Environmental circumstances influencing tic expression in children

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• 作者：Bel&eacute ; n Caurí ; n^a ; Mercedes Serrano^a ; ^b ; Emilio Ferná ; ndez-Alvarez^a ; Jaume Campistol^a ; ^b ; Bel&eacute ; n P&eacute ; rez-Dueñ ; as^a ; ^b ; ^{bperez@hsjdbcn.org" class="auth_mail}
• 关键词：Tics ; Tourette syndrome ; ADHD ; Movement disorders ; Children
• 刊名：European Journal of Paediatric Neurology
• 出版年：March, 2014
• 年：2014
• 卷：18
• 期：2
• 页码：157-162
• 全文大小：266 K

文摘

Aim

To assess the clinical features and severity of tics and environmental factors influencing tic expression in a cohort of children with tic disorders.

Methods

We performed a cross-sectional study in a cohort of children and adolescents (N聽=聽92) with tic disorders referred to the outpatient clinic of a tertiary-level paediatric centre in Barcelona. The severity of tics was evaluated using the Yale Global Tic Severity Scale (YGTSS). A questionnaire including a list of environmental factors and common daily activities that might influence tic occurrence was completed for patients greater than 5 years old.

Results

Children were classified as having Tourette syndrome (TS) (52 patients), chronic motor or phonic tics (22 patients) and tics of less than 12 months' duration (18 patients). Tics worsened with stressful situations, activities related to school, playing video games and watching TV. A significant proportion of children reported a reduction in tics while they were concentrating on artistic or creative activities or when playing sports and participating in outdoor activities. The YGTSS scores were higher for TS patients (P聽<聽.001) and correlated positively with the time of evolution of tics (r聽=聽.273, P聽=聽.026). Poor school performance was associated with TS (p聽=聽.043) and higher scores on the YGTSS (P聽=聽.018), as well as attention deficit/hyperactivity disorder (P聽=聽.007).

Conclusions

Several activities of daily living were identified as modifying tic severity in children and may be important clues for tic management. In a subgroup of children with TS, tics were associated with significant morbidity and poor academic performance. Our results emphasise the importance of developing specific school programmes and tailored recommendations in patients with TS.