Psychiatric Treatment and Management of Psychiatric Comorbidities of Movement Disorders

Abstract

Pediatric movement disorders may present with psychiatric symptoms at many points during the course of the disease. For the relatively common pediatric movement disorder, Tourette syndrome, psychiatric comorbidities are well-described and treatment is well-studied. Managing these comorbidities may be more effective than improving the movements themselves. For more uncommon movement disorders, such as juvenile-onset Huntington disease, treatment of psychiatric comorbidities is not well-characterized, and best-practice recommendations are not available. For the least common movement disorders, such as childhood neurodegeneration with brain iron accumulation, psychiatric features may be nonspecific so that underlying diagnosis may be apparent only after recognition of other symptoms. However, psychiatric medication, psychotherapy, and psychosocial support for these disorders may prove helpful to many children and adolescents.

Postnatal developmental trajectory of dopamine receptor 1 and 2 expression in cortical and striatal brain regions

“…If adult levels reflect healthy D1 versus D2 balance, then our results suggest that the low D1:D2 ratio earlier in life may be one of the potential mechanisms underlying the pathophysiology of the heightened vulnerability of early childhood disorders, such as attention deficit hyperactivity disorder (ADHD), Tourette syndrome, and autism. Specifically, D2 dominance in these ages may confer vulnerability, which is consistent with the fact that many medications for these disorders involve D2 antagonism (Kaufmann et al, 2017;Walsh, Soe, & Sarawgi, 2018). Our data also show that D1:D2 ratio is lower in males compared to females at P17 and P35, which correspond to the fact that ADHD, Tourette syndrome, and autism preferentially affect males over females.…”