Analysis of risk factors of children with Tourette syndrome

Abstract

Objective To investigate the risk factors of children with Tourette syndrome (TS). Methods From March 2013 to June 2015, a total of 331 cases of children aged 4-12 years old who went to Department of Neurology, Mianyang Central Hospital were selected as research subjects. They were divided into TS group (n=206) and non TS group (n=125) according to the diagnostic results of TS. Self-designed questionnaire Risk Factors of Children with Tourette Syndrome Questionnaire was used to investigate all the research subjects in this study, including gender, onset age, personality traits of children, combined with attention-deficit hyperactivity disorder (ADHD) and other TS comorbidities or not, family history of neurological and psychiatric diseases, electroencephalogram examination results, times of recurrent respiratory tract infections within 1 year, history of long term drug therapy, family relationships, educational level of parents, personality traits of the father and mother, parenting style, blood level of lead (Pb), blood level of zinc (Zn), blood level of selenium (Se), the level of 25 hydroxy vitamin D, history of perinatal diseases and living habits of children. Univariate analysis and multivariate unconditional logistic regression analysis were used to analyze the 19 possible risk factors of TS. There were no significant differences between 2 groups in children′s age, gender ratio and other basic clinical data (P>0.05). This study was in line with all the ethical standards established by the Human Trials Board of Mianyang Central Hospital, and has been approved by it, and the informed consent of the clinical study was signed with all the guardians of the children. Results ①The univariate analysis of risk factors of TS in children showed that 7 factors including scores of father′s and mother′s personality traits, score of children′s living habit, combined with ADHD and other TS comorbidities, family history of neurological and psychiatric diseases, times of recurrent respiratory tract infections within 1 year and score of history of perinatal diseases were related to the onset of TS in children, and all the differences were statistically significant (P<0.05). ②The multivariate unconditional logistic regression analysis of risk factors of TS in children showed that combined with ADHD and other TS comorbidities, family history of neurological and psychiatric diseases, times of recurrent respiratory tract infections within 1 year and history of perinatal diseases were independent risk factors in the onset of TS in children (OR=4.237, 2.922, 1.040, 1.077; 95%CI: 2.316-7.750, 1.598-5.343, 1.019-1.062, 1.035-1.121; P<0.001). Conclusions TS comorbidity such as ADHD, family history of neurological and psychiatric diseases, recurrent respiratory tract infection and history of perinatal diseases are major risk factors for the onset of TS in children. And early intervention for these factors can effectively improve the prognosis and the quality of life of TS in children. Key words: Tourette syndrome; Recurrent respiratory tract infection; History of abnormal perinatal disease; Family medical history; Comorbidity; Child