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Complementary Therapies in Medicine Jun 2021To systematically evaluate the clinical efficacy and safety of acupuncture in the treatment of Tic Disorders (TD) in children, and to clarify the current evidence... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To systematically evaluate the clinical efficacy and safety of acupuncture in the treatment of Tic Disorders (TD) in children, and to clarify the current evidence regarding the clinical application of acupuncture in the treatment of TD.
METHODS
Randomized controlled trials (RCTs) comparing acupuncture treatment with pharmaceutical treatment for TD were included in this review. A comprehensive search of 6 electronic literature databases was conducted, and the retrieval date was from the establishment of the database to April 2020. The Cochrane Collaboration's bias risk assessment tool was used to evaluate the bias risk of the included literature, and adopted the Review Manager 5.3 was used for statistical analysis of the data in the included literature.
RESULTS
A total of 22 RCTs (1668 participants) were included in this review. Meta-analysis indicated that acupuncture showed superior effects in the following aspects, including higher overall effective rate [RR = 1.20,95 % CI(1.09,1.20),P<0.00001], significant reduction in Yale Global Tic Severity Scale (YGTSS) scores [MD=-2.79,95 %CI(-4.75,-0.82),P = 0.005], lower incidence of adverse effects [RR = 0.26,95 %CI(0.17,0.41),P<0.00001], and reduced recurrence rate [RR = 0.28,95 %CI(0.17,0.46),P<0.00001].
CONCLUSION
Acupuncture treatment alone is more effective in the treatment of TD than pharmaceutical treatment, as seen in the reduction of YGTSS scores, fewer adverse effects and lower recurrence rates.
Topics: Acupuncture Therapy; Bias; Child; Humans; Randomized Controlled Trials as Topic; Tic Disorders; Treatment Outcome
PubMed: 33989798
DOI: 10.1016/j.ctim.2021.102734 -
Frontiers in Psychiatry 2021Comorbidities are seen with obsessive-compulsive disorder (OCD) across the lifespan. Neurodevelopmental comorbidities are common in young children, followed by mood,...
Comorbidities are seen with obsessive-compulsive disorder (OCD) across the lifespan. Neurodevelopmental comorbidities are common in young children, followed by mood, anxiety, and obsessive-compulsive related disorders (OCRDs) in children, adolescents and adults, and neurological and degenerative disorders in the elderly. Understanding comorbidity prevalence and patterns has clinical and research implications. We conducted a systematic review and meta-analysis on comorbidities in OCD across the lifespan, with the objective to, first, estimate age-wise pattern and prevalence of comorbidities with OCD and, second, to examine associations of demographic (age at assessment, gender distribution) and clinical characteristics (age of onset, illness severity) with comorbidities. Four electronic databases (PubMed, EMBASE, SCOPUS, and PsycINFO) were searched using predefined search terms for articles published between 1979 and 2020. Eligible studies, across age, reported original findings on comorbidities and had an OCD sample size of ≥100. We excluded studies that did not use standardised diagnostic assessments, or that excluded patients on the basis of comorbidity. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The review protocol has been registered on the International Prospective Register of Systematic Reviews. A comorbidity rate of 69% was found in a pooled sample of more than 15,000 individuals. Mood disorders (major depressive disorder), anxiety disorders (generalised anxiety disorder), neurodevelopmental disorders (NDDs) and OCRDs were the commonest comorbidities. Anxiety disorders prevailed in children, mood disorders in adults, whereas NDDs were similarly prevalent. Higher comorbidity with any psychiatric illness, NDDs, and severe mental disorders was seen in males, vs. females. Illness severity was inversely associated with rates for panic disorder, tic disorders, OCRDs, obsessive compulsive personality disorder, and anorexia nervosa. This systematic review and meta-analysis provides base rates for comorbidities in OCD across the lifespan. This has implications for comprehensive clinical evaluation and management planning. The high variability in comorbidity rates suggests the need for quality, multi-centric, large studies, using prospective designs. Unique Identifier: CRD42020215904.
PubMed: 34858219
DOI: 10.3389/fpsyt.2021.703701 -
Frontiers in Immunology 2022Tic disorder is a neurodevelopmental disorder characterized by motor and phonic tic symptoms. Tourette syndrome (TS) is a subtype of tic disorder that shows more... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Tic disorder is a neurodevelopmental disorder characterized by motor and phonic tic symptoms. Tourette syndrome (TS) is a subtype of tic disorder that shows more persistent tic symptoms. The etiological mechanism of TS concerning immune dysfunction remains unclear due to limited evidence, especially for pediatric TS patients.
METHOD
In the present study, a meta-analysis was performed to confirm the identified changes in proinflammatory cytokines and T cells of pediatric TS patients. A total of five databases, including PubMed, Web of Science, PsycINFO, Google Scholar and the China National Knowledge Infrastructure (CNKI), were used for the literature search. The standardized mean difference (SMD) and mean difference (MD) with a 95% confidence interval (CI) were used to present the effect size of each type of proinflammatory cytokine and T cell. Sensitivity analysis, subgroup analysis and meta-regression analysis were used to explore the heterogeneity of the meta-analysis. This meta-analysis was registered in the International Platform of Registered Systematic Review and Meta-analysis Protocols (number: INPLASY2021110079).
RESULTS
In the 25 studies included in this meta-analysis, thirteen studies focused on the levels of T cells, and twelve studies focused on the levels of proinflammatory cytokines. Based on the random-effects model, the pooled MDs are -1.45 (95% CI: -3.44, 0.54) for CD3 cells, -4.44 (95% CI: -6.80, -2.08) for CD4 cells, and 1.94 (95% CI: -0.08, 3.97) for CD8 cells. The pooled SMDs are1.36 for IL-6 (95% CI: 0.00, 2.72) and 2.39 for tumor necrosis factor alpha (TNF-α) (95% CI: 0.93, 3.84).
CONCLUSION
We provided evidence of immune dysfunction in pediatric TS patients, with elevated levels of particular proinflammatory cytokines and disproportionate changes in T-cell subpopulations. Small to large effect sizes were identified for increased IL-6 levels as well as a reduced number of T helper cells, while a large effect size was identified for increased TNF-α levels. These results indicate a close association between peripheral immune activation and TS. However, the most direct and meaningful interaction between peripheral immune status and microglial activation in the central nervous system in TS patients requires further exploration.
Topics: Child; Cytokines; Humans; Interleukin-6; T-Lymphocytes; Tourette Syndrome; Tumor Necrosis Factor-alpha
PubMed: 35693824
DOI: 10.3389/fimmu.2022.843247 -
Medicine Jul 2016Tic disorders (TD) are common neuropsychiatric disorders among children and adolescents. Still, there is great uncertainty regarding their epidemiology in China. We aim... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Tic disorders (TD) are common neuropsychiatric disorders among children and adolescents. Still, there is great uncertainty regarding their epidemiology in China. We aim to depict the prevalence of TD for children in China and explore the influence of sex, age, geographic distribution, and diagnostic criteria on the prevalence rates.
METHODS
We searched PubMed, EMBASE, four Chinese electronic databases, and relevant lists. Two reviewers independently selected trials, assessed trial quality, and extracted the data.
RESULTS
We included 13 studies investigating 269,571 participants. The sample size ranged from 563 to 216,005 participants. The age of participants ranged from 3 to 16 years. The meta-analysis of the prevalence of TD was 6.1% [95% CI: 0.036-0.100, I = 49.7%]. The prevalence of transient tic disorder (TTD), chronic tic disorder (CTD), and Tourette syndrome (TS) was 1.7% [95% CI = 0.009-0.031, I = 49%], 1.2% [95% CI = 0.007-0.022, I = 48.3%], and 0.3% [95% CI = 0.001-0.008, I = 49.5%], respectively. The prevalence of TD in boys [5.1%, 95% CI = 0.026-0.098, I = 49.3%] was higher than that in girls [2.4%, 95% CI = 0.009-0.065, I = 49.4%]. The prevalence of TD in urban area [2.6%, 95% CI = 0.019-0.034, I = 35.5%] was higher than that in rural area [2.2%, 95% CI = 0.016-0.030, I = 33.9%]. The prevalence of TD in central China [10.7%, 95% CI = 0.043-0.242, I = 49.2%] was higher than that in North China [7.8%, 95% CI = 0.007-0.522, I = 49.9%] and East China [4.4%, 95% CI = 0.015-0.120, I = 49.8%].
CONCLUSION
TD is a common disease in China, with prevalence differing based on sex, age, and region.
Topics: Adolescent; Age Factors; Child; Child, Preschool; China; Cross-Sectional Studies; Female; Humans; Male; Sex Factors; Tic Disorders
PubMed: 27472724
DOI: 10.1097/MD.0000000000004354 -
Movement Disorders : Official Journal... Mar 2017Several clinician, informant, and self-report instruments for tics and associated phenomena have been developed that differ in construct, comprehensiveness, and ease of... (Review)
Review
BACKGROUND
Several clinician, informant, and self-report instruments for tics and associated phenomena have been developed that differ in construct, comprehensiveness, and ease of administration.
OBJECTIVE
A Movement Disorders Society subcommittee aimed to rate psychometric quality of severity and screening instruments for tics and related sensory phenomena.
METHODS
Following the methodology adopted by previous Movement Disorders Society subcommittee papers, a review of severity and screening instruments for tics was completed, applying a classification as "recommended," "suggested," or "listed" to each instrument.
RESULTS
A total of 5 severity scales (Yale Global Tic Severity Scale, Tourette Syndrome Clinical Global Impression, Tourette's Disorder Scale, Shapiro Tourette syndrome Severity Scale, Premonitory Urges for Tics Scale) were "recommended," and 6 (Rush Video-Based Tic Rating Scale, Motor tic, Obsessions and compulsions, Vocal tic Evaluation Survey, Tourette Syndrome Global Scale, Global Tic Rating Scale, Parent Tic Questionnaire, Tourette Syndrome Symptom List) were "suggested." A total of 2 screening instruments (Motor tic, Obsession and compulsions, Vocal tic Evaluation Survey and Autism-Tics, Attention Deficit/Hyperactivity Disorder and Other Comorbidities Inventory) were "recommended," whereas 2 others (Apter 4-questions screening and Proxy Report Questionnaire for Parents and Teachers) were "suggested."
CONCLUSIONS
Our review does not support the need for developing new tic severity or screening instruments. Potential objectives of future research include developing a rating instrument targeting the full spectrum of tic-related abnormal behaviors, assessing/screening malignant forms of tic disorders, and developing patient-reported outcome measures. © 2017 International Parkinson and Movement Disorder Society.
Topics: Humans; Severity of Illness Index; Tic Disorders
PubMed: 28071825
DOI: 10.1002/mds.26891 -
Developmental Neurobiology Mar 2021Ash1l potentially contributes to neurodevelopmental diseases. Although specific Ash1l mutations are rare, they have led to informative studies in animal models that may... (Review)
Review
Ash1l potentially contributes to neurodevelopmental diseases. Although specific Ash1l mutations are rare, they have led to informative studies in animal models that may bring therapeutic advances. Ash1l is highly expressed in the brain and correlates with the neuropathology of Tourette syndrome (TS), autism spectrum disorder, and intellectual disability during development, implicating shared epigenetic factors and overlapping neuropathological mechanisms. Functional convergence of Ash1l generated several significant signaling pathways: chromatin remodeling and transcriptional regulation, protein synthesis and cellular metabolism, and synapse development and function. Here, we systematically review the literature on Ash1l, including its discovery, expression, function, regulation, implication in the nervous system, signaling pathway, mutations, and putative involvement in TS and other neurodevelopmental traits. Such findings highlight Ash1l pleiotropy and the necessity of transcending a single gene to complicated mechanisms of network convergence underlying these diseases. With the progress in functional genomic analysis (highlighted in this review), and although the importance and necessity of Ash1l becomes increasingly apparent in the medical field, further research is required to discover the precise function and molecular regulatory mechanisms related to Ash1l. Thus, a new perspective is proposed for basic scientific research and clinical interventions for cross-disorder diseases.
Topics: Animals; Autism Spectrum Disorder; DNA-Binding Proteins; Intellectual Disability; Neurodevelopmental Disorders; Tourette Syndrome
PubMed: 33258273
DOI: 10.1002/dneu.22795 -
Frontiers in Psychology 2022At present, tic disorder has attracted the attention of medical researchers in many countries. More clinicians choose non-drug therapy, especially cognitive-behavioral...
BACKGROUND
At present, tic disorder has attracted the attention of medical researchers in many countries. More clinicians choose non-drug therapy, especially cognitive-behavioral therapy (CBT) because of the cognitive side effects of drug therapy. However, few studies had assessed its efficacy. It is necessary to have a more comprehensive understanding of the literature quality of CBT and its intervention effect.
METHODS
In this study, MEDLINE, Embase, and Cochrane were searched from the beginning to June 15, 2021 to study the efficacy of -CBT on tic disorder. Only studies using the Yale Global Tic Severity Scale (YGTSS) and the control group were included.
RESULTS
A total of 12 randomized controlled trials (RCTs), including 536 patients with tic disorders, were identified. The results showed that the effect of CBT was better than that of the control group. The pooled standardized mean difference (SMD) was -0.34 (95% CI: -0.61, -0.07). The effect size of CBT differs from different intervention conditions. In seven studies, the subjects' motor tic scores were counted. The sample size of the experimental group was 224 and that of the control group was 218. The pooled SMD was -0.43 (95% CI: -0.75, -0.11). Seven studies counted the vocal tic scores of subjects, 224 in the experimental group and 218 in the control group. The pooled SMD was -0.22 (95% CI: -0.54, -0.11). Seven studies counted the tic impairment scores of subjects, 220 in the experimental group and 214 in the control group. The pooled SMD was -0.48 (95% CI: -0.73, -0.23).
CONCLUSION
The literature shows that different CBTs can significantly reduce the total score of tic disorder and the score of motor tic, but cannot significantly reduce the score of vocal tic. In the future, more new interventions were needed to improve the symptoms of different patients, especially vocal tic.
PubMed: 35401364
DOI: 10.3389/fpsyg.2022.851250 -
Computational and Mathematical Methods... 2023[This retracts the article DOI: 10.1155/2022/2365210.].
[This retracts the article DOI: 10.1155/2022/2365210.].
PubMed: 37475918
DOI: 10.1155/2023/9897247 -
Frontiers in Pediatrics 2023To evaluate the correlation between tic disorders and allergies and to inform strategies for the treatment and prevention of tic disorders. (Review)
Review
AIM
To evaluate the correlation between tic disorders and allergies and to inform strategies for the treatment and prevention of tic disorders.
METHODS
We conducted online searches of the MEDLINE, Embase, Cochrane, CNKI, CBM, WanFang, and VIP Information databases. Case-control studies and cohort studies related to tic disorders and allergic conditions were searched. Two researchers screened the literature, extracted data, and evaluated quality in strict accordance with the predetermined retrieval strategy and inclusion criteria. Finally, RevMan 5.4 software was used to conduct a meta-analysis. We used the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach to rating the certainty of evidence about each allergy outcome as high, moderate, low, or very low.
RESULTS
We obtained seven eligible studies involving eight allergic conditions. The following allergic conditions were significantly associated with the presence of a tic disorder: asthma (OR = 1.90, 95% CI = 1.57-2.30, < 0.001), allergic rhinitis (OR = 2.61, 95% CI = 1.90-3.57, < 0.001), allergic conjunctivitis (OR = 3.65, 95% CI = 1.53-8,67, = 0.003), eczema (OR = 3.87, 95% CI = 2.24-6.67, < 0.001) and food allergy (OR = 2.79, 95% CI = 1.56-4.99, < 0.001). There was no significant correlation between atopic dermatitis, urticaria, drug allergy, and tic disorder.
CONCLUSION
The occurrence of tic disorders may be associated with the presence of certain allergic disorders. However, whether allergy is one of the causes of tic disorders remains unclear.
SYSTEMATIC REVIEW REGISTRATION
The registration number for this systematic review is PROSPERO: CRD42021231658.
PubMed: 37020645
DOI: 10.3389/fped.2023.1064001