]
Abstract
AIM To evaluate the effectiveness of a modified four-session Comprehensive Behavioral Intervention for Tics programme for decreasing tics in children and adolescents with Tourette's syndrome. BACKGROUND Comprehensive Behavioral Intervention for Tics programme has been shown to decrease tic severity. However, the lack of behaviour therapists in countries, such as in Taiwan, may preclude application of the standard eight-session, 10-week programme. DESIGN Randomized controlled study. METHODS Participants aged 6-18 years diagnosed with Tourette's syndrome or chronic tic disorder were recruited from February 2015 through September 2016. Participants in the control and intervention groups (N = 23 each) received the routine care (daily pyridoxine [50 mg] and psychoeducation). The intervention group received additional four behavioural intervention sessions over a 3-month period that included psychoeducation, habit reversal training, relaxation training, and education on tic relapse prevention. The outcome measures, Yale Global Tic Severity Scale scores, were assessed at before and after the completion of programme for both groups and again at 3 months follow-up for the intervention group. The effect of the intervention on severity scores was assessed using a generalized estimated equation. RESULTS Comparison of scores before and after intervention showed that the intervention significantly decreased the severity of total motor tics (B = -3.28, p < .01) and total tics (B = -5.86, p < .01) as compared with control treatment. YGTSS scores for the intervention group were lower at 3-month follow-up as compared with before treatment or immediately after treatment completion (total tics, p < .001). CONCLUSION The modified four-session Comprehensive Behavioral Intervention for Tics programme was more effective than routine care for decreasing tic severity in our cohort of 6- to 18-year olds. This improvement was maintained 3 months after intervention. IMPACT Healthcare providers, including nurses, in countries currently not adopting Comprehensive Behavioral Intervention for Tics programme should be made aware of the positive effects of this modified intervention for Tourette's syndrome.
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Affiliation(s)
- Chia-Wen Chen
- School of Nursing, College of nursing, Taipei Medical University, Taipei, Taiwan
| | - Huei-Shyong Wang
- Division of Pediatric Neurology, Chang Gung Children's Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Hsiu-Ju Chang
- School of Nursing, College of nursing, Taipei Medical University, Taipei, Taiwan
| | - Chang-Wei Hsueh
- Division of Pediatric Neurology, Landseed International Hospital, Taoyuan, Taiwan
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Pal P, Kamble N, Jhunjhunwala K, Yadav R, Bhattacharya A. Can yoga lead to maladaptive plasticity resulting in disorder of motor control? ANNALS OF MOVEMENT DISORDERS 2020. [DOI: 10.4103/aomd.aomd_23_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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