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Dy-Hollins ME, Carr SJ, Essa A, Osiecki L, Lackland DT, Voeks JH, Mejia NI, Sharma N, Budman CL, Cath DC, Grados MA, King RA, Lyon GJ, Rouleau GA, Sandor P, Singer HS, Chibnik LB, Mathews CA, Scharf JM. The Challenge of Examining Social Determinants of Health in People Living With Tourette Syndrome. Pediatr Neurol 2024; 155:55-61. [PMID: 38608551 PMCID: PMC11132913 DOI: 10.1016/j.pediatrneurol.2024.02.008] [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: 10/12/2023] [Revised: 01/19/2024] [Accepted: 02/15/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND To examine the association between race, ethnicity, and parental educational attainment on tic-related outcomes among Tourette Syndrome (TS) participants in the Tourette Association of America International Consortium for Genetics (TAAICG) database. METHODS 723 participants in the TAAICG dataset aged ≤21 years were included. The relationships between tic-related outcomes and race and ethnicity were examined using linear and logistic regressions. Parametric and nonparametric tests were performed to examine the association between parental educational attainment and tic-related outcomes. RESULTS Race and ethnicity were collapsed as non-Hispanic white (N=566, 88.0%) versus Other (N=77, 12.0%). Tic symptom onset was earlier by 1.1 years (P < 0.0001) and TS diagnosis age was earlier by 0.9 years (P = 0.0045) in the Other group (versus non-Hispanic white). Sex and parental education as covariates did not contribute to the differences observed in TS diagnosis age. There were no significant group differences observed across the tic-related outcomes in parental education variable. CONCLUSIONS Our study was limited by the low number of nonwhite or Hispanic individuals in the cohort. Racial and ethnic minoritized groups experienced an earlier age of TS diagnosis than non-Hispanic white individuals. Tic severity did not differ between the two groups, and parental educational attainment did not affect tic-related outcomes. There remain significant disparities and gaps in knowledge regarding TS and associated comorbid conditions. Our study suggests the need for more proactive steps to engage individuals with tic disorders from all racial and ethnic minoritized groups to participate in research studies.
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Affiliation(s)
- Marisela E Dy-Hollins
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
| | - Samuel J Carr
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Angela Essa
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Lisa Osiecki
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Daniel T Lackland
- Department of Neurology, Medical University of South Carolina, Charleston, South Carolina
| | - Jenifer H Voeks
- Department of Neurology, Medical University of South Carolina, Charleston, South Carolina
| | - Nicte I Mejia
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Nutan Sharma
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Danielle C Cath
- Department of Psychiatry, University Medical Center Groningen, Rijks Universiteit Groningen, and Drenthe Mental Health Institute, Groningen, Netherlands
| | - Marco A Grados
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Robert A King
- Yale Child Study Center, Yale School of Medicine, New Haven, Connecticut
| | - Gholson J Lyon
- George A. Jervis Clinic and Institute for Basic Research in Developmental Disabilities, Staten Island, New York
| | - Guy A Rouleau
- Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University Health Center, Montreal, Canada
| | - Paul Sandor
- Department of Psychiatry, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Harvey S Singer
- Departments of Pediatrics and Neurology, Johns Hopkins Hospital, Kennedy Krieger Institute, Baltimore, Maryland
| | - Lori B Chibnik
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Carol A Mathews
- Department of Psychiatry, Center for OCD, Anxiety and Related Disorders, University of Florida, Gainsville, Florida
| | - Jeremiah M Scharf
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Kim S, Kim MS, Kim J, Hong SB. Incidence trend and epidemiology of tic disorders among youths and adults in Korea from 2003 to 2020: A national population-based study. Psychiatry Res 2024; 331:115634. [PMID: 38141266 DOI: 10.1016/j.psychres.2023.115634] [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: 07/28/2023] [Revised: 11/23/2023] [Accepted: 11/25/2023] [Indexed: 12/25/2023]
Abstract
Tic disorder is a highly prevalent neurodevelopmental disorder; however, research on its incidence trends is still rare. We aimed to investigate its annual incidence rates and the characteristics of incident cases in the general Korean population using data from the National Health Insurance Service-National Health Information Database as a proxy measurement for true incidence in the community. The total number of incident cases and incidence rates of tic disorders from 2003 to 2020 were compared between youths and adults. Both the number of incident cases and the annual incidence rates of tic disorders significantly increased from 2003 to 2020. The overall increasing trend in the incidence rates was significantly greater in youths than in adults; however, the incidence rates in adults showed a relatively recent increase. The male predominance regarding the newly diagnosed case number in youths was no longer observed in adults. Tic disorders occurred more commonly in the low-income group than in the high-income group. Neurodevelopmental comorbidities in youths and mood or anxiety disorders and schizophrenia in adults were more frequently observed. Antipsychotic medication adherence was higher in youths than in adults. Efforts are required to raise awareness and promote expert education for adult patients with tic disorders.
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Affiliation(s)
- Sujin Kim
- Department of Psychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Mi-Sook Kim
- Division of Clinical Epidemiology, Medical Research Collaborating Center, Biomedical Research Institution, Seoul National University Hospital, Seoul, South Korea
| | - Jinhee Kim
- Division of Clinical Epidemiology, Medical Research Collaborating Center, Biomedical Research Institution, Seoul National University Hospital, Seoul, South Korea
| | - Soon-Beom Hong
- Department of Psychiatry, Seoul National University Hospital, Seoul, South Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea; Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, South Korea.
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Sung Y, Hong SB. Diagnostic Hierarchy of Tic Disorders in Real-World Clinical Practice. Soa Chongsonyon Chongsin Uihak 2023; 34:236-241. [PMID: 37841482 PMCID: PMC10568186 DOI: 10.5765/jkacap.230034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 07/04/2023] [Accepted: 07/21/2023] [Indexed: 10/17/2023] Open
Abstract
Objectives According to the 10th revision of the International Classification of Diseases, the main categories of tic disorders (F95.0, F95.1, and F95.2) follow a diagnostic hierarchy based on the duration and diversity of tic symptoms. The present study investigated the use of this diagnostic hierarchy in real-world clinical practice. Methods Based on the National Health Insurance Service-National Health Information Database, the diagnosis of transient tic disorder (F95.0) made after a diagnosis of chronic motor or vocal tic disorder (F95.1) or Tourette's syndrome (F95.2) and diagnosis of chronic motor or vocal tic disorder (F95.1) made after a diagnosis of Tourette's syndrome (F95.2) were referred to as type A errors. The diagnosis of transient tic disorder (F95.0) repeated after a period of >12 months was referred to as type B error. Demographic and clinical differences according to the diagnostic error types were analyzed using analysis of variance, Student's t-tests, and chi-squared tests. Results Most participants (96.5%) were without errors in the diagnosis of tic disorders. Higher proportions of males (p=0.005) and antipsychotic prescriptions (p<0.001) were observed in patients with type A or B diagnostic errors. A higher proportion of health insurance holders was observed among those with type A errors (p=0.027). Conclusion Errors were absent in majority of the tic diagnoses in real-world clinical practice in terms of the diagnostic hierarchy.
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Affiliation(s)
- Yeeji Sung
- Department of Psychiatry, Seoul National University Hospital, Seoul, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Soon-Beom Hong
- Department of Psychiatry, Seoul National University Hospital, Seoul, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
- Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Korea
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Chou CY, Agin-Liebes J, Kuo SH. Emerging therapies and recent advances for Tourette syndrome. Heliyon 2023; 9:e12874. [PMID: 36691528 PMCID: PMC9860289 DOI: 10.1016/j.heliyon.2023.e12874] [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: 09/13/2022] [Revised: 11/27/2022] [Accepted: 01/05/2023] [Indexed: 01/09/2023] Open
Abstract
Tourette syndrome is the most prevalent hyperkinetic movement disorder in children and can be highly disabling. While the pathomechanism of Tourette syndrome remains largely obscure, recent studies have greatly improved our knowledge about this disease, providing a new perspective in our understanding of this condition. Advances in electrophysiology and neuroimaging have elucidated that there is a reduction in frontal cortical volume and reduction of long rage connectivity to the frontal lobe from other parts of the brain. Several genes have also been identified to be associated with Tourette syndrome. Treatment of Tourette syndrome requires a multidisciplinary approach which includes behavioral and pharmacological therapy. In severe cases surgical therapy with deep brain stimulation may be warranted, though the optimal location for stimulation is still being investigated. Studies on alternative therapies including traditional Chinese medicine and neuromodulation, such as transcranial magnetic stimulation have shown promising results, but still are being used in an experimental basis. Several new therapies have also recently been tested in clinical trials. This review provides an overview of the latest findings with regards to genetics and neuroimaging for Tourette syndrome as well as an update on advanced therapeutics.
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Affiliation(s)
- Chih-Yi Chou
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Initiative for Columbia Ataxia and Tremor, Columbia University, New York, NY, USA
| | - Julian Agin-Liebes
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Initiative for Columbia Ataxia and Tremor, Columbia University, New York, NY, USA
| | - Sheng-Han Kuo
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Initiative for Columbia Ataxia and Tremor, Columbia University, New York, NY, USA
- Corresponding author. 650 West 168th Street, Room 305, New York, NY, 10032, USA. Fax: +(212) 305 1304.
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Chang Y, Zhang Y, Bai Y, Lin R, Qi Y, Li M. The correlation between tic disorders and allergic conditions in children: A systematic review and meta-analysis of observational studies. Front Pediatr 2023; 11:1064001. [PMID: 37020645 PMCID: PMC10067604 DOI: 10.3389/fped.2023.1064001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 02/22/2023] [Indexed: 04/07/2023] Open
Abstract
Aim To evaluate the correlation between tic disorders and allergies and to inform strategies for the treatment and prevention of tic disorders. Methods We conducted online searches of the MEDLINE, Embase, Cochrane, CNKI, CBM, WanFang, and VIP Information databases. Case-control studies and cohort studies related to tic disorders and allergic conditions were searched. Two researchers screened the literature, extracted data, and evaluated quality in strict accordance with the predetermined retrieval strategy and inclusion criteria. Finally, RevMan 5.4 software was used to conduct a meta-analysis. We used the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach to rating the certainty of evidence about each allergy outcome as high, moderate, low, or very low. Results We obtained seven eligible studies involving eight allergic conditions. The following allergic conditions were significantly associated with the presence of a tic disorder: asthma (OR = 1.90, 95% CI = 1.57-2.30, P < 0.001), allergic rhinitis (OR = 2.61, 95% CI = 1.90-3.57, P < 0.001), allergic conjunctivitis (OR = 3.65, 95% CI = 1.53-8,67, P = 0.003), eczema (OR = 3.87, 95% CI = 2.24-6.67, P < 0.001) and food allergy (OR = 2.79, 95% CI = 1.56-4.99, P < 0.001). There was no significant correlation between atopic dermatitis, urticaria, drug allergy, and tic disorder. Conclusion The occurrence of tic disorders may be associated with the presence of certain allergic disorders. However, whether allergy is one of the causes of tic disorders remains unclear. Systematic review registration The registration number for this systematic review is PROSPERO: CRD42021231658.
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Affiliation(s)
- Ying Chang
- Department of Traditional Chinese Medicine, Children’s Hospital Capital Institute of Pediatrics, Beijing, China
| | - Ying Zhang
- Evidence Based Medicine Center, Beijing University of Chinese Medicine, Beijing, China
| | - Yifan Bai
- Department of Pediatrics, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Run Lin
- College of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yaping Qi
- TCM Pediatrics Department, Beijing Changping District Maternity and Child Care Hospital, Beijing, China
| | - Min Li
- Department of Traditional Chinese Medicine, Children’s Hospital Capital Institute of Pediatrics, Beijing, China
- Department of Pediatrics, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
- Correspondence: Li Min
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Yang C, Yang Y, Zhang L, Zhao L. Medication Choices in Children With Tic Disorders in Mainland China, Macao, Hong Kong, and Taiwan: Perspectives of Guardians and Physicians. Front Pharmacol 2022; 13:852414. [PMID: 35592414 PMCID: PMC9110660 DOI: 10.3389/fphar.2022.852414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/31/2022] [Indexed: 11/17/2022] Open
Abstract
Objective: Survey pediatricians and guardians of children with tic disorder on medication needs and choices. Methods: We designed a cross-sectional survey for pediatricians in mainland China, Hong Kong, Macao, and Taiwan, as well as for the guardians of patients with tic disorder from West China Second University Hospital. We collected and analyzed information on clinicians’ medical behavior and medication choices and on guardians’ knowledge of tic disorder, medical treatment behaviors, and medication choices and needs. Results: We collected responses from 242 physicians and 610 guardians. For patients with tic disorder and without comorbidities, the first-line drugs selected by physicians were tiapride (60.74%), clonidine (32.64%), haloperidol (25.62%), aripiprazole (16.53%), and sulpiride (12.4%). Physicians reported making medication choices by considerations such as clinical guidelines, clinical efficacy, a low incidence of adverse drug reactions, sufficient clinical research evidence, convenient dosage forms, and patient adherence. Guardians reported making medication choices by considerations such as a low incidence of adverse drug reactions, physician recommendations, clinical efficacy, dose, dosage forms, and the convenience and steadiness of obtaining the medication. However, guardians exhibited insufficient knowledge of tic disorder and treatment options. Conclusions: Physicians and patient guardians differ in their considerations when selecting medications, highlighting a gap in optimizing treatment.
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Affiliation(s)
- Chunsong Yang
- Department of Pharmacy, Evidence-based Pharmacy Center, West China Second Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Yaya Yang
- Department of Pharmacy, Evidence-based Pharmacy Center, West China Second Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Lingli Zhang
- Department of Pharmacy, Evidence-based Pharmacy Center, West China Second Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Li Zhao
- Department of Health Policy and Management, West China School of Public Health/West China Fourth Hospital, Sichuan University, Chengdu, China
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Cha JH, Ahn JH, Kim YJ, Lee BG, Kim JI, Park HK, Kim BN, Lee HJ. Impact of Preterm Birth on Neurodevelopmental Disorders in South Korea: A Nationwide Population-Based Study. J Clin Med 2022; 11:2476. [PMID: 35566601 PMCID: PMC9099635 DOI: 10.3390/jcm11092476] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 12/14/2022] Open
Abstract
Neurodevelopmental disorder (NDD) in preterm infants has become of great interest. We aimed to investigate the impact of preterm birth on the proportion of NDD using nationwide data provided by the Korean National Health Insurance Service. We included 4894 extremely preterm or extremely low-birth-weight (EP/ELBW; <28 weeks of gestation or birth weight < 1000 g) infants, 70,583 other preterm or low-birth-weight (OP/LBW; 28−36 weeks of gestation or birth weight < 2500 g) infants, and 264,057 full-term infants born between 2008 and 2015. We observed their neurodevelopment until 6 years of age or until the year 2019, whichever occurred first. Diagnoses of NDDs were based on the World Health Organization’s International Classification of Diseases 10th revision. An association between preterm birth and NDD was assessed using a multivariable logistic regression model. There was a stepwise increase in the risk of overall NDD with increasing degree of prematurity, from OP/LBW (adjusted odds ratio 4.46; 95% confidence interval 4.34−4.58), to EP/ELBW (16.15; 15.21−17.15). The EP/ELBW group was strongly associated with developmental delay (21.47; 20.05−22.99), cerebral palsy (88.11; 79.89−97.19), and autism spectrum disorder (11.64; 10.37−13.06). Preterm birth considerably increased the risk of NDD by the degree of prematurity.
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Affiliation(s)
- Jong Ho Cha
- Department of Pediatrics, Hanyang University Hospital, Hanyang University College of Medicine, Seoul 04763, Korea; (J.H.C.); (J.-H.A.); (H.-K.P.)
| | - Ja-Hye Ahn
- Department of Pediatrics, Hanyang University Hospital, Hanyang University College of Medicine, Seoul 04763, Korea; (J.H.C.); (J.-H.A.); (H.-K.P.)
| | - Yun Jin Kim
- Biostatistical Consulting and Research Lab, Medical Research Collaborating Center, Hanyang University, Seoul 04763, Korea;
| | - Bong Gun Lee
- Department of Orthopedic Surgery, Hanyang University Hospital, Hanyang University College of Medicine, Seoul 04763, Korea;
| | - Johanna Inhyang Kim
- Clinical Research Institute of Developmental Medicine, Hanyang University Hospital, Seoul 04763, Korea;
- Department of Psychiatry, Hanyang University Hospital, Hanyang University College of Medicine, Seoul 04763, Korea
| | - Hyun-Kyung Park
- Department of Pediatrics, Hanyang University Hospital, Hanyang University College of Medicine, Seoul 04763, Korea; (J.H.C.); (J.-H.A.); (H.-K.P.)
- Clinical Research Institute of Developmental Medicine, Hanyang University Hospital, Seoul 04763, Korea;
| | - Bung-Nyun Kim
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, Seoul 03080, Korea
| | - Hyun Ju Lee
- Department of Pediatrics, Hanyang University Hospital, Hanyang University College of Medicine, Seoul 04763, Korea; (J.H.C.); (J.-H.A.); (H.-K.P.)
- Clinical Research Institute of Developmental Medicine, Hanyang University Hospital, Seoul 04763, Korea;
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Zykov V, Kashirina E, Naugolnykh Y. Electromyography in childhood patients with tic hyperkinesis and Tourette’s syndrome. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:19-25. [DOI: 10.17116/jnevro202112111219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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