RT Journal Article
T1 Association of Group A Streptococcus Exposure and Exacerbations of Chronic Tic Disorders: A Multinational Prospective Cohort Study.
A1 Martino, Davide
A1 Schrag, Anette
A1 Anastasiou, Zacharias
A1 Apter, Alan
A1 Benaroya-Milstein, Noa
A1 Buttiglione, Maura
A1 Cardona, Francesco
A1 Creti, Roberta
A1 Efstratiou, Androulla
A1 Hedderly, Tammy
A1 Heyman, Isobel
A1 Huyser, Chaim
A1 Madruga, Marcos
A1 Mir, Pablo
A1 Morer, Astrid
A1 Mol-Debes, Nanette
A1 Moll, Natalie
A1 Müller, Norbert
A1 Müller-Vahl, Kirsten
A1 Munchau, Alexander
A1 Nagy, Peter
A1 Plessen, Kerstin Jessica
A1 Porcelli, Cesare
A1 Rizzo, Renata
A1 Roessner, Veit
A1 Schnell, Jaana
A1 Schwarz, Markus
A1 Skov, Liselotte
A1 Steinberg, Tamar
A1 Tarnok, Zsanett
A1 Walitza, Susanne
A1 Dietrich, Andrea
A1 Hoekstra, Pieter J
K1 Child
K1 Prospective Studies
K1 Streptococcal Infections
K1 Adolescent
K1 Tics
K1 Linear Models
K1 Logistic Models
K1 Obsessive-Compulsive Disorder
AB To examine prospectively the association between group A Streptococcus (GAS) pharyngeal exposures and exacerbations of tics in a large multicenter population of youth with chronic tic disorders (CTD) across Europe. We followed up 715 children with CTD (age 10.7 ± 2.8 years, 76.8% boys), recruited by 16 specialist clinics from 9 countries, and followed up for 16 months on average. Tic, obsessive-compulsive symptom (OCS), and attention-deficit/hyperactivity disorder (ADHD) severity was assessed during 4-monthly study visits and telephone interviews. GAS exposures were analyzed using 4 possible combinations of measures based on pharyngeal swab and serologic testing. The associations between GAS exposures and tic exacerbations or changes of tic, OC, and ADHD symptom severity were measured, respectively, using multivariate logistic regression plus multiple failure time analyses and mixed effects linear regression. A total of 405 exacerbations occurred in 308 of 715 (43%) participants. The proportion of exacerbations temporally associated with GAS exposure ranged from 5.5% to 12.9%, depending on GAS exposure definition. We did not detect any significant association of any of the 4 GAS exposure definitions with tic exacerbations (odds ratios ranging between 1.006 and 1.235, all p values >0.3). GAS exposures were associated with longitudinal changes of hyperactivity-impulsivity symptom severity ranging from 17% to 21%, depending on GAS exposure definition. This study does not support GAS exposures as contributing factors for tic exacerbations in children with CTD. Specific workup or active management of GAS infections is unlikely to help modify the course of tics in CTD and is therefore not recommended.
PB Wolters Kluwer Health
YR 2021
FD 2021-02-10
LK https://hdl.handle.net/10668/27815
UL https://hdl.handle.net/10668/27815
LA en
NO Martino D, Schrag A, Anastasiou Z, Apter A, Benaroya-Milstein N, Buttiglione M, et al. Association of Group A Streptococcus Exposure and Exacerbations of Chronic Tic Disorders: A Multinational Prospective Cohort Study. Neurology. 2021 Mar 23;96(12):e1680-e1693.
DS RISalud
RD Apr 8, 2025