RT Journal Article
T1 Lack of Association of Group A Streptococcal Infections and Onset of Tics: European Multicenter Tics in Children Study.
A1 Schrag, Anette-Eleonore
A1 Martino, Davide
A1 Wang, Hanyuying
A1 Ambler, Gareth
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 Mir, Pablo
A1 Morer, Astrid
A1 Moll, Natalie
A1 Müller, Norbert E
A1 Müller-Vahl, Kirsten R
A1 Plessen, Kerstin J
A1 Porcelli, Cesare
A1 Rizzo, Renata
A1 Roessner, Veit
A1 Schwarz, Markus
A1 Tarnok, Zsanett
A1 Walitza, Susanne
A1 Dietrich, Andrea
A1 Hoekstra, Pieter J
A1 European Multicentre Tics in Children Study (EMTICS), 
AB The goal of this work was to investigate the association between group A streptococcal (GAS) infections and tic incidence among unaffected children with a family history of chronic tic disorders (CTDs). In a prospective cohort study, children with no history for tics who were 3 to 10 years of age with a first-degree relative with a CTD were recruited from the European Multicentre Tics in Children Study (EMTICS) across 16 European centers. Presence of GAS infection was assessed with throat swabs, serum anti-streptolysin O titers, and anti-DNAse titers blinded to clinical status. GAS exposure was defined with 4 different definitions based on these parameters. Cox regression analyses with time-varying GAS exposure were conducted to examine the association of onset of tics and GAS exposure during follow-up. Sensitivity analyses were conducted with Cox regression and logistic regression analyses. A total of 259 children were recruited; 1 child was found to have tic onset before study entry and therefore was excluded. Sixty-one children (23.6%) developed tics over an average follow-up period of 1 (SD 0.7) year. There was a strong association of sex and onset of tics, with girls having an ≈60% lower risk of developing tics compared to boys (hazard ratio [HR] 0.4, 95% confidence interval [CI] 0.2-0.7). However, there was no statistical evidence to suggest an association of any of the 4 GAS exposure definitions with tic onset (GAS exposure definition 1: HR 0.310, 95% CI 0.037-2.590; definition 2: HR 0.561, 95% CI 0.219-1.436; definition 3: HR 0.853, 95% CI 0.466-1.561; definition 4: HR 0.725, 95% CI 0.384-1.370). These results do not suggest an association between GAS exposure and development of tics. This study provides Class I evidence that group A streptococcal exposure does not associate with the development of tics in children with first-degree relatives with chronic tic disorder.
YR 2022
FD 2022-02-02
LK http://hdl.handle.net/10668/20401
UL http://hdl.handle.net/10668/20401
LA en
DS RISalud
RD Apr 10, 2025