Progress on the mechanism of comorbidity of tic disorder and allergic diseases / 国际儿科学杂志

Tic disorder（TD）is a complex chronic neuropsychiatric disorder characterized by rapid，involuntary，non-hythmic，single or multi-part muscle movement or vocal twitching. Both TD and allergic diseases are related to the body's immune imbalance.The symptoms involve different parts or organs，and the pathogenesis are complex，which seriously affect the quality of life.Clinical studies have found a clear correlation between TD and allergic diseases，but the relationship mechanism is still unclear，mainly involving neuro-immune cross-disorders.This paper reviews the research progress of the relevant mechanisms of TD and allergic diseases，in order to enhance the cognition of the two diseases，and provide new ideas and directions for the etiological research and treatment of TD.

Development course and research prospects of tic disorder in children / 中华实用儿科临床杂志

Tic disorder(TD), including Tourette syndrome, was first reported in 1825 and officially named in 1885.Until 1961, Haloperidol was proven to be effective in treating TD, which ushered in a new era of clinical understanding and research on TD.This paper introduces the history of research, development issues and research prospects related to TD.

Research progress in etiology and pathogenesis of pediatric tic disorder / 中华实用儿科临床杂志

Tic disorder (TD) is one of the typical neurodevelopmental disorders in childhood.More studies have confirmed that the etiology and pathogenesis of TD are related to genetics, environment, immunology, and psychology, etc.Identifying the etiology and pathogenesis helps to guide the treatment of TD.This paper reviews the research progress in the etiology and pathogenesis of pediatric TD in recent years.

Research progress in neuropsychology of children with tic disorder / 中华实用儿科临床杂志

The nervous system is the carrier of psychological activities, and its functional state directly affects psychological activities.Neuropsychology allows people to understand human psychological activities from the perspective of neuroscience and the correlation between the production of psychological activities and the physiological activities of the brain.It also includes establishing quantitative relationships between human perception, memory, thinking, imagination, attention, personality, intelligence, behavior, and brain function.Neuropsychology is a discipline that studies the relationship between the nervous system and psychological activities and behaviors.Tic disorder (TD) belong to neurodevelopmental disorders and are closely related to neuropsychological states.Studying the neuropsychology of TD is of great significance for their clinical diagnosis and treatment.This article summarizes the current research progress in neuropsychology related to TD in children internationally.

Advances of medicated management for tic disorder in children / 中华实用儿科临床杂志

In recent years, more attention has been paid to the treatment of tic disorder (TD) in children owing to a decrease in onset of age and cure rate and an increase in refractory cases.The present article reviews advances in drug therapies for TD, including α2-adrenergic receptors, dopamine receptor D blockers, typical and atypical antipsychotic drugs, antiepileptic drugs, and botulinum toxin type A, as well as the sustainable treatment up to adulthood.It also highlights the regular treatment, full-course treatment, and individualized treatment for TD in children.

Research progress on tic disorder accompanied by attention deficit hyperactive disorder in children / 中华实用儿科临床杂志

Tic disorder (TD) is a neurodevelopmental disorder characterized by sudden, rapid, repetitive, non-rhythmic motor or vocal tics at single or multiple sites.Attention deficit hyperactive disorder (ADHD) is one of the common comorbidities of TD.Early identification and intervention of inattention, hyperactivity, impulsivity, as well as comorbid ADHD in TD patients can improve its prognosis.Currently, a significant amount of research on TD accompanied by ADHD has been conducted both domestically and internationally.This article provides a systematic review and summary of the epidemiology, etiology, pathogenesis, clinical features, treatment and intervention for TD comorbid with ADHD, aiming to enrich the understanding of clinicians regarding TD comorbid with ADHD and promote its early identification and intervention.

Health education strategies for children with tic disorder / 中华实用儿科临床杂志

Tic disorder (TD) is a type of neuropsychiatric disorders, which starts in childhood and is characterized by tics.Its clinical manifestations are varied and occasionally accompanied by a variety of comorbidities.Health education can achieve the purpose of preventing diseases and improving the quality of life.For neuropsychiatric disorders such as TD, health education can not only promote the rehabilitation of patients but also help them return to society.This paper briefly describes the methods and strategies of health education for TD children, to improve the social awareness of the disease, guide the family members, teachers, classmates and partners of TD children to get along with them, and establish confidence for TD children to overcome the disease.

Research progress in animal models for tic disorder / 中华实用儿科临床杂志

Tic disorder (TD) is a neurodevelopmental disorder that occurs in childhood, characterized by involuntary movements or vocal tics and occasionally accompanied by various comorbidities.It may seriously affect children′s daily life, learning and social activities.Exploring its etiology and pathological mechanisms and developing drugs require extensive research on animal models.There are currently various methods for constructing TD models, including induced and spontaneous animal models, such as induced animal models with abnormal neurotransmitters and immune functions and spontaneous animal models based on genetic engineering.However, no animal model can fully match the manifestations of TD.This article summarizes the commonly used animal models for TD to provide references for exploring pathological mechanisms and developing drugs.

Analysis of intervention and treatment status for children with tic disorder and family needs / 中华实用儿科临床杂志

Objective:To evaluate the current situation of interventional treatment for children with tic disorder and family needs for interventions and to analyze the factors influencing intervention needs.Methods:This cross-sectional study encompassed 362 children and their families who sought medical attention at Children′s Hospital of Chongqing Medical University, from October 2022 to January 2023.Factors influencing their intervention needs were analyzed.Results:A total of 362 children were surveyed.The main therapies of family concern included medication and behavioral intervention.Currently, the predominant therapy employed in the care of these children was medication (102/126, 80.9%), not with standing the fact that 77.8% of parents expressed discontent with its efficacy.Of the children and families included in the survey, 276 (76.2%) gave responses delineating their specific intervention needs.The paramount among these was the need for social support, with the score of (2.69±0.96) points.Multiple linear regression analysis revealed the notable influence of the duration of the ailment, the presence of comorbidities, the gravity of the disorder, the monthly household income, parental anxiety levels, and concerns germane to the therapeutic regimen on the family needs for interventions (all P<0.05). Conclusions:The extant therapeutic approaches applied in tic disorder exhibit a discernable constraint in terms of efficacy.Parents evince a pronounced yearning for interventions.These needs are contingent upon a spectrum of determinants.Clinicians are advised to consider the family needs for interventions when formulating therapeutic strategies, so that they can propound bespoke intervention plans to ameliorate therapeutic outcomes.

Research progress on susceptibility genes in children with tic disorder / 中华实用儿科临床杂志

Tic disorder (TD) is a neurodevelopmental disorder that starts in childhood with tics as its primary clinical manifestation.It is a group of movement disorders with unknown causes.At present, the main pathogenic genes of TD have not been identified.In this paper, TD neurotransmitter-associated susceptibility genes ( DRD2, DRD4, SLC6A4, HDC, ADRA2A), related susceptibility gene variations ( ASH1L, CELSR3, PNKD, NRXN1, CNTN6), and other susceptibility genes ( FLT3, SLITRK1) were reviewed to provide references for the precision treatment based on gene variations.

Research progress in cognitive function characteristics of children with tic disorder / 中华实用儿科临床杂志

The prevalence rate of tic disorder in Chinese children and adolescents is relatively high, and tic disorder is often co-occurring with psychiatric disorders such as attention deficit and hyperactive disorder and obsessive compulsive disorder.The cognitive impairments of tic disorder patients with different clinical types, course of disease and comorbidities are different, but all affect the learning and life quality of patients.Exploration of the cognitive function characteristics of tic disorder patients is conducive to further understanding of the disease and its etiological mechanism, and has guiding significance for clinical recognition, diagnosis and treatment.

Visualization Analysis on Literature about TCM Treatment of Tic Disorder from 2000 to 2022 / 中国中医药信息杂志

Objective To investigate the current status,research hotspots,and emerging trends in the field of TCM treatment for tic disorder(TD);To provide references for relevant research.Methods Literature on the TCM treatment for TD was retrieved from CNKI,VIP,Wanfang Data,Web of Science Core Collection,and PubMed databases from January 1,2000 to May 1,2022.NoteExpress 3.7.0.9296 software was used for literature management.VOSviewer 1.6.18 software was utilized to conduct co-occurrence analysis on author,institution,and keyword information.R 4.1.3 was applied to statistically analyze keyword frequency and time distributions and generate visualizations.Results A total of 1 520 articles were included in the analysis,involving 107 core authors.High-frequency keywords included experience of famous doctors,clinical observation,acupuncture,and ear acupoints.Commonly used Chinese herbal medicines included Acori Tatarinowii Rhizoma and Bombyx Batryticatus.Frequently prescribed TCM formulae included Wendan Decoction,Changpu Yujin Decoction,Yinqiao Powder,and Tianma Gouteng Decoction.Conclusion Current research hotspots in this field focus on experience of famous doctors,the clinical efficacy of TCM interventions for TD,and molecular biological mechanism studies.Emerging research trends include external TCM treatment and comorbidity investigations.

Electrophysiological analysis of early warning information processing in children with transient tic disorder / 中华行为医学与脑科学杂志

Objective:To explore the changing characteristics of early warning information ability in children with transient tic disorder(TTD).Methods:A total of 32 children with TTD(TTD group) diagnosed and treated at Changzhou Children's Hospital from 2018 to 2022 and 36 healthy control children(HC group) recruited from ordinary primary schools in Changzhou city were tested with CPT-Go/Nogo task and their behavioral data and cue/uncue-N2, P3b and CNV components of event related potential(ERP) were analyzed and compared by SPSS 25.0 software.Results:(1)Comparison of behavioral data: there was no statistical difference in the correct number(37(34, 39) vs 38(37, 40)), false number(1(0, 2) vs 1(0, 2))and correct reaction time((511.27±99.27)ms vs(504.88±92.23)ms)between TTD and HC group(all P>0.05). (2) Comparison of ERP components: in the HC group, the amplitudes of cue-CNV were higher than those in uncue-CNV in lead Cz((-4.61±4.67)μV vs(-1.07±3.20)μV)and Pz((-4.17±3.74)μV vs(-1.79±3.49)μV) and the differences were statistically significant(both P<0.01). The amplitude of cue-P3b in lead Pz were higher than that in uncue-P3b((9.13±4.99)μV vs(6.12±6.24)μV) and the difference was statistically significant( P<0.01). Compare with HC group((-4.12±4.25)μV, (-4.61±4.67)μV, (9.13±4.99)μV), the amplitudes of uncue-N2, cue-CNV and cue-P3b in TTD group((-1.29±4.48)μV, (-2.03±3.19)μV, (6.59±3.41)μV) were respectively lower, and the differences were statistically significant(all P<0.05). Conclusion:Children with TTD may have dysfunction in conflict monitoring, attention allocation, and maintaining alertness when processing early warning information, but there may be corresponding compensation mechanisms for brain function.

To explore the distribution of TCM syndrome types of refractory tic disorder in children based on cluster analysis / 国际中医中药杂志

Objective:To explore the clinical characteristics and distribution of Tranditional Chinese Medicine (TCM) syndrome types of refractory tic disorders in children based on clustering analysis.Methods:A cross-sectional study. 183 children aged 3-18 years with refractory tic disorders from pediatric encephalopathy outpatient department of the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine who met the inclusion criteria from October 2015 to January 2022 were recruited. Frequency descriptive analysis, systematic clustering analysis and principal component analysis were conducted by Microsoft Office Excel 2016 and IBM SPSS Statistics 26.0 to explore the clinical characteristics and syndrome distribution of the disease.Results:The TCM symptoms of 183 children with refractory tic disorders were clustered into 6 categories, and finally 5 types of syndrome were obtained, among which the syndrome of spleen deficiency and liver hyperactivity mixed with dampness accounted for the largest proportion (27.32%), followed by the syndrome of phlegm-fire disturbing spirit (21.31%), the syndrome of wind-heat invading lung (18.03%), the syndrome of phlegm-qi stagnation (17.49%), and the syndrome of dampness and yin deficiency (15.85%).Conclusion:Through the mining and analysis of the outpatient information of pediatric encephalopathy in our hospital, the common syndrome differentiation types of refractory tic disorder are obtained, which can provide a reference for the TCM syndrome differentiation types of refractory tic disorder in children.

Correlation study of imaging characteristics of diffusion tensor imaging and the Yale Global Tic Severity Scale in children with tic disorders / 中华实用儿科临床杂志

Objective:To explore the correlation between imaging features of children with tic disorders and their features assessed by the Yale Global Tic Severity Scale (YGTSS).Methods:A retrospective study.A total of 33 children with tic disorders treated in the Department of Child Rehabilitation, the First Affiliated Hospital of Xinxiang Medical University from January 2022 to March 2023 were included in the tic disorder group, and 10 healthy age-matched children received physical examination during the same period were included in the healthy control group.Under the functional positioning of functional magnetic resonance imaging (fMRI), the active area of children with tic disorders at varying degrees was found.In the region of interest (ROI), localization monitoring and diffusion tensor imaging (DTI) were performed, and the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) were recorded.In the same ROI (bilateral thalamus, genu of internal capsule, splenium of corpus callosum, globus pallidus, caudate nucleus) of children in healthy control group, ADC and FA were recorded.Imaging data were compared between groups using the independent sample t test, and their correlation with YGTSS scores was identified by the Pearson correlation analysis. Results:There were significant differences in ADC of the left thalamus (0.869±0.077 vs.0.794±0.083, P=0.022), the right thalamus (0.853±0.055 vs.0.798±0.054, P=0.014), the left caudate nucleus (0.871±0.121 vs.0.787±0.052, P=0.003) and the right caudate nucleus (0.856±0.075 vs.0.788±0.063, P=0.010) between tic disorder group and healthy control group.No significant differences were detected in ADC of the remaining ROI between groups (all P>0.05). There were significant differences in FA of the left thalamus (0.259±0.050 vs.0.344±0.077, P=0.007), the right thalamus (0.265±0.057 vs.0.347±0.095, P=0.026) and the right caudate nucleus (0.168±0.118 vs.0.309±0.181, P=0.041) between tic disorder group and healthy control group.No significant differences were detected in ADC and FA between children with mild and moderate tic disorders (all P>0.05). ADC of the left thalamus and the right caudate nucleus were significantly correlated with YGTSS scores in children with tic disorders ( r=0.407 and 0.372, respectively; all P<0.05). FA of the right thalamus was negatively correlated with YGTSS scores in children with tic disorders ( r=-0.439, P<0.05). Conclusions:ADC of the thalamus and caudate nucleus, and FA of the right thalamus are significantly correlated with YGTSS scores of children with tic disorders.High ADC of the left thalamus and the right caudate nucleus are correlated with high YGTSS scores, indicating a severe symptom of tic disorder in children.A high FA of the right thalamus is correlated with low YGTSS scores, indicating a mild symptom of tic disorder in children.

Three oral Chinese patent medicines for children with tic disorder: a rapid health technology assessment / 中国中药杂志

This study aims to comprehensively evaluate the clinical value of Shaoma Zhijing Granules(SZG), Changma Xifeng Tablets(CXT), and Jiuwei Xifeng Granules(JXG) in the treatment of children with tic disorder with the method of rapid health technology assessment(RHTA), which is expected to serve as a reference for medical and health decision-making and clinical rational use of drugs in children. To be specific, relevant articles were retrieved from eight databases and three clinical trial registry platforms. After the quality evaluation, rapid assessment was carried out from the dimensions of disease burden and unmet needs, technical characteristics, safety, efficacy and economy, and the results were analyzed and presented descriptively. A total of 22 articles(1 in English, 21 in Chinese) were screened out: 18 randomized controlled trials(RCTs) and 4 clinical controlled trials(CCTs). Among them, 5 were about the SZG(all RCTs) and 9 were on CXT(6 RCTs and 3 CCTs). The rest 8 focused on JXG(7 RCTs and 1 CCT). Moreover, the overall risk of bias for 94.40% RCTs was evaluated as "some concerns" and only one(5.60%) had high risk of bias. In terms of quality, the 4 CCTs scored 5-6 points(<7 points), suggesting low quality. SZG alone or in combination with tiapride has obvious advantages in improving traditional Chinese medicine syndromes and tic symptoms compared with tiapride alone, with the average daily cost of CNY 79.44-119.16. Compared with conventional western medicine or placebo, CXT alone or in combination with conventional western medicine can improve the total effective rate and alleviate tic symptoms, and the average daily cost is CNY 22.50-67.50. JXG alone or in combination with conventional western medicine can effectively relieve tic symptoms compared with conventio-nal western medicine or placebo, with the average daily cost of CNY 82.42-164.85. The adverse events related to the three Chinese patent medicines mainly occurred in the digestive, respiratory, and nervous systems, all of which were mild. In general, SZG, CXT, and JXG are effective for children with tic disorder. They have been approved to be used in this field, of which SZG was approved in 2019, with the most up-to-date research evidence and high-quality RCT in Q1 journals. However, the comparative analysis of the three was affected by many factors, which should be further clarified. Based on the large sample data available in multiple dimensions, a comprehensive comparative evaluation of the three Chinese patent medicines should be carried out, thereby highlighting the advantages and disadvantages of them and serving a reference for rational clinical use and drug supervision.

Treating children's tic disorder based on " visceral theory" from lung, liver and spleen / 国际中医中药杂志

The pathogenesis of tic disorder in children is closely related to the dysfunction of the internal organs, especially the lung, spleen and liver. The main causes of tic disorder caused by visceral disorders are as follows: lung guard is the main cause of the disease, liver wind is the key to the pathogenesis and spleen deficiency and wind phlegm are the pathological basis. At the same time, the lung, liver, and spleen are mutually restrictive and affect each other. The main manifestations are that if the lung is affected by evil, the wood will punish the gold; if the spleen is insufficiency and the liver is hyperactive, the earth deficiency will be leading to over-restriction by wood. Based on the understanding of the related theories about viscera's disease and viscera's generation, we pay attention to distinguish the etiology and pathogenesis of the viscera, and we treat tic disorders based on syndrome differentiation of lung, liver and spleen with curative effect.

Prevention and caring of children's tic disorders based on incubative evil theory / 国际中医中药杂志

Tic disorder (TD) is a common neuro-developmental disorders in children during school age. The cause is complex and it can be induced or aggravated by varies of factors such as genetics, exogenous pathogens, and emotions. TD affects children's self-cognition, academic level, and social function, and causes parents to have unhealthy psychological states such as anxiety and depression, and affects family harmony. Therefore, clinical attention should not only be paid to the treatment of this disease, but also to prevention and nursing care. Incubative evil theory is one of the important theories of Traditional Chinese Medicine. This theory can help to treat and prevent diseases. Incubative evil is characterized by no symptoms with spontaneous attack by latent pathogen, but symptoms appearance induced by the pathogen. The pathological process of TD is similar to incubative evil characteristics. This paper discusses the prevention and nursing care of children's tic disorder based on the theory of incubative evil.

GAO Hong's clinical experience in treatment of tic disorder with acupuncture technique of cultivating the primary and regulating the mind / 中国针灸

The paper introduces the clinical experience of GAO Hong in treatment of tic disorder. GAO Hong believes that tic disorder results from the primary qi deficiency and mind disturbance. Acupuncture for cultivating the primary and regulating the mind is proposed specially for tic disorder. This acupuncture technique focuses on harmonizing and regulating governor vessel and conception vessel. In clinical practice, the conception vessel acupoints on the abdomen and the governor vessel acupoints on the head are selected particularly, e.g. Zhongwan (CV 12), Xiawan (CV 10), Qihai (CV 6) and Guanyuan (CV 4) on the abdomen; Baihui (GV 20), Shenting (GV 24), Benshen (GB 13) and Yintang (GV 24+) on the head. The needling sequence and the insertion depth are emphasized, which affect the curative effect and GV 20 is generally punctured first. Besides, considering to the type of disorder and the affected site, tic disorder is treated in view of both syndrome/pattern differentiation and symptom differentiation.

Research progress of refractory tic disorders / 中华实用儿科临床杂志

Refractory tic disorders (RTD) are a recently emerging concept gradually formed in pediatric neurology/psychiatry.Currently, the concept and diagnostic criteria of RTD remain unclarified, and it is extremely difficult to treat RTD.In this article, the definition, clinical features, influence factors, diagnosis, differential diagnosis, pharmacological treatment and non-pharmacological treatment of RTD in children were reviewed.