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Clinical precursors of tics: an EMTICS study.
Thaïra J C Openneer1, Chaim Huyser2,3, Davide Martino4
1Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Summary
Children at risk for Tourette syndrome (TS) may show early signs of conduct, autism spectrum disorder (ASD), and emotional problems before tic onset. These precursors, including compulsions, differ between sexes, suggesting tailored monitoring for early detection, especially in females.
Area of Science:
- Neurodevelopmental disorders
- Child and adolescent psychiatry
- Genetics of tic disorders
Background:
- Tourette syndrome (TS) frequently co-occurs with attention-deficit/hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD).
- The existence of clinical precursors before the onset of tics in children remains largely unknown.
- Understanding these precursors is crucial for early identification and intervention in at-risk populations.
Purpose of the Study:
- To identify clinical characteristics that may predict the onset of tics in children.
- To compare these characteristics in children who develop tics versus those who do not.
- To explore potential sex differences in these predictive factors.
Main Methods:
- Longitudinal study of 187 first-degree relatives (3-10 years old) of children with TS.
- Follow-up for up to 7 years within the European Multicentre Tics in Children Study (EMTICS).
- Utilized penalized logistic regression (LASSO) to analyze baseline clinical characteristics predicting tic onset, with sex-specific analyses.
Main Results:
- Children who developed tics showed higher baseline severity of conduct problems, autism spectrum disorder (ASD) symptoms, compulsions, and emotional problems.
- Conduct and ASD problems were identified as male-specific predictors of tic onset.
- Compulsions and oppositional/emotional problems were identified as female-specific predictors.
Conclusions:
- Clinical precursors to tic onset exist and are identifiable before tics manifest.
- Sex-specific monitoring is essential for early detection of tics, particularly in at-risk females.
- Contrary to common belief, tics often persist beyond one year after onset.
