Tourette syndrome and other tic disorders in a total population of children: Clinical assessment and background

Department of Neuroscience, Child and Adolescent Psychiatry, University Hospital, Uppsala, Sweden.
Acta Paediatrica (Impact Factor: 1.84). 12/2005; 94(11):1608-14. DOI: 10.1080/08035250510043879
Source: PubMed

ABSTRACT To describe the symptoms, onset, heredity, pre-/perinatal events and socio-economic status in Tourette syndrome (TS) and other tic disorders.
From a total population of 4479 children, 25 (0.6%) with TS, 58 (1.3%) with chronic motor/vocal tics (CMVT) and 214 (4.8%) with transient tics (TT) in the last year were found. A three-stage procedure was used: tic screening, telephone interview and clinical assessment. The TS group was compared with 25 children with TT and 25 controls without tics.
The mean age of the first symptoms of TS was significantly lower than the onset of CMVT. All except one with TS had contact with medical services. The tics of children with TS were significantly more severe than the tics of others. Younger age of onset of TS indicated more severe tics. Parents and siblings of children with TS had an increased prevalence of tic disorders, obsessive-compulsive behaviour (OCD), attention-deficit/hyperactivity disorder (ADHD) and depression. Eighty per cent had a first-degree relative with a psychiatric disorder. A non-significant increase with regards to reduced optimality score in the pre-, peri- or neonatal periods was found in children with TS compared to controls. No differences were found concerning socio-economic status.
Almost all children from a total population with TS have sought help from medical services. An increased prevalence of tics, OCD, depression or ADHD was found in the parents/siblings of children with TS, which draws attention to the importance of thorough investigation of family members.

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Available from: Anne-Liis von Knorring, Oct 05, 2014
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    • "Other reported hair colours were blonde hair 35 (21%), dark brown 44 (27%), light brown 52 (31%) and black 12 (8%). From published data, 2–6% of the population or control groups in Australia have red hair [15] [16] [17] [18] [19] [20] [21] [22] (Fig. 1). As shown the estimated proportion of individuals with red hair is higher in this study, and significantly higher than five of the eight populations or control group studies. "
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    ABSTRACT: Tourette syndrome is a chronic, idiopathic, childhood onset neuropsychiatric disorder with both motor and vocal tics. Tourette syndrome occurs worldwide and the clinical features are similar irrespective of the country of origin, with genetic causes suspected, but to date not proven. A link between red hair colour and Tourette syndrome has been hypothesised as a result of an observation that red hair is over represented in this condition. A causal association between red hair and melanocortin-1 receptor has been shown, and is the only gene that is known to explain physiological variation in human pigmentation. Melanocortins are believed to be involved in many disease states including pigmentary disorders, adrenal disorders, obesity, anorexia, prolonged and neuropathic pain, and inflammatory response. The mode of inheritance for Tourette syndrome is thought to be autosomal recessive, same as for red hair with both aggregating in families. To explore the hypothesis, 168 postal questionnaires sent to Tourette syndrome patients on the registry of the 'Tourette Syndrome Association of Australia', were analysed. In this study 22, 13% (95% CI 8.9-19.4) of the Tourette syndrome population had red hair. Data from Australian studies suggests, the normal population with red hair is 2-6%. The proportions of red haired individuals in this study were significantly higher than five of the eight population control groups. Fifty five percent of the Tourette syndrome patients had relatives with red hair. Of these 30% were first degree and 46% were second degree relatives, with a further 24% of more distant relatives. Many Tourette syndrome patients had multiple red haired relatives, since 90 patients yielded a total of 181 relatives with red hair. If this hypothesis is correct the MCIR gene, through a neurological effect, or a gene for Tourette syndrome, located on chromosome 16 in the vicinity of MC1R, could be on the causal pathway. As these figures demonstrate, the hypothesis that there is an association between red hair and Tourette syndrome needs further evaluation.
    Medical Hypotheses 06/2009; 73(5):849-53. DOI:10.1016/j.mehy.2009.03.052 · 1.07 Impact Factor
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    • "Itard (1825) was the first to scientifically describe impairing chronic motor and vocal tics (TD) in a French noblewoman forced to live isolated on accouint of her impairing tics. The majority of affected children suffer from additional major problems, including as ADHD, OCD, anxiety and ASD (Kadesjö & Gillberg, 2000; Robertson, 2000; Khalifa & von Knorring, 2005). The prevalence rate for TD is estimated at 1-2% of the general population of school age children, with at least a threefold higher rate in boys than girls (Kadesjö & Gillberg, 2000; Khalifa & von Knorring, 2003). "
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