Disturbed sleep in children with Tourette syndrome

Kostanecka-Endress, Tatiana; Banaschewski, Tobias; Kinkelbur, Jörg; Wüllner, Ina; Lichtblau, Sigrid; Cohrs, Stefan; Rüther, Eckart; Woerner, Wolfgang; Hajak, Göran; Rothenberger, Aribert

doi:10.1016/s0022-3999(02)00602-5

Cited by 86 publications

(41 citation statements)

References 33 publications

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“…In that small study, patients with Tourette syndrome and healthy controls had similar nocturnal movements. 19 Sleep in tic disorders has been studied alongside attention deficit hyperactivity disorder (ADHD) because of their frequent comorbidity. Children with ADHD (both with and without comorbid tic disorder) had shorter REM sleep latency and an increased REM sleep percentage than those with tic disorder alone, including shorter REM sleep latency and an increased REM sleep percentage.…”

Section: Brief Summarymentioning

confidence: 99%

Rapid Eye Movement Sleep Abnormalities in Children with Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS)

Gaughan

Buckley

Hommer

et al. 2016

Journal of Clinical Sleep Medicine

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Study Objectives: Polysomnographic investigation of sleep architecture in children presenting with pediatric acute-onset neuropsychiatric syndrome (PANS). Methods: Fifteen consecutive subjects meeting criteria for PANS (mean age = 7.2 y; range 3-10 y) underwent single-night full polysomnography (PSG) read by a pediatric neurologist. Results: Thirteen of 15 subjects (87%) had abnormalities detected with PSG. Twelve of 15 had evidence of rapid eye movement (REM) sleep motor disinhibition, as characterized by excessive movement, laughing, hand stereotypies, moaning, or the continuation of periodic limb movements during sleep (PLMS) into REM sleep. Conclusions: This study shows various forms of REM sleep motor disinhibition present in a population of children with PANS. Keywords: obsessive compulsive disorder, PANS, polysomnography, REM sleep behavior disorder Citation: Gaughan T, Buckley A, Hommer R, Grant P; Williams K, Leckman JF, Swedo SE. Rapid eye movement sleep abnormalities in children with pediatric acute-onset neuropsychiatric syndrome (PANS). J Clin Sleep Med 2016;12(7):1027-1032. I NTRO DUCTI O N Schenck et al.1 were the first to suggest that rapid eye movement (REM) sleep neurobehavioral disorders were a separate category of parasomnia in a 1986 case series of four males aged 67-72 y. Polysomnography (PSG) of these four subjects showed a loss of chin atonia and high limb-twitch activity among other REM sleep pathology, whereas videography showed various REM sleep behaviors including punching, kicking, and dream enactment.1 Since then, REM sleep behavior disorder (RBD) has been recognized across a wide range of ages, sometimes decades prior to the onset of other neurobehavioral changes and often heralding serious neurodegenerative conditions affecting synuclein.2 A recent retrospective study of patients showing REM sleep without atonia on PSG found a majority (73%) of patients had idiopathic RBD, defined as RBD in the absence of known neurological or sleep disorders.3 Recent reports suggest that clinical and subclinical forms of RBD occur in children and adolescents.4 Although pediatric RBD is considered to be a rare occurrence, its prevalence may be underestimated due to limited awareness, overlap with other parasomnias, and the requirement of nocturnal PSG for diagnosis.4,5 Additionally, it is unclear whether or not the adult clinical definitions should pertain to pediatric presentations due to a current lack of neuropathologic studies of childhood RBD.4 Differentiating RBD from other parasomnias in the younger population is significant clinically because of the potential to inform on neuropsychiatric state and therefore guide treatment choices, as evidenced in conditions such as narcolepsy where 60% of patients will have RBD. In adult psychiatric populations, RBD has been associated with the use of psychotropic medications and particularly with serotonin reuptake-blocking antidepressants.3,7 However, a recent study suggests that antidepressants cannot fully explain RBD symptomatology in their psychiat...

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Section: Brief Summarymentioning

confidence: 99%

Rapid Eye Movement Sleep Abnormalities in Children with Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS)

Gaughan

Buckley

Hommer

et al. 2016

Journal of Clinical Sleep Medicine

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“…Videotelemetry with combined EEG and EMG recording is not indicated in the evaluation of TS except when attempting to evaluate a sleep disorder (see 18 for review). 19 Although differences in brain volumes and dopamine function between patients with TS and normal controls have been demonstrated in neuroimaging studies, 20 -22 computerized tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET) and single photon emission tomography (SPECT) have no current role in the diagnostic evaluation of TS.…”

Section: Diagnosis Of Ts and Assessment Of Ticsmentioning

confidence: 99%

Contemporary assessment and pharmacotherapy of Tourette syndrome

et al. 2006

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Summary:To develop a guide to clinical assessment and pharmacotherapy for children and adults with Tourette syndrome (TS), we reviewed published literature over the past 25 years to identify original articles and reviews on the assessment and pharmacological treatment of Tourette syndrome, attention-deficit/hyperactivity disorder (ADHD) and obsessivecompulsive disorder (OCD). The literature search also included a survey of reviews published in book chapters. The assessment section was compiled from several reviews. Pharmacological treatments were classified into those with strong empirical support (as evidenced by two positive placebo-controlled studies for tics, OCD, or ADHD in TS samples); modest empirical support (one positive placebo-controlled study), or minimal support (open-label data only). We conclude that accurate diagnosis, including identification of comorbid conditions, is an essential step toward appropriate treatment for patients with TS. In many patients with TS, symptom management requires pharmacotherapy for tics or coexisting conditions. The evidence supporting efficacy and safety for medications used in patients with TS varies. But this evidence offers the best guide to clinical practice.

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“…In particular, there is evidence that sleep disturbances diagnosed as excessive daytime sleepyness (EDS) [Carmelli et al, 2001] or narcolepsy [Taheri and Mignot, 2002] has a genetic component. Poor quality of sleep may also be involved in disorders such as attention deficit-hyperactivity disorder (ADHD) comorbid with Tourette syndrome (TS) [Allen et al, 1992;Freeman et al, 2000;Cohrs et al, 2001;Kostanecka-Endress et al, 2003] that may have complex genetic origins [Barr and Sandor, 1998;Comings, 2001].…”

Section: Introductionmentioning

confidence: 99%

Variants of the orexin2/hcrt2 receptor gene identified in patients with excessive daytime sleepiness and patients with Tourette's syndrome comorbidity

Thompson

Comings²,

Abu-Ghazalah

et al. 2004

American J of Med Genetics Pt B

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The orexin-2/hypocretin-2 (OX2R) receptor gene is mutated in canine narcolepsy and disruption of the prepro-orexin/hypocretin ligand gene results in both an animal model of narcolepsy and sporadic cases of the human disease. This evidence suggests that the structure of the OX2R gene, and its homologue, the OX1R gene, both members of the G protein-coupled receptor (GPCR) family, and the gene encoding the peptide ligands, the prepro-orexin/hypocretin gene, may be variables in the etiology of sleep disorders. We report a single stranded conformational polymorphism (SSCP) analysis of the coding regions of these genes in idiopathic sleep disorder patients diagnosed with excessive daytime sleepiness (EDS) (n = 28), narcolepsy (n = 28), Tourette's syndrome/chronic vocal or motor tic disorder (n = 70), and control subjects (n = 110). Two EDS patients showed a Pro11Thr change. One Tourette's syndrome patient was found to have a Pro10Ser alteration. The Pro10Ser and Pro11Thr variants were not found in non-disease populations. Analysis of the ability of the mutant receptors to mobilize calcium compared to the wild-type receptor in response to orexin agonists indicated that they resulted in decreased potency at high (etaM) concentrations of orexin ligands. Further work is warranted to study the variability of the orexin/hypocretin system in a variety of disorders characterized by EDS.

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Disturbed sleep in children with Tourette syndrome

Cited by 86 publications

References 33 publications

Rapid Eye Movement Sleep Abnormalities in Children with Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS)

Rapid Eye Movement Sleep Abnormalities in Children with Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS)

Contemporary assessment and pharmacotherapy of Tourette syndrome

Variants of the orexin2/hcrt2 receptor gene identified in patients with excessive daytime sleepiness and patients with Tourette's syndrome comorbidity

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