Tourette's syndrome, tics tied to cardiometabolic risks

  • Brander G & al.
  • JAMA Neurol
  • 14 Jan 2019

  • curated by Susan London
  • Clinical Essentials
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Takeaway

  • Individuals with Tourette's syndrome (TS) or chronic tic disorder (CTD) had elevated metabolic and cardiovascular risk compared with both the general population and unaffected siblings.

Why this matters

  • Importance for monitoring, targeting of interventions.

Key results

  • Over a mean of 22.2 years, individuals with TS/CTD had higher risk for any metabolic/cardiovascular disorder vs:
    • Unaffected general population (aHR, 1.99; 95% CI, 1.90-2.09).
    • Sibling controls (aHR, 1.37; 95% CI, 1.24-1.51).
  • Specific elevated risks vs general population:
    • Obesity (aHR, 2.76; 95% CI, 2.47-3.09).
    • Type 2 diabetes (aHR, 1.67; 95% CI, 1.42-1.96).
    • Circulatory system diseases (aHR, 1.76; 95% CI, 1.67-1.86).
  • Certain risks were significantly more elevated for males vs females.
  • Elevation of risk for any metabolic/cardiovascular disorder:
    • Evident from childhood.
    • Attenuated after excluding patients with comorbid attention-deficit/hyperactivity disorder (aHR, 1.52; 95% CI, 1.42-1.62).
  • Among patients with TS/CTD, risks for metabolic/cardiovascular disorders were lower for those receiving antipsychotics >1 year vs not receiving these medications.

Study design

  • Swedish longitudinal population-based cohort study:
    • 14,045,026 individuals overall (7804 with TS or CTD).
    • 5141 families with siblings discordant for TS or CTD.
  • Main outcomes: metabolic, cardiovascular conditions.
  • Funding: Tourettes Action; others.

Limitations

  • Patients with milder tics not captured.
  • Possible underestimation of some conditions.
  • Lack of data on potential lifestyle confounders.

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