Objective: To evaluate the role of inflammatory triggering factors in the onset of tics and Tourette syndrome in a prospective cohort of paediatric population.

Background: Chronic tics and Tourette’s syndrome are a neurodevelopment disorders. It has been hypothesised that genetic factors during the development interact with other environmental factors to established the disorder. A great emphasis has been placed on immunological factors.

Methods: Paediatric patients attending Movement Disorders Clinic of Bambino Gesù Children’s Hospital were prospectively enrolled in the study. Only patients with an onset of tics less than 6 months and with an history longer than 3 months were included. The patients underwent an extensive clinical, biochemical evaluation. A comprehensive biochemical and immunological work up was performed. All patients performed throat tampon for group A streptococcal infection. Control group was constituted by age -matched healthy children. Patients were clinically evaluated after 6, 9 and 12 months of follow-up. Analysis of variance (ANOVA) was used to compare the the groups; logistic and linear regression was applied to identify variables associated to tic disorders progression.

Results: Forty-five patients with relatively recent onset of tics and 20 age matched controls were recruited for the study. The mean age was 9,45 +/- 5,6 (mean +/- SD), 75% were males and 25% females in both groups. Children with tics had an onset of symptoms of 4,5 months (mean). Thirty children had an associated comorbid condition. We did not find any statistically difference between patients and controls for blood count cells, haemoglobin, total amount of immunoglobulins. Analysis of ferritin, transferrin revealed a statistically higher levels in the patients group compared to controls (p<0.01), while a significant lower levels of non ceruloplasmin copper was found in the patients group. Levels of transferrin and ferritin were found statistically related (linear regression p<0,01) to initial severity of tics. Follow-up revealed that severity of progression of tic disorders was related to higher initial levels transferrin and ferritin (p<0,05), as well as a lower levels of non ceruloplasmin copper (p<0,05).

Conclusions: Our preliminary study demonstrates that immunological as well as inflammatory factors may play a role in triggering tics onset in young population.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-inflammatory-burden-of-tic-onset-in-a-paediatric-cohort-a-preliminary-study/