Study On Non-motor Symptoms In Children With Tourette Syndrome

ObjectivesTo evaluate the occurrence of non-motor symptoms such as premonitory urge and tic-related cognition in children with Tourette syndrome(TS),and to explore the relationship between non-motor symptoms and tic symptoms in children with TS at different ages and the relationship between non-motor symptoms and comorbidities.It provides a theoretical basis for clinical psychological intervention and reasonable treatment.MethodsThe research subjects were 105 children with TS who were admitted to the Children’s Health Department of Qingdao University Affiliated Hospital from August 2019 to August2020,with an age range of 8-15 years.The basic situation of the children and their family information were obtained by filling out the basic situation questionnaire of the children’s parents,and the Yale Global Tic Severity Scale(YGTSS)and the Attention Deficit Hyperactivity Disorder Rating Scale(Swanson,Nolan,and Pelham-IV rating scales,SNAP-IV)to assess the comprehensive tic severity and attention deficit hyperactivity disorder(ADHD)in children.The children filled in The Beliefs About Tics Scale(BATS)and Prenonitory Urge for Tics Scale(PUTS)to evaluate non-motor symptoms such as tic-related cognition and prenonitory urge,using The Children’s Yale-Brown Obsessive-Compulsive Scale(CY-BOCS)to assess the status of obsessive-compulsive disorder(OCD)in children.In this study,105 children were divided into two groups,8-10 years old and those over11 years old,to analyze the occurrence of non-motor symptoms in children with TS at different ages and their correlation with the severity of comprehensive tics.The comorbidities of children were screened by SNAP-IV and CY-BOCS,and 105 children were divided into four groups:TS,TS+ADHD,TS+OCD,and TS+ADHD+OCD.Association of cognitive and other non-motor symptoms with TS comorbidities.SPSS 22.0 software was used for statistical analysis and processing of data.Results(1)92.4%of the 105 children with TS had premonitory urge,the PUTS score was16.36±5.63,the BATS score was 36.84±11.21,and the YGTSS score was 33.22±12.95.Among them,90.3%of children in the 8-10-year-old group(young age group)experienced premonitory urge,while the report rate of the≥11-year-old group(older age group)was95.3%.The PUTS score of the younger age group was significantly lower than that of the older age group(15.35±4.72vs.17.81±6.53,t=-2.117,P=0.038).There was a statistically significant difference in PUTS between the two age groups.The BATS score in the younger age group was lower than that in the older age group(35.60±11.13vs.38.63±11.23,t=-1.368,P=0.174),but there was no statistical difference between the two age groups.(2)Pearson was used to analyze all the children,and the results showed that the PUTS score was significantly positively correlated with the YGTSS total score and each subscale(r was 0.266 to 0.542,P<0.05),and the BATS score was related to the YGTSS total score and each subscale.There was a significant positive correlation(r ranged from 0.251 to 0.550,P<0.05).(3)The PUTS score of the younger age group was significantly positively correlated with the YGTSS total score,tic frequency,intensity,complexity,interference and damage degree(r ranged from 0.260 to 0.562,P<0.05),while the PUTS score of the older age group was significantly positively correlated with the total score of YGTSS,the number of tics,frequency,intensity and damage degree(r ranged from 0.314 to 0.513,P<0.05).The BATS score in the younger age group was significantly positively correlated with the YGTSS total score and each subscale(r ranged from 0.292 to 0.596,P<0.05),and the BATS score in the older age group was significantly positively correlated with the YGTSS total score,the number of tics,the intensity and the degree of damage(r ranged from 0.307to 0.460,P<0.05).(4)According to comorbidities,105 children were divided into four groups according to comorbidities:TS group(47 cases),TS+ADHD group(29 cases),TS+OCD group(19cases),and TS+ADHD+OCD group(10 cases).The PUTS scores were(15.06±5.03 vs.15.59±5.80 vs.19.16±5.44 vs.19.40±5.99,F=3.387,P=0.012),and the BATS scores were(33.55±10.46 vs.36.59±10.87 vs.43.74±10.71 vs.39.90±11.39,F=4.385,P=0.006).Children with tic disorders have comorbidities such as attention deficit hyperactivity disorder and obsessive-compulsive disorder,and the premonitory urge is more significant,and the children’s cognitive level of tic suppression is higher.In the TS group,the PUTS score was positively correlated with the YGTSS total score and tic damage(r ranged from 0.386 to 0.393,P<0.05),and the BATS score was positively correlated with the YGTSS total score,tic frequency,intensity and damage(r ranged from0.306 to 0.377,P<0.05).0.05);in the TS+ADHD group,the PUTS score was positively correlated with the YGTSS total score,the number of tics,frequency,damage(r ranged from0.380 to 0.560,P<0.05).Interference and damage were positively correlated(r ranged from0.400 to 0.551,P<0.05);in the TS+OCD group,PUTS and BATS scores were positively correlated with YGTSS total score,tic intensity,complexity,interference and damage(r ranged from 0.521 to 0.620,P<0.05)(r ranged from 0.534 to 0.842,P<0.05);while in the TS+ADHD+OCD group,the PUTS and BATS scores had no correlation with the YGTSS total score and each subscale(P>0.05).(5)Premonitory urge,tics-related cognition,concentration and gender were the factors affecting the severity of comprehensive tic symptoms(R~2=0.42,F=7.678,P<0.05).Conclusions1.This study shows that non-motor symptoms exist in the vast majority of children with TS,and are positively correlated with the severity of comprehensive tics.2.There are significant differences in aura impulse in children with TS of different ages.3.In children with TS with comorbidities,non-motor symptoms were more pronounced.4.Non motor symptoms are important factors affecting the severity of comprehensive tics.