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Recurrence of Tic disorders in children after medication withdrawal: A cohort study on long-term outcomes
Si Zhang1, Yuxin Chai1, Zilin Chen1
1Department of Paediatrics, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Insights
Tic recurrence is common in children with tic disorders after stopping medication, with over half relapsing within a year. Factors like screen time and emotional stimuli influence recurrence risk.
Area of Science:
- Pediatric Neurology
- Child Psychiatry
- Neurodevelopmental Disorders
Background:
- Tic disorders affect a significant number of children.
- Medication withdrawal is a common clinical scenario.
- Understanding relapse predictors is crucial for effective management.
Purpose of the Study:
- To determine the relapse rate in children with tic disorders after discontinuing medication.
- To identify risk factors associated with tic recurrence.
Main Methods:
- Prospective cohort study of 387 children.
- 12-month monthly follow-up post-medication discontinuation.
- Cox regression analysis to identify prognostic factors.
Main Results:
- 61% of children relapsed within 12 months.
- Recurrence included original tics, new tics, or both.
- Key predictors: treatment duration, tic severity, screen time, negative emotions, snacking.
Conclusions:
- Tic recurrence after medication withdrawal is frequent in children.
- Modifiable factors like screen time and diet impact recurrence.
- Addressing these predictors can improve prevention strategies.
Aim:
To evaluate the relapse rate in children with tic disorders following medication withdrawal and to identify the risk factors associated with tic recurrence.
Methods:
This prospective cohort study enrolled 387 children who had recently discontinued medication and had been tic-free for at least 3 months. Participants were followed monthly for 12 months to monitor tic relapse. The primary outcome was the time from medication discontinuation to tic recurrence, while the secondary outcome was the characteristics of the recurrence. Cox regression models were used to identify prognostic factors associated with relapse.
Results:
During the 12-month follow-up, 235 participants (61 %) experienced tic relapse. Among these, 120 participants (51 %) had a recurrence of their original tic symptoms, 75 (32 %) developed new symptoms alongside their original tics, and 39 (17 %) presented with entirely new tic symptoms. Significant prognostic factors for tic recurrence included treatment duration, Yale Global Tic Severity Scale score at the worst-ever phase, average daily screen time, negative emotional stimuli, and snack consumption.
Conclusion:
Tic recurrence following medication discontinuation is common in children with tic disorders and is associated with several modifiable prognostic factors. Clinicians should address these predictors to develop more effective prevention strategies and reduce tic recurrence.
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