Antineuronal Antibodies in Pediatric OCD and Tourette Syndrome

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
A. Morer
Keyword(s):  
Tourette Syndrome ◽  
Clinical Features ◽  
Antibody Binding ◽  
Tic Disorders ◽  
Antineuronal Antibodies ◽  
Molecular Weights ◽  
Pediatric Ocd ◽  
Biological Features ◽  
Immunological Markers ◽  
History Of

The objective of our study was to test the autoimmune hypothesis of OCD and TS as disorders related with PANDAS, and find clinical features or specific immunological markers related with them. Child onset OCD in adults has been associated with higher mean ASLO titers, higher frequencies of history of tic disorders, tonsillitis in childhood and compulsive symptoms. Also, two proteins, with molecular weights of 86kDa and 55kDa, have shown antibody binding in sera from 7 patients.The fact that some clinical and biological features related with PANDAS are found in adults and that antineuronal antibodies exist in patients with OCD or TS diagnosis that don't meet PANDAS criteria, lends further evidence that autoimmunity related with OCD is wider than PANDAS.

scholarly journals Clinical features of Tourette syndrome and tic disorders

2014 ◽  
Vol 3 (4) ◽  
pp. 372-379 ◽  
Author(s):  
James F. Leckman ◽  
Robert A. King ◽  
Michael H. Bloch
Keyword(s):  
Tourette Syndrome ◽  
Clinical Features ◽  
Tic Disorders

scholarly journals Practice guideline recommendations summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders

Neurology ◽  
2019 ◽  
Vol 92 (19) ◽  
pp. 896-906 ◽  
Author(s):  
Tamara Pringsheim ◽  
Michael S. Okun ◽  
Kirsten Müller-Vahl ◽  
Davide Martino ◽  
Joseph Jankovic ◽  
...  
Keyword(s):  
Systematic Review ◽  
Tourette Syndrome ◽  
Treatment Options ◽  
Tic Disorders ◽  
Future Research ◽  
Comorbid Disorders ◽  
Institute Of Medicine ◽  
Patient Representatives ◽  
History Of ◽  
Chronic Tic Disorders

ObjectiveTo make recommendations on the assessment and management of tics in people with Tourette syndrome and chronic tic disorders.MethodsA multidisciplinary panel consisting of 9 physicians, 2 psychologists, and 2 patient representatives developed practice recommendations, integrating findings from a systematic review and following an Institute of Medicine–compliant process to ensure transparency and patient engagement. Recommendations were supported by structured rationales, integrating evidence from the systematic review, related evidence, principles of care, and inferences from evidence.ResultsForty-six recommendations were made regarding the assessment and management of tics in individuals with Tourette syndrome and chronic tic disorders. These include counseling recommendations on the natural history of tic disorders, psychoeducation for teachers and peers, assessment for comorbid disorders, and periodic reassessment of the need for ongoing therapy. Treatment options should be individualized, and the choice should be the result of a collaborative decision among patient, caregiver, and clinician, during which the benefits and harms of individual treatments as well as the presence of comorbid disorders are considered. Treatment options include watchful waiting, the Comprehensive Behavioral Intervention for Tics, and medication; recommendations are provided on how to offer and monitor these therapies. Recommendations on the assessment for and use of deep brain stimulation in adults with severe, treatment-refractory tics are provided as well as suggestions for future research.

Comorbidity in Pediatric OCD

2017 ◽  
Author(s):  
Michael H. Bloch
Keyword(s):  
Tourette Syndrome ◽  
Attention Deficit ◽  
Late Adolescence ◽  
Tic Disorders ◽  
Pharmacological Treatments ◽  
Pediatric Ocd ◽  
Male Preponderance ◽  
Definition Of

Tic disorders, including Tourette syndrome (TS), are not formally part of the category of “OCD-related disorders” in the DSM; but the association with OCD is sufficiently strong, and clinically important, that the OCD diagnosis now carries an optional “tic-related” specifier. Comorbidity is the norm in TS; in addition to OCD, attention deficit symptoms are particularly common. The presence of these comorbidities can affect both behavioral and pharmacological treatments, which are reviewed in this chapter. Tics commonly begin in childhood (part of the definition of TS), often improving in late adolescence. Approximately 30% of children with TS will develop OCD; the onset of OCD symptoms is usually later than that of tics, and they are more likely to persist into adulthood. Tic-associated OCD has a male preponderance and is more likely to be characterized by symmetry-related obsessions and compulsions. Like OCD, tic disorders are characterized by abnormalities in the cortico-striatal circuitry.

scholarly journals Altered urinary tetrahydroisoquinoline derivatives in patients with Tourette syndrome: reflection of dopaminergic hyperactivity?

2020 ◽  
Author(s):  
Philipp Capetian ◽  
Veit Roessner ◽  
Caroline Korte ◽  
Susanne Walitza ◽  
Franz Riederer ◽  
...  
Keyword(s):  
Tourette Syndrome ◽  
Diagnostic Value ◽  
Tic Disorders ◽  
Operating Characteristics ◽  
Roc Curve Analysis ◽  
Two Phase ◽  
Dopaminergic Neurotransmission ◽  
Hyperactivity Disorder ◽  
The Central Nervous System ◽  
Chronic Tic Disorders

AbstractTetrahydroisoquinolines (TIQs) such as salsolinol (SAL), norsalsolinol (NSAL) and their methylated derivatives N-methyl-norsalsolinol (NMNSAL) and N-methyl-salsolinol (NMSAL), modulate dopaminergic neurotransmission and metabolism in the central nervous system. Dopaminergic neurotransmission is thought to play an important role in the pathophysiology of chronic tic disorders, such as Tourette syndrome (TS). Therefore, the urinary concentrations of these TIQ derivatives were measured in patients with TS and patients with comorbid attention-deficit/hyperactivity disorder (TS + ADHD) compared with controls. Seventeen patients with TS, 12 with TS and ADHD, and 19 age-matched healthy controls with no medication took part in this study. Free levels of NSAL, NMNSAL, SAL, and NMSAL in urine were measured by a two-phase chromatographic approach. Furthermore, individual TIQ concentrations in TS patients were used in receiver-operating characteristics (ROC) curve analysis to examine the diagnostic value. NSAL concentrations were elevated significantly in TS [434.67 ± 55.4 nmol/l (standard error of mean = S.E.M.), two-way ANOVA, p < 0.0001] and TS + ADHD patients [605.18 ± 170.21 nmol/l (S.E.M.), two-way ANOVA, p < 0.0001] compared with controls [107.02 ± 33.18 nmol/l (S.E.M.), two-way ANOVA, p < 0.0001] and NSAL levels in TS + ADHD patients were elevated significantly in comparison with TS patients (two-way ANOVA, p = 0.017). NSAL demonstrated an AUC of 0.93 ± 0.046 (S.E.M) the highest diagnostic value of all metabolites for the diagnosis of TS. Our results suggest a dopaminergic hyperactivity underlying the pathophysiology of TS and ADHD. In addition, NSAL concentrations in urine may be a potential diagnostic biomarker of TS.

scholarly journals AB0450 PERIPHERAL MACROVASCULAR INVOLVEMENT IN SYSTEMIC SCLEROSIS AS COMPARED WITH HEALTHY CONTROLS: A SMALL COHORT STUDY BY COLOR AND SPECTRAL DOPPLER ULTRASONOGRAPHY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1252.2-1252
Author(s):  
R. D’alessandro ◽  
E. Garcia Gonzales ◽  
P. Falsetti ◽  
C. Baldi ◽  
F. Bellisai ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Clinical Features ◽  
Doppler Ultrasonography ◽  
Power Doppler ◽  
Ulnar Artery ◽  
Artery Occlusion ◽  
Power Doppler Ultrasonography ◽  
Digital Ulcers ◽  
Healthy Controls ◽  
History Of

Background:Together with autoimmune-inflammation and fibrosis, microvasculopathy is a hallmark of SSc. However, also macrovascular changes may occur including peripheral proliferative vasculopathy. Whether this changes may represent a specific SSc marker with a predictive value remains a matter of debate.[1,2,3]Objectives:To study peripheral macrovascular involvement by color doppler ultrasound (CDUS) with spectral wave analysis (SWA) in a cohort of 40 SSc patients as compared to healthy controls. To further analyze any differences among the SSc population.Methods:Forty SSc patients and 36 healthy controls were examined by CDUS with SWA of both hands. Macrovascular involvement was assessed by measuring the resistivity index (RI) of distal ulnar and radial arteries. Examinations were performed with an Esaote MyLab Twice machine equipped with a linear 10-22 MHz probe. Ultrasound examination was carried out by two independent rheumatologists blinded to clinical conditions of the patients. Statistical analysis was performed by using MaxStat software.Results:The RI index resulted increased in the SSc cohort as compared with healthy controls (left ulnar RI 0.977 vs 0.715; right ulnar RI 0.996 vs 0.699; left radial RI 0.988 vs 0.706; right radial RI 0.999 vs 0.688; p<0.001). SSc patients with an increased RI in one artery were more probable to have an increased RI in the other vessels too (r 2 = 0.35; p<0.01). In addition, 8 out of 40 SSc patients presented left ulnar artery occlusion (UAO) and 7 out of 40 SSc patients presented right UAO, of which 6 presented bilateral UAO. Awaiting to enlarge the cohort for further analysis, descriptive data regarding increased RI at CDUS/SWA and clinical features, including years from onset of the disease, subtype of SSc, mRSS, history of digital ulcers, interstitial lung disease and PAH are described in Table 1.Conclusion:Peripheral macrovascular involvement was observed in SSc patients as compared with healthy controls. Further studies will determine whether this feature may have specificity for diagnosis/prognosis in SSc.References:[1]Lescoat A, Yelnik CM, Coiffier G et al. Ulnar Artery Occlusion and Severity Markers of Vasculopathy in Systemic Sclerosis: A Multicenter Cross-Sectional Study. Arthritis Rheumatol. 2019;71:983-990.[2]Lescoat A, Coiffier G, Rouil A et al. Vascular Evaluation of the Hand by Power Doppler Ultrasonography and New Predictive Markers of Ischemic Digital Ulcers in Systemic Sclerosis: Results of a Prospective Pilot Study. Arthritis Care Res (Hoboken). 2017;69:543-551.[3]Schioppo T, Orenti A, Boracchi P, De Lucia O, Murgo A, Ingegnoli F. Evidence of macro- and micro-angiopathy in scleroderma: An integrated approach combining 22-MHz power Doppler ultrasonography and video-capillaroscopy. Microvasc Res. 2019;122:125-130.Table 1.Main clinical features of the SSc cohort (n=40) studied by CDUS for macrovascular involvement.SSc cohort (n = 40)Years from onsetrange (35 y – 0 y)mean = 10.5 yAutoantibodiesACA 13/40Anti-TopoI 14/40Other 13/40mRSSrange (0 -30)mean = 3ILD17/40PAH7/40Capillaroscopy patternEarly 10/40Active 11/40Late 6/40History of digital ulcers16/40Left ulnar IR0.977Left radial IR0.988Right ulnar IR0.996Right radial IR0.999Disclosure of Interests:None declared.

Psoas Abscess: Diagnosis and Treatment

2006 ◽  
Vol 5 (1) ◽  
pp. 13-16
Author(s):  
Raj Kandasamy ◽  
◽  
Asha Srikanth ◽  
SM Rutter ◽  
CJ Butcher ◽  
...  
Keyword(s):  
Clinical Features ◽  
Case History ◽  
Diagnostic Tests ◽  
Psoas Abscess ◽  
Diagnosis And Treatment ◽  
Uncommon Presentation ◽  
Appropriate Treatment ◽  
History Of

Psoas abscess is an uncommon presentation on the acute medical take. However recognition and appropriate treatment is essential. This review is designed to highlight the clinical features, microbiology, diagnostic tests and treatment for this condition. In order to illustrate some of the pitfalls and complexities in the management of psoas abscess we have included a case history of a patient who was recently treated in our department.

scholarly journals The prevalence of tic disorders in children and adolescents in Brazil

2014 ◽  
Vol 72 (12) ◽  
pp. 942-948 ◽  
Author(s):  
Helvio L. Alves ◽  
Elizabeth M. A. B. Quagliato
Keyword(s):  
Special Education ◽  
Children And Adolescents ◽  
Tourette Syndrome ◽  
Special Education Students ◽  
Tic Disorders ◽  
Education Students ◽  
Tic Disorder ◽  
Item Questionnaire ◽  
Chronic Tic Disorder

Tourette syndrome (TS) and tic disorders represent events of familiar magnitude characterized by involuntary movements and/or vocalization. To determine the prevalence of TS/tic disorders we studied a sample of 762 subjects (388 M, 374 F), between 1992 and 1997, age 6 to 43 years old, taken out of a population of 10,155 subjects (4,918 M, 5,237 F; age: 3-56 years old). A structured 4-item questionnaire, direct interview (multistaged), >1 yr follow-up, were used. 9,565 subjects (4,614 M, 4,951 F) sent back the questionnaires, 3,354 of these (1,671 M, 1,683 F) with positive answers to tics. 42 subjects (31 M, 11 F, age: 7-21 years old, mean: 11 years old) met the DSM-III-R criteria. The total minimal prevalence of TS is 0.43%, with a 3:1 ratio male/female. The minimal prevalence of chronic tic disorder is 2.27%. The total minimal prevalence for tic disorders at all is 2.91%. No special education students participation.

Development of Tics in a Thirteen-Year-Old Male Following Atomoxetine Use

CNS Spectrums ◽  
2008 ◽  
Vol 13 (4) ◽  
pp. 301-303 ◽  
Author(s):  
Jessica Sears ◽  
Nitin C. Patel
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Single Dose ◽  
Tourette Syndrome ◽  
Attention Deficit ◽  
Interventional Therapy ◽  
Prior History ◽  
Unique Case ◽  
Hyperactivity Disorder ◽  
History Of ◽  
Pharmacologic Therapies

ABSTRACTTics and Tourette syndrome are common comorbidities of patients diagnosed with attention-deficit/hyperactivity disorder (ADHD). One of the mainstay pharmacologic therapies for ADHD has been stimulants. However, this class of drugs has been associated with tic exacerbations, thus limiting their utility in this patients subgroup. Atomoxetine has been explored as an alternative treatment as one of the few non-stimulants available to treat ADHD. Early data identifies atomoxetine's influence on Tourette symptomatology to be not merely equivocal but potentially suppressive in the manifestation of tics. There are, however, case studies describing patients experiencing recurrences of tics following treatment with atomoxetine. We present a unique case of a patient, without any prior history of a movement disorder, who developed tics following a single dose of atomoxetine that did not improve until interventional therapy was initiated.

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