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The clinical features and initial pharmacotherapeutic options of children with Tic disorders
Yuxin Xiang1, Chang Tong1, Dan Sun1
1Department of Neurology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Insights
This study analyzed 805 pediatric patients with tic disorders (TD), finding that Tourette syndrome (TS), age, and ADHD significantly impact tic severity. Clonidine patch (CAP) and traditional Chinese medicine (TCM) were common initial treatments.
Area of Science:
- Pediatric Neurology
- Neurodevelopmental Disorders
- Clinical Pharmacology
Background:
- Tic disorders (TD) are common childhood neurodevelopmental conditions with varied presentations, often leading to delayed diagnosis and treatment.
- Early identification and intervention are crucial for improving outcomes in pediatric TD.
- This study focuses on characterizing clinical features and initial pharmacotherapy in newly diagnosed pediatric TD patients.
Purpose of the Study:
- To characterize the clinical features of newly diagnosed pediatric tic disorders across different severity levels.
- To identify factors associated with varying tic severity in children.
- To examine predictors of initial pharmacotherapy initiation in pediatric TD.
Main Methods:
- A retrospective cohort study of 805 newly diagnosed pediatric TD patients.
- Tic severity assessed using the Yale Global Tic Severity Scale (YGTSS) and categorized as mild, moderate, or severe.
- Statistical analyses included chi-square tests, Wilcoxon rank-sum tests, multivariate analyses, and logistic regression to identify associations and predictors.
Main Results:
- Provisional tic disorder, chronic tic disorder, and Tourette syndrome (TS) comprised the patient cohort.
- Higher tic severity was significantly associated with a diagnosis of TS, earlier age at onset, earlier age at diagnosis, and comorbid attention-deficit/hyperactivity disorder (ADHD).
- Clonidine patch (CAP) and traditional Chinese medicine (TCM) were the most frequent initial pharmacotherapy choices, with YGTSS scores and comorbid ADHD predicting treatment initiation.
Conclusions:
- The study provides insights into clinical profiles and pharmacotherapeutic strategies for newly diagnosed pediatric TD.
- Baseline factors like TS diagnosis, age, and ADHD significantly influence tic severity.
- CAP and TCM are prevalent initial treatment options for pediatric TD, with severity and comorbidities guiding pharmacotherapy decisions.
Purpose:
Tic disorders (TD) are common childhood neurodevelopmental conditions, characterized by diverse manifestations, leading to misdiagnosis and delayed therapy. Timely identification of TD and access to care can improve clinical outcomes. This retrospective study characterizes clinical features and initial pharmacotherapy in newly diagnosed pediatric TD.
Method:
This retrospective cohort study included 805 newly diagnosed pediatric TD patients. Tic severity was assessed using the Yale Global Tic Severity Scale (YGTSS), with patients stratified into mild (YGTSS scores < 25), moderate (25-50), and severe (>50) groups. Chi-square tests/Fisher-exact tests and Wilcoxon rank-sum tests compared group differences in baseline characteristics. Multivariate analyses identified factors associated with tic severity, and logistic regression analyses identified predictors of pharmacotherapy initiation.
Results:
In 805 subjects, 73.43%, 11.18% and 15.39% were classified into provisional tic disorder, chronic tic disorder, and Tourette syndrome (TS). The prevalence of comorbid attention-deficit/hyperactivity disorder (ADHD) was higher in moderate (21.45%) and severe (36.36%) groups than in the mild group (15.60%). The diagnosis of Tourette syndrome (aOR = 1.40, 95% CI: 1.23-160.31), age at onset (aOR = 1.63, 95% CI: 1.22-2.18), and age at diagnosis (aOR = 1.63, 95% CI: 1.22-2.17), comorbid ADHD (aOR = 7.12, 95% CI: 1.39-36.43) were positively associated with greater tic severity. Clonidine patch (CAP) and traditional Chinese medicine (TCM) were the most common choices initial pharmacotherapy in newly diagnosed pediatric TD. Scores of YGTSS, comorbid ADHD predicted treatment initiation.
Conclusions:
This study contributed insights into the clinical profiles across tic severity and pharmacotherapeutic approaches in newly diagnosed pediatric TD. The findings highlighted the independent associations between baseline factors and tic severity, as well as the predictors of pharmacotherapy initiation. CAP and TCM served as the most common choices in newly diagnosed pediatric TD.
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