Dystonic motor and phonic tics in Tourette syndrome
Dystonic motor and phonic tics in Tourette syndrome
复制标题
DOI：
10.1007/s00415-022-11174-z
复制
发表时间：
2022-05-14
影响因子：
6
通讯作者：
Jankovic, Joseph
中科院分区：
文献类型：
--
作者：
Baizabal-Carvallo, Jose Fidel;Alonso-Juarez, Marlene;Jankovic, Joseph
背景肌张力障碍性抽搐与阵挛性抽搐的不同之处在于其更缓慢和更持续的性质。肌张力障碍性抽搐通常存在于抽动秽语综合征（TS）和其他抽搐障碍患者中。然而，其现象学和对整体损害的影响尚未得到广泛研究。材料与方法：我们评估了在我们的运动障碍门诊评估的TS患者的临床病史和视频记录中的抽搐持续时间。张力障碍性抽搐定义为持续时间>= 1000 ms（ms）的抽搐。结果201例TS患者中，有156例可用于抽搐持续时间分析，其中57例（36.5%）为张力障碍性运动性抽搐，其中9例（5.7%）为张力障碍性语音性抽搐。肌张力障碍性运动性抽搐的持续时间范围为1033 - 15,000 ms，肌张力障碍性声音性抽搐的持续时间范围为1132 - 17,766 ms。与无肌张力障碍性抽搐的患者相比，肌张力障碍性抽搐的患者年龄大24.4岁比16.5岁（P = 0.005），发病年龄大12.9岁比7.2岁（P < 0.001）。双变量分析显示，存在张力障碍性抽搐，更大的抽搐严重程度和更广泛的身体分布之间的关联。多变量回归分析显示，与评估时年龄较大（P = 0.001）、视频记录中抽搐严重程度较大（P = 0.001）以及与复杂运动性抽搐同时发生（P = 0.020）有统计学相关性。张力障碍性抽搐的存在增加了考虑进行脑深部电刺激治疗的风险，比值比：15.7（P = 0.002）。结论：约三分之一的TS患者中观察到张力障碍性抽搐，与TS的严重程度增加有关。
Background Dystonic tics differ from clonic tics by their slower and more sustained nature. Dystonic tics are often present in patients with Tourette syndrome (TS) and other tic-disorders. However, their phenomenology and impact on overall impairment have not been extensively studied. Materials and methods We assessed clinical history and tic duration in video-recordings from patients with TS evaluated at our movement disorders clinic. Dystonic tics were defined as those lasting >= 1000 ms (ms). Results Of the total of 201 patients with TS, there were 156 with video-recordings suitable for tic duration analysis, of their tics, 57 (36.5%) of whom had dystonic motor tics, including 9 (5.7%) with dystonic phonic tics. Dystonic motor tics had a duration range between 1033 and 15,000 ms and dystonic phonic tics between 1132 and 17,766 ms. Patients with dystonic tics were older 24.4 vs. 16.5 years (P = 0.005) and had an older age at onset 12.9 vs. 7.2 years (P < 0.001), than patients without dystonic tics. The bivariate analysis showed an association between the presence of dystonic tics, greater tic severity and wider body distribution. The multivariate regression analysis showed a statistical association with older age at evaluation (P = 0.001), greater tic severity on video-recordings (P = 0.001) and co-occurrence with complex motor tics (P = 0.020). The presence of dystonic tics increased the risk for being considered for deep brain stimulation therapy, odds ratio: 15.7 (P = 0.002). Conclusion Dystonic tics, observed in about a third of patients with TS, are associated with increased severity of TS.