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Sun F, Zhang G, Zhang X. Improvement of Tourette syndrome symptoms after intractable temporal lobe epileptic surgery: a case report. Int J Neurosci 2023; 133:806-811. [PMID: 34623200 DOI: 10.1080/00207454.2021.1990914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 03/25/2021] [Accepted: 09/24/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND The comorbidities of either epilepsy or Tourette syndrome (TS) are heterogeneous. However, the co-occurrence of epilepsy and TS conditions is rarely encountered, let alone effective treatments that address both neurologic disorders at the same time. METHODS We report a 24-year-old female patient who was diagnosed with TLE and TS. She presented for seizure control. After evaluation with stereo-electroencephalography and electrocorticography monitoring, the patient underwent a resective surgery treatment and was followed for 9 months. RESULTS At the last follow-up, the patient remained seizure free and unexpectedly showed great improvement in TS symptoms and its psychiatric comorbidities. CONCLUSION This anecdotal case highlights the close association between TLE and TS and we suggest that epilepsy and TS share some common pathophysiologic mechanisms.
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Affiliation(s)
- Fengqiao Sun
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Xicheng District, Beijing, China
| | - Guojun Zhang
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Xicheng District, Beijing, China
| | - Xiaohua Zhang
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Xicheng District, Beijing, China
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Saia F, Prato A, Saccuzzo L, Madia F, Barone R, Fichera M, Rizzo R. Copy Number Variations in Children with Tourette Syndrome: Systematic Investigation in a Clinical Setting. Genes (Basel) 2023; 14:500. [PMID: 36833427 PMCID: PMC9956985 DOI: 10.3390/genes14020500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 02/07/2023] [Accepted: 02/13/2023] [Indexed: 02/18/2023] Open
Abstract
Tourette syndrome (TS) is a neurodevelopmental disturbance with heterogeneous and not completely known etiology. Clinical and molecular appraisal of affected patients is mandatory for outcome amelioration. The current study aimed to understand the molecular bases underpinning TS in a vast cohort of pediatric patients with TS. Molecular analyses included array-CGH analyses. The primary goal was to define the neurobehavioral phenotype of patients with or without pathogenic copy number variations (CNVs). Moreover, we compared the CNVs with CNVs described in the literature in neuropsychiatric disorders, including TS, to describe an effective clinical and molecular characterization of patients for prognostic purposes and for correctly taking charge. Moreover, this study showed that rare deletions and duplications focusing attention on significant genes for neurodevelopment had a statistically higher occurrence in children with tics and additional comorbidities. In our cohort, we determined an incidence of potentially causative CNVs of about 12%, in line with other literature studies. Clearly, further studies are needed to delineate the genetic background of patients with tic disorders in a superior way to elucidate the complex genetic architecture of these disorders, to describe the outcome, and to identify new possible therapeutic targets.
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Affiliation(s)
- Federica Saia
- Child and Adolescent Neurology and Psychiatric Section, Department of Clinical and Experimental Medicine, Catania University, 95124 Catania, Italy
| | - Adriana Prato
- Child and Adolescent Neurology and Psychiatric Section, Department of Clinical and Experimental Medicine, Catania University, 95124 Catania, Italy
- Department of Cognitive Sciences, Psychology, Education and Cultural Studies, University of Messina, 98121 Messina, Italy
| | - Lucia Saccuzzo
- Department of Biomedical and Biotechnological Sciences, Medical Genetics, University of Catania, 95124 Catania, Italy
| | - Francesca Madia
- Laboratory of Neurogenetics and Neuroscience, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Rita Barone
- Child and Adolescent Neurology and Psychiatric Section, Department of Clinical and Experimental Medicine, Catania University, 95124 Catania, Italy
| | - Marco Fichera
- Department of Biomedical and Biotechnological Sciences, Medical Genetics, University of Catania, 95124 Catania, Italy
- Research Unit of Rare Diseases and Neurodevelopmental Disorders, Oasi Research Institute-IRCCS, 94018 Troina, Italy
| | - Renata Rizzo
- Child and Adolescent Neurology and Psychiatric Section, Department of Clinical and Experimental Medicine, Catania University, 95124 Catania, Italy
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Wang H, Yang Y, Zhou D, Bai C, Shi M. Correlation between Serum Levels of Vitamin A and Vitamin D with Disease Severity in Tic Disorder Children. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:7121900. [PMID: 35685731 PMCID: PMC9173974 DOI: 10.1155/2022/7121900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/09/2022] [Accepted: 05/19/2022] [Indexed: 11/29/2022]
Abstract
Purpose To explore and analyze the correlation between serum vitamins A and D levels and disease severity in children with tic disorder. Methods A total of 59 children with tic disorders treated in the Linping Hospital of Traditional Chinese Medicine from April 2018 to May 2021 were selected as the observation group. 55 healthy children with matched age and sex who underwent physical examination were selected as the control group. Children in the observation group were subdivided to the mild group (n = 35) and moderate-to-severe group (n = 24) according to the Yale comprehensive tic severity scale. Afterwards, they were grouped into the temporary group (n = 25), persistent group (n = 22), and Tourette's syndrome group (n = 12) according to their clinical characteristics and course of disease. The severity and serum vitamins A and D levels were collected and compared, and then, Spearman correlation analysis was performed to analyze the correlation between the severity and serum vitamins A and D levels. Results Compared with the control group, the serum vitamin A and D levels in the observation group were lower. Compared with the mild group, the serum vitamins A and D levels were lower in the moderate-to-severe group. Spearman correlation analysis revealed a significant negative correlation between disease severity and serum vitamins A and D levels. Regarding the serum D levels, the temporary group > the persistent group > Tourette's syndrome group. There was no significant difference in serum vitamin A levels among the three groups. Conclusion Vitamins A and D deficiency in children is strongly associated with tic disorders, and vitamins A and D demonstrate a negative correlation with the severity of tic disorders. Vitamin D is also linked to the clinical type of tic disorder.
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Affiliation(s)
- Helin Wang
- Department of Pediatric, Linping Hospital of Traditional Chinese Medicine, Hangzhou 311106, China
| | - Yali Yang
- Department of Pediatric, Linping Hospital of Traditional Chinese Medicine, Hangzhou 311106, China
| | - Dandan Zhou
- Department of Pediatric, Linping Hospital of Traditional Chinese Medicine, Hangzhou 311106, China
| | - Chengjie Bai
- Department of Pediatric, Linping Hospital of Traditional Chinese Medicine, Hangzhou 311106, China
| | - Minqiang Shi
- Department of Pediatric, Linping Hospital of Traditional Chinese Medicine, Hangzhou 311106, China
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EWAS of Monozygotic Twins Implicate a Role of mTOR Pathway in Pathogenesis of Tic Spectrum Disorder. Genes (Basel) 2021; 12:genes12101510. [PMID: 34680906 PMCID: PMC8535383 DOI: 10.3390/genes12101510] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/21/2021] [Accepted: 09/23/2021] [Indexed: 11/17/2022] Open
Abstract
Tic spectrum disorder (TSD) is an umbrella term which includes Gilles de la Tourette syndrome (GTS) and chronic tic disorder (CTD). They are considered highly heritable, yet the genetic components remain largely unknown. In this study we aimed to investigate disease-associated DNA methylation differences to identify genes and pathways which may be implicated in TSD aetiology. For this purpose, we performed an exploratory analysis of the genome-wide DNA methylation patterns in whole blood samples of 16 monozygotic twin pairs, of which eight were discordant and six concordant for TSD, while two pairs were asymptomatic. Although no sites reached genome-wide significance, we identified several sites and regions with a suggestive significance, which were located within or in the vicinity of genes with biological functions associated with neuropsychiatric disorders. The two top genes identified (TSC1 and CRYZ/TYW3) and the enriched pathways and components (phosphoinosides and PTEN pathways, and insulin receptor substrate binding) are related to, or have been associated with, the PI3K/AKT/mTOR pathway. Genes in this pathway have previously been associated with GTS, and mTOR signalling has been implicated in a range of neuropsychiatric disorders. It is thus possible that altered mTOR signalling plays a role in the complex pathogenesis of TSD.
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Bearpark J, Mujong DP, Seri S, Cavanna AE. Headache in patients with Tourette syndrome: A systematic literature review. CEPHALALGIA REPORTS 2020. [DOI: 10.1177/2515816320915711] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Aim: To systematically review the available literature on the prevalence and clinical characteristics of headache in patients with Tourette syndrome (TS), a neurodevelopmental condition characterized by the chronic presence of motor and vocal tics. Design: We conducted a systematic literature review of original studies using three clinical databases (Medline, EMBASE and PsycInfo), according to the standards outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Outcome measures included both tic severity and tic frequency. Results: Our systematic literature review identified six studies on the prevalence and characteristics of headache in patients with TS (data on paediatric patients were available from five studies and data on adult patients from four studies). The proportion of patients with TS who had a diagnosis of headache ranged from 29% to 62%. Migraine was the most commonly investigated headache disorder in this patient population. The findings of the reviewed studies showed that the prevalence of migraine in patients with TS ranges between 13% and 43% and is significantly higher compared to the two control groups ( p < 0.05). Discussion: The prevalence of headache in patients with TS could be higher than in the general population, with the most reliable data being available for migraine. Overall, the literature on the prevalence and characteristics of headache in TS is sparse and highly heterogeneous. Further research on the prevalence and clinical correlates of migraine, tension-type headache and other types of headache in patients with TS across the lifespan is needed to inform clinical practice aimed at improving health-related quality of life in patients with tics.
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Affiliation(s)
- Jack Bearpark
- Department of Neuropsychiatry, The Barberry National Centre for Mental Health, BSMHFT and University of Birmingham, Birmingham, UK
| | - Datapwa Pamilerin Mujong
- Department of Neuropsychiatry, The Barberry National Centre for Mental Health, BSMHFT and University of Birmingham, Birmingham, UK
| | - Stefano Seri
- School of Life and Health Sciences, Aston University, Birmingham, UK
| | - Andrea Eugenio Cavanna
- Department of Neuropsychiatry, The Barberry National Centre for Mental Health, BSMHFT and University of Birmingham, Birmingham, UK
- School of Life and Health Sciences, Aston University, Birmingham, UK
- University College London and Institute of Neurology, London, UK
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Aksu G, Kütük M, Tufan A, Toros F, Uludüz D, Özge A. The close relation of tic disorders with childhood migraine and atopic background of both children and mothers. NEUROL SCI NEUROPHYS 2020. [DOI: 10.4103/nsn.nsn_6_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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Freitas ME, Ruiz-Lopez M, Dalmau J, Erro R, Privitera M, Andrade D, Fasano A. Seizures and movement disorders: phenomenology, diagnostic challenges and therapeutic approaches. J Neurol Neurosurg Psychiatry 2019; 90:920-928. [PMID: 30796133 DOI: 10.1136/jnnp-2018-320039] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 02/06/2019] [Accepted: 02/07/2019] [Indexed: 02/07/2023]
Abstract
Seizures and movement disorders (MDs) are distinct neurological conditions presenting with abnormal movements. Despite sharing an overlap in phenomenology, these movements have different origins. In order to explore the overlaps and the narrow boundaries between these two conditions, we performed a review of the literature to explore the risk of seizures in MDs. We discussed the mimics and chameleons including MDs that look like seizure (eg, paroxysmal dyskinesia, status dystonicus) and seizures that look like MDs (eg, epilepsia partialis continua, nocturnal frontal lobe epilepsy). Additionally, we examined the therapeutic challenges as well as the anatomical and chemical pathways relevant in the interplay between epilepsy and MDs. Finally, we proposed an algorithm to guide clinicians towards the final diagnosis of conditions characterised by the co-occurrence of MDs and seizures.
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Affiliation(s)
- Maria Eliza Freitas
- Medicine, McMaster University Division of Neurology, Hamilton, Ontario, Canada
| | - Marta Ruiz-Lopez
- Service of Neurology, Fundación Jimenez Diaz University Hospital, Madrid, Spain
| | - Josep Dalmau
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Roberto Erro
- Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', University of Salerno, UCL Institute of Neurology, Baronissi, Italy
| | - Michael Privitera
- Epilepsy Center, University of Cincinnati Gardner Neuroscience Institute, Cincinnati, Ohio, USA
| | | | - Alfonso Fasano
- Neurology, Krembil Brain Institute; Movement Disorders Centre and the Edmond J Safra Program in Parkinson's Disease, Toronto, Ontario, Canada
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Balint B, Wiethoff S, Martino D, Del Gamba C, Latorre A, Ganos C, Houlden H, Bhatia KP. Quick Flicks: Association of Paroxysmal Kinesigenic Dyskinesia and Tics. Mov Disord Clin Pract 2018; 5:317-320. [PMID: 29984260 PMCID: PMC6016019 DOI: 10.1002/mdc3.12615] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 02/21/2018] [Accepted: 02/21/2018] [Indexed: 01/04/2023] Open
Abstract
Background Paroxysmal kinesigenic dyskinesia (PKD) is a rare disorder characterised by brief attacks of chorea, dystonia, or mixed forms precipitated by sudden movement. Methods Observational study with a cohort of 14 PKD patients and genetic testing for PRRT2 mutations. Results In a series of 14 PKD patients seen in our clinic at the National Hospital of Neurology, Queen Square, from 2012–2017, we noted tics in 11 patients (79%), which stand in stark contrast to the estimated lifetime prevalence of tics estimated to reach 1%. Conclusions The two reasons to point out this possible association are the clinical implications and the potential opportunity of a better understanding of shared pathophysiological mechanisms of neuronal hyperexcitability.
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Affiliation(s)
- Bettina Balint
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology Queen Square London UK.,Department of Neurology University Hospital Heidelberg Germany.,Neuroimmunology Group, Nuffield Department of Clinical Neurosciences John Radcliffe Hospital Oxford UK
| | - Sarah Wiethoff
- Center for Neurology and Hertie Institute for Clinical Brain Research Eberhard Karls-University Tübingen Germany.,Department of Molecular Neuroscience, UCL Institute of Neurology Queen Square London UK
| | - Davide Martino
- Department of Clinical Neurosciences University of Calgary Canada
| | - Claudia Del Gamba
- Neurology Unit, Department of Clinical and Experimental Medicine University of Pisa
| | - Anna Latorre
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology Queen Square London UK.,Department of Neurology and Psychiatry, Sapienza University of Rome Rome Italy
| | - Christos Ganos
- Department of Neurology University Medical Center, Hamburg-Eppendorf (UKE) Hamburg Germany
| | - Henry Houlden
- Department of Molecular Neuroscience, UCL Institute of Neurology Queen Square London UK
| | - Kailash P Bhatia
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology Queen Square London UK
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The Potential Application of Multiscale Entropy Analysis of Electroencephalography in Children with Neurological and Neuropsychiatric Disorders. ENTROPY 2017; 19:e19080428. [PMID: 33535366 DOI: 10.3390/e19080428] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 08/11/2017] [Accepted: 08/16/2017] [Indexed: 01/25/2023]
Abstract
Electroencephalography (EEG) is frequently used in functional neurological assessment of children with neurological and neuropsychiatric disorders. Multiscale entropy (MSE) can reveal complexity in both short and long time scales and is more feasible in the analysis of EEG. Entropy-based estimation of EEG complexity is a powerful tool in investigating the underlying disturbances of neural networks of the brain. Most neurological and neuropsychiatric disorders in childhood affect the early stage of brain development. The analysis of EEG complexity may show the influences of different neurological and neuropsychiatric disorders on different regions of the brain during development. This article aims to give a brief summary of current concepts of MSE analysis in pediatric neurological and neuropsychiatric disorders. Studies utilizing MSE or its modifications for investigating neurological and neuropsychiatric disorders in children were reviewed. Abnormal EEG complexity was shown in a variety of childhood neurological and neuropsychiatric diseases, including autism, attention deficit/hyperactivity disorder, Tourette syndrome, and epilepsy in infancy and childhood. MSE has been shown to be a powerful method for analyzing the non-linear anomaly of EEG in childhood neurological diseases. Further studies are needed to show its clinical implications on diagnosis, treatment, and outcome prediction.
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Abstract
We present selected highlights from research that appeared during 2015 on Tourette syndrome and other tic disorders. Topics include phenomenology, comorbidities, developmental course, genetics, animal models, neuroimaging, electrophysiology, pharmacology, and treatment. We briefly summarize articles whose results we believe may lead to new treatments, additional research or modifications in current models of TS.
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Affiliation(s)
- Cheryl A Richards
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA; Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Kevin J Black
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA; Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA; Department of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA; Department of Neuroscience, Washington University School of Medicine, St. Louis, Missouri, USA
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