scholarly journals Association of Group A Streptococcus Exposure and Exacerbations of Chronic Tic Disorders

Neurology ◽  
2021 ◽  
Vol 96 (12) ◽  
pp. e1680-e1693 ◽  
Author(s):  
Davide Martino ◽  
Anette Schrag ◽  
Zacharias Anastasiou ◽  
Alan Apter ◽  
Noa Benaroya-Milstein ◽  
...  
Keyword(s):  
Symptom Severity ◽  
Failure Time ◽  
Group A Streptococcus ◽  
Tic Disorders ◽  
Active Management ◽  
Contributing Factors ◽  
Obsessive Compulsive ◽  
Group A ◽  
Chronic Tic Disorders ◽  
Gas Exposure

ObjectiveTo examine prospectively the association between group A Streptococcus (GAS) pharyngeal exposures and exacerbations of tics in a large multicenter population of youth with chronic tic disorders (CTD) across Europe.MethodsWe followed up 715 children with CTD (age 10.7 ± 2.8 years, 76.8% boys), recruited by 16 specialist clinics from 9 countries, and followed up for 16 months on average. Tic, obsessive-compulsive symptom (OCS), and attention-deficit/hyperactivity disorder (ADHD) severity was assessed during 4-monthly study visits and telephone interviews. GAS exposures were analyzed using 4 possible combinations of measures based on pharyngeal swab and serologic testing. The associations between GAS exposures and tic exacerbations or changes of tic, OC, and ADHD symptom severity were measured, respectively, using multivariate logistic regression plus multiple failure time analyses and mixed effects linear regression.ResultsA total of 405 exacerbations occurred in 308 of 715 (43%) participants. The proportion of exacerbations temporally associated with GAS exposure ranged from 5.5% to 12.9%, depending on GAS exposure definition. We did not detect any significant association of any of the 4 GAS exposure definitions with tic exacerbations (odds ratios ranging between 1.006 and 1.235, all p values >0.3). GAS exposures were associated with longitudinal changes of hyperactivity–impulsivity symptom severity ranging from 17% to 21%, depending on GAS exposure definition.ConclusionsThis study does not support GAS exposures as contributing factors for tic exacerbations in children with CTD. Specific workup or active management of GAS infections is unlikely to help modify the course of tics in CTD and is therefore not recommended.

Anti-Basal Ganglia Antibodies and Streptococcal Infection in ADHD

2015 ◽  
Vol 22 (9) ◽  
pp. 864-871 ◽  
Author(s):  
Sergio Aguilera-Albesa ◽  
Nerea Crespo-Eguílaz ◽  
José Luis Del Pozo ◽  
Pablo Villoslada ◽  
Rocío Sánchez-Carpintero
Keyword(s):  
Basal Ganglia ◽  
Group A Streptococcus ◽  
Tic Disorders ◽  
Healthy Children ◽  
Cognitive Measures ◽  
Dynamic Nature ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Additional Group ◽  
Group A

Objective: Group A Streptococcus has been associated with ADHD, tic disorders (TD), and obsessive–compulsive disorder (OCD) through anti-basal ganglia antibodies (ABGA). Method: We investigated the association between ABGA and streptococcal exposure with behavioral, motor, and cognitive measures in 38 children with ADHD not comorbid to OCD or TD (nc-ADHD) and in 38 healthy children. An additional group of 15 children with TD and/or OCD was examined. Results: ABGA titers were present in 3% of nc-ADHD patients and controls but in 27% of TD and/or OCD patients. Evidence of streptococcal exposure was similar between ADHD patients and controls living in the same urban area. Behavioral, motor, and cognitive measures were not associated with anti-streptococcal antibodies. Conclusion: ABGA do not distinguish nc-ADHD from controls. The differences in the frequency of streptococcal exposure in previous studies are determined by the dynamic nature of the infection rather than the behavioral phenotype of ADHD.

Poststreptococcal Movement Disorders

2017 ◽  
Author(s):  
Davide Martino ◽  
Gavin Giovannoni
Keyword(s):  
Movement Disorders ◽  
Streptococcal Infection ◽  
Group A Streptococcus ◽  
Neuropsychiatric Symptoms ◽  
Causal Link ◽  
Obsessive Compulsive ◽  
Behavioral Abnormalities ◽  
Group A ◽  
Obsessive Compulsive Disorders ◽  
Compulsive Disorders

The spectrum of “poststreptococcal” movement disorders and other behavioral abnormalities has expaanded and the array of neuropsychiatric features associated with rheumatic fever (RF) has been broadened. However, it is difficult to establish a causal link between Group A Streptococcus (GAS) and neuropsychiatric symptoms beyond RF, which has fuelled a long-lasting, and still unsolved, debate as to whether putative “poststreptococcal” disorders such as the PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infection) phenotype are distinct entities or not. This chapter provides an up-to-date overview of the conditions that are well established (Sydenham’s chorea) or proposed (poststreptococcal tic and obsessive-compulsive disorders) as secondary to an immune response toward GAS.

Cohort profile: Epidemiology and Genetics of Obsessive–compulsive disorder and chronic tic disorders in Sweden (EGOS)

2020 ◽  
Vol 55 (10) ◽  
pp. 1383-1393 ◽  
Author(s):  
Behrang Mahjani ◽  
Karin Dellenvall ◽  
Anna-Carin Säll Grahnat ◽  
Gun Karlsson ◽  
Aki Tuuliainen ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Tic Disorders ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Chronic Tic Disorders

scholarly journals Evidence-Based Pharmacotherapy for Pediatric Obsessive-Compulsive Disorder and Chronic Tic Disorders

2011 ◽  
Vol 3 ◽  
pp. JCNSD.S6616 ◽  
Author(s):  
Alessandro S. De Nadai ◽  
Eric A. Storch ◽  
Joseph F. Mcguire ◽  
Adam B. Lewin ◽  
Tanya K. Murphy
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Psychosocial Interventions ◽  
Evidence Base ◽  
Tic Disorders ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Behavioral Healthcare ◽  
Pediatric Ocd ◽  
Chronic Tic Disorders

In recent years, much progress has been made in pharmacotherapy for pediatric obsessive-compulsive disorder (OCD) and chronic tic disorders (CTDs). What were previously considered relatively intractable conditions now have an array of efficacious medicinal (and psychosocial) interventions available at clinicians' disposal, including selective serotonin reuptake inhibitors, atypical antipsychotics, and alpha-2 agonists. The purpose of this review is to discuss the evidence base for pharmacotherapy with pediatric OCD and CTDs with regard to efficacy, tolerability, and safety, and to put this evidence in the context of clinical management in integrated behavioral healthcare. While there is no single panacea for these disorders, there are a variety of medications that provide considerable relief for children with these disabling conditions.

scholarly journals Validity and clinical utility of the obsessive compulsive inventory - child version: further evaluation in clinical samples

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Kristina Aspvall ◽  
Matti Cervin ◽  
Per Andrén ◽  
Sean Perrin ◽  
David Mataix-Cols ◽  
...  
Keyword(s):  
Psychometric Properties ◽  
Clinical Utility ◽  
Tic Disorders ◽  
Self Report ◽  
Clinical Samples ◽  
Older Children ◽  
Obsessive Compulsive ◽  
Swedish Version ◽  
Compulsive Disorder ◽  
Chronic Tic Disorders

Abstract Background Obsessive-compulsive disorder (OCD) is a clinically heterogeneous disorder. Currently, the Obsessive Compulsive Inventory-Child Version (OCI-CV) is the only self-report measure that fully captures this symptom heterogeneity in children and adolescents. The psychometric properties of the OCI-CV are promising but evaluations in large clinical samples are few. Further, no studies have examined whether the measure is valid in both younger and older children with OCD and whether scores on the measure are elevated in youths with OCD compared to youths with other mental disorders. Methods To address these gaps in the literature, we investigated the psychometric properties and validity of a Swedish version of the OCI-CV in a large clinical sample of youth aged 6–18 years with OCD (n = 434), anxiety disorders (n = 84), and chronic tic disorders (n = 45). Results Internal consistency coefficients at the total scale and subscale level were consistent with the English original and in the acceptable range. Confirmatory factor analyses revealed an adequate fit for the original six-factor structure in both younger and older children with OCD. Correlations between total scores on the OCI-CV and the Children’s Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) were small at pre-treatment (r = 0.19) but large at post-treatment (r = 0.62). Youth with OCD scored higher than those with anxiety and chronic tic disorders, and the OCI-CV was sensitive to symptom change for youth undergoing treatment for OCD. Conclusions This Swedish version of the OCI-CV appears to be a valid and reliable measure of the OCD symptom dimensions across age groups and has good clinical utility.

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