Fine-motor skill deficits in childhood predict adulthood tic severity and global psychosocial functioning in Tourette's syndrome
Fine-motor skill deficits in childhood predict adulthood tic severity and global psychosocial functioning in Tourette's syndrome
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DOI：
10.1111/j.1469-7610.2005.01561.x
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发表时间：
2006-06-01
影响因子：
7.6
通讯作者：
Schultz, Robert T.
中科院分区：
文献类型：
--
作者：
Bloch, Michael H.;Sukhodolsky, Denis G.;Schultz, Robert T.
背景：大多数多发性抽动症(TS)儿童在青春期抽动症状显著减少。目前，还没有确定的临床措施可以预测谁的抽搐症状会持续到成年。TS患者在涉及精细运动协调和视觉-运动整合的神经心理测试中存在缺陷。我们试图确定这些神经心理测试是否有助于预测未来的症状严重程度。方法：对32例8~14岁的TS患儿进行临床评估和集中神经心理测验，包括普渡钉板、Beery视觉-运动整合(VMI)测验和Rey-Osterreith复杂图形测验(RCFT)。对这些儿童进行了平均7.5年后的随访临床评估。用有序Logistic回归分析进行时间1的神经心理测试与时间2的抽动严重程度、强迫症严重程度和整体心理社会功能的相关性。结果：普渡钉板测验中优势手表现不佳预示成人抽动严重程度较差，并与儿童抽动时的严重程度相关。在VMI和普渡钉板测试中的糟糕表现(包括优势手和非优势手)也预示着成年后全球心理社会功能的恶化。这些神经心理测试都不能预测TS患者强迫症症状的未来病程。结论：精细运动技能缺陷可能是TS儿童未来抽动严重程度和整体心理社会功能的预测指标。我们假设普渡钉板试验的表现可以作为TS研究中有用的内表型，并提供了TS患者存在的基底节功能障碍程度的粗略测量。
Background: Most children with Tourette's syndrome (TS) experience a significant decline in tic symptoms during adolescence. Currently no clinical measures have been identified that can predict whose tic symptoms will persist into adulthood. Patients with TS have deficits on neuropsychological tests involving fine-motor coordination and visual-motor integration. We seek to determine if these neuropsychological tests are useful in predicting future symptom severity. Methods: Thirty-two children, aged 8 - 14, with TS underwent clinical evaluation and a focused neuropsychological testing battery consisting of the Purdue Pegboard, Beery Visual-Motor Integration (VMI) Test and the Rey-Osterreith Complex Figure Task (RCFT). A follow-up clinical assessment was performed on these children an average of 7.5 years later. Ordinal logistic regression analysis was used to correlate neuropsychological testing at Time 1 with tic severity, OCD severity and global psychosocial functioning at Time 2. Results: Poor performance with the dominant hand on the Purdue Pegboard test predicted worse adulthood tic severity and correlated with tic severity at the time of childhood assessment. Poor performance on the VMI and Purdue Pegboard tests (both dominant and non-dominant hand) also predicted worse adulthood global psychosocial functioning. None of the neuropsychological tests were useful in predicting the future course of OCD symptoms in TS patients. Conclusion: Fine motor skill deficits may be a predictor of future tic severity and global psychosocial function in children with TS. We hypothesize that performance on the Purdue Pegboard test may serve as a useful endophenotype in the study of TS and provide a rough measure of the degree of basal ganglia dysfunction present in TS patients.