先兆冲动在共患注意缺陷多动障碍与抽动障碍儿童抽动严重程度关联中的中介作用

doi:10.11852/zgetbjzz2024-0214

中国儿童保健杂志 ›› 2024, Vol. 32 ›› Issue (10): 1050-1054.DOI: 10.11852/zgetbjzz2024-0214

先兆冲动在共患注意缺陷多动障碍与抽动障碍儿童抽动严重程度关联中的中介作用

陆彦婷, 陈亮亮, 刘秀梅

福建医科大学妇儿临床医学院;福建省儿童医院(上海儿童医学中心福建医院)儿童保健科,福建福州 350012

收稿日期:2024-03-01 修回日期:2024-04-08 发布日期:2024-10-11 出版日期:2024-10-10
通讯作者: 刘秀梅,E-mail:xmliu0615@fjmu.edu.cn
作者简介:陆彦婷(1988-),女,主治医师,硕士研究生在读,主要研究方向为儿童保健。

Mediating role of premonitory urge on the impact of comorbidity with attention-deficit/hyperactivity disorder on tic severity in children with tic disorder

LU Yanting, CHEN Liangliang, LIU Xiumei

College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University; Department of Child Healthcare,Fujian Children′s Hospital (Fujian Branch of Shanghai Children′s Medical Center), Fuzhou, Fujian 350012, China

Received:2024-03-01 Revised:2024-04-08 Online:2024-10-10 Published:2024-10-11
Contact: LIU Xiumei, E-mail:xmliu0615@fjmu.edu.cn

摘要/Abstract

摘要： 目的研究共患注意缺陷多动障碍(ADHD)对抽动障碍(TD)儿童抽动严重程度的影响,探讨先兆冲动在二者关联中的中介作用。方法纳入2022年11月—2023年10月于福建省儿童医院儿童保健/发育行为科门诊就诊的TD共患ADHD(TD+ADHD)患儿68例,单纯TD患儿150例,采用先兆冲动量表(PUTS)、耶鲁综合抽动严重程度量表(YGTSS)评估患儿的先兆冲动及抽动严重程度,采用Pearson相关分析变量间的关联,通过PROCESS软件检验中介效应。结果 1)TD+ADHD组PUTS总分高于单纯TD组(t=2.22,P＜0.05),运动性抽动的频率(t=2.20)及复杂性(t=2.05)、发声性抽动的强度(t=2.19)及复杂性(t=2.64)在TD+ADHD组与单纯TD组间的差异存在统计学意义(P<0.05);2)PUTS总分与YGTSS的运动性抽动(包括种类、复杂性、干扰性、总运动抽动的严重程度)、发声性抽动、总损害率、总的严重程度之间呈正相关(r=0.170～0.354,P＜0.05);3)控制儿童年龄、性别等混杂因素后,PUTS总分在共患ADHD与TD发声强度关联间的中介作用为25.70%,在共患ADHD与TD发声复杂性关联间的中介作用为14.32%。结论 TD+ADHD患儿先兆冲动明显,先兆冲动是共患ADHD影响TD发声强度及复杂性的中介因素。

关键词: 抽动障碍, 注意缺陷多动障碍, 先兆冲动, 抽动严重程度, 中介效应

Abstract: Objective To examine the effect of comorbidity with attention-deficit/hyperactivity disorder (ADHD) on tic severity in children with tic disorder (TD), and to explore the mediating role of premonitory urge in the association. Methods A total of 68 TD children comorbid with ADHD (TD+ADHD) and 150 children with TD were recruited from the Child Health Care/Developmental Behavior Outpatient Department of Fujian Children′s Hospital between November 2022 and October 2023. The Premonitory Urge for Tics Scale (PUTS) and the Yale Global Tic Severity Scale (YGTSS) were administered to assess premonitory urges and tic severity, respectively. Pearson correlation analysis was used to examine the associations among variables, and the PROCESS software was used to test the mediation effect. Results The TD+ADHD group scored significantly higher on the PUTS compared to the TD group (t= 2.22, P<0.05). Statistically significant differences were also found between the two groups in terms of frequency (t=2.20) and complexity (t=2.05) of motor tics, as well as intensity (t=2.19) and complexity (t=2.64) of vocal tics (P<0.05). 2) Positive correlations were found between total PUTS scores and motor tics (including number, complexity, disruptiveness, and severity of total motor tics), vocal tics, total impairment rate, and total severity of the YGTSS (r=0.170 - 0.354, P<0.05). 3) After controlling the confounding factors such as children′s age and gender, it was found that the total PUTS score mediated 25.70% of the association between comorbid ADHD and TD vocal intensity and 14.32% of the association between comorbid ADHD and TD vocal complexity. Conclusion Premonitory urge is evident in children comorbid TD and ADHD, and premonitory urge is a mediator of the effect of comorbidity with ADHD on the strength and complexity of TD vocalizations.

Key words: tic disorder, attention-deficit/hyperactivity disorder, premonitory urge, tic severity, mediating effect

中图分类号:

R749.94

陆彦婷, 陈亮亮, 刘秀梅. 先兆冲动在共患注意缺陷多动障碍与抽动障碍儿童抽动严重程度关联中的中介作用[J]. 中国儿童保健杂志, 2024, 32(10): 1050-1054.

LU Yanting, CHEN Liangliang, LIU Xiumei. Mediating role of premonitory urge on the impact of comorbidity with attention-deficit/hyperactivity disorder on tic severity in children with tic disorder[J]. Chinese Journal of Child Health Care, 2024, 32(10): 1050-1054.

参考文献

[1] American Psychiatric Association.Diagnostic and statistical manual of mental disorders DSM-5[M]. Arlington:American Psychiatric Association,2013.
[2] Liu ZS, Cui YH, Sun D, et al. Current status, diagnosis, and treatment recommendation for tic disorders in China[J]. Front Psychiatry, 2020, 11: 774.
[3] 卢青, 孙丹, 刘智胜. 中国抽动障碍诊断和治疗专家共识解读[J].中华实用儿科临床杂志,2021, 36(9): 647-653.
Lu Q,Sun D,Liu ZS.Interpretation of the Chinese expert consensus on the diagnosis and treatment of tic disorder[J].Chin J Appl Clin Pediatr.2021,36(9): 647-653.(in Chinese)
[4] Openneer TJC,Forde NJ, Akkermans SEA, et al. Executive function in children with Tourette syndrome and attention-deficit/hyperactivity disorder:Cross-disorder or unique impairments?[J].Cortex,2020,124:176-187.
[5] Kim M,Chung S-K,Yang J-C,et al.Development of the Korean Form of the Premonitory Urge for Tics Scale: A reliability and validity study[J].Soa Chongsonyon Chongsin Uihak, 2020,31(3):146-153.
[6] Essing J, Jakubovski E, Psathakis N,et al. Premonitory Urges reconsidered: Urge location corresponds to tic location in patients with primary tic disorders[J]. J Mov Disord, 2022,15(1):43-52.
[7] Brandt V, Essing J, Jakubovski E,et al.Premonitory Urge and tic severity, comorbidities,and quality of life in chronic tic disorders[J]. Mov Disord Clin Pract,2023,10(6):922-932.
[8] Openneer TJC, Tárnok Z, Bognar E, et al.The premonitory Urge for Tics Scale in a large sample of children and adolescents:Psychometric properties in a developmental context.An EMTICS study[J].Eur Child Adolesc Psychiatry,2020,29(10):1411-1424.
[9] Li Y, Woods D W, Gu Y, et al. Psychometric properties of the Chinese version of the Premonitory Urge for Tics Scale: A preliminary report[J]. Front Psychol, 2021, 12: 573803.
[10] Matsuda N, Nonaka M, Kono T, et al.Premonitory awareness facilitates tic suppression: Subscales of the Premonitory Urge for Tics Scale and a new self-report questionnaire for tic-associated sensations[J]. Front Psychiatry, 2020, 11:592.
[11] Gu Y, Li Y, Cui YH. Correlation between premonitory urges and tic symptoms in a Chinese population with tic disorders[J]. Pediatr Investig,2020,4(2):86-90.
[12] McGuire JF, Piacentini J, Storch E A, et al. A multicenter examination and strategic revisions of the Yale Global Tic Severity Scale[J]. Neurology,2018, 90(19):e1711-e1719.
[13] Reese H E, Scahill L, Peterson A L,et al. The premonitory urge to tic: Measurement, characteristics, and correlates in older adolescents and adults[J]. Behav Ther, 2014, 45(2): 177-186.
[14] Brandt V C, Beck C, Sajin V, et al. Convergentvalidity of the PUTS[J]. Front Psychiatry, 2016, 7: 51.
[15] Brandt VC, Münchau A. Evidence ofdifferent neural pathways for motor and vocal tic-like expressions in monkeys[J].Mov Disord,2016,31(7):971.
[16] McCairn K W, Nagai Y, Hori Y, et al. A Primary role for nucleus accumbens and related limbic network in vocal tics[J]. Neuron, 2016, 89(2): 300-307.
[17] Jackson SR, Sigurdsson HP, Dyke K,et al. The role of the cingulate cortex in the generation of motor tics and the experience of the premonitory urge-to-tic in Tourette syndrome[J].J Neuropsychol, 2021,15(3):340-362.
[18] Conceição V A, Dias Ã, Farinha A C, et al.Premonitory urges and tics in Tourette syndrome: Computational mechanisms and neural correlates[J]. Curr Opin Neurobiology, 2017, 46: 187-199
[19] Jackson SR, Loayza J, Crighton M, et al. The role of the insula in the generation of motor tics and the experience of the premonitory urge-to-tic in Tourette syndrome[J]. Cortex, 2020, 126: 119-133.
[20] Jankovic J. Coprolalia andmalignant phonic tics[M/OL]//Frucht SJ.Movement disorder emergencies.Current clinical neurology.Humana,Cham.https://doi.org/10.1007/978-3-030-75898-1_13.

先兆冲动在共患注意缺陷多动障碍与抽动障碍儿童抽动严重程度关联中的中介作用

Mediating role of premonitory urge on the impact of comorbidity with attention-deficit/hyperactivity disorder on tic severity in children with tic disorder

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