Combined Neurometabolic Therapy in Various Clinical Forms of Tic Hyperkinesis in Children: Effects on Motor and Non-Motor Symptoms
https://doi.org/10.52667/2712-9179-2025-5-3-34-40
Abstract
Tic hyperkinesis is one of the most common forms of extrapyramidal pathology in childhood. Recently, interest in non-motor manifestations of tic hyperkinesis in children has increased, as they include ADHD, OCD and anxiety disorder. It is assumed that all these neuropsychiatric diseases have a single pathophysiological basis. However, the question of effective therapy of these comorbid disorders accompanying tic hyperkinesis in children still remains. Aim: to im-prove the quality of inpatient medical care in military hospitals and increase patient satisfaction with medical services. Materials and methods: the study involved 167 patients (193 boys and 74 girls) with tic hyperkinesis aged 6 to 12 years (mean age 8.2 ± 2.3 years). All patients were divided into four groups depending on the clinical course of the disease: Group I: 32 patients with transient tics; Group II: 120 patients with chronic tics. Group III: 15 patients with Gilles de la Tourette syndrome. Motor symptoms were assessed using the YGTSS scale, and non-motor symptoms were assessed using standardized scales: Y-BOCS, SNAP-IV and STAI. The severity of symptoms was assessed before and after treatment. Results: combination neuropharmacotherapy was effective in reducing the severity of tics, ADHD, OCD, and anxiety disorder symptoms in all clinical forms of tic hyperkinesis in children. In addition, combination therapy statistically significantly reduced the severity of tics in patients with Gilles de la Tourette syndrome, ADHD symptoms in patients with transient tics and Gilles de la Tourette syndrome, and OCD symptoms in patients with Gilles de la Tourette syndrome compared to monotherapy. Conclusion: the results of this study showed that combination therapy with hopantenic acid in combination with the main line of therapy in children with tic hyperkinesis is effective in treating both tics themselves and symptoms of ADHD, OCD, and anxiety disorder.
About the Authors
Dilorom A. NurmatovaUzbekistan
100058 Tashkent
Zaynutdinkhuzha F. Sayfitdinkhuzhaev
Russian Federation
634050 Tomsk
Natalia G. Zhukova
Russian Federation
634050 Tomsk
Oybek Ya. Bustanov
Uzbekistan
170100 Andijan
Nargiza A. Nasriddinova
Uzbekistan
170100 Andijan
Jahongir M. Okhunbaev
Uzbekistan
100058 Tashkent
References
1. Kadesjö, B.; Gillberg, C. Tourette’s disorder: epidemiology and comorbidity in primary school children. J Am Acad Child Adolesc Psychiatry 2000, 39(5): 548-555. https://doi.org/10.1097/00004583-200005000-00007
2. Li, F.; Cui, Y.; Li, Y.; Guo, L.; Ke, X.; Liu, J. Prevalence of mental disorders in school children and adolescents in China: diagnostic data from detailed clinical assessments of 17,524 individuals. J Child Psychol Psychiatry 2022, 63:34–46. https://doi.org/10.1111/jcpp.13445
3. Alves, H.L.; Quagliato, E.M. The prevalence of tic disorders in children and adolescents in Brazil. Arq Neuropsiquiatr 2014, 72(12):942-948. https://doi.org/10.1590/0004-282X20140174
4. Khalifa, N.; von Knorring, A. Prevalence of tic disorders and Tourette syndrome in a Swedish school population. Developmental Medicine & Child Neurology 2003, 45:5. https://doi.org/10.1017/s0012162203000598
5. Surén, P.; Bakken, I.J.; Skurtveit, S.; Handal, M.; Reichborn-Kjennerud, T.; Stoltenberg, C.; Nøstvik, L.I.; Weidle, B. Tidsskr Nor Laegeforen 2019, 139(17). https://doi.org/10.4045/tidsskr.19.0411
6. Zavadenko, N.N.; Doronina, O.B.; Nesterovsky, Yu.E. Chronic tics and Tourette syndrome in children and adolescents: diagnostic and treatment characteristics. S.S. Korsakov Journal of Neurology and Psychiatry 2015, 115(1):102‑109. (In Russ.) https://doi.org/10.17116/jnevro201511511102-109
7. Ueda, K.; Black, KJ. A Comprehensive review of tic disorders in children. J Clin Med 2021, 10(11):2479. https://doi.org/10.3390/jcm10112479
8. Freeman, R.; Fast, D.; Burd, L.; Kerbeshian, J.; Robertson, M.; Sandor, P. An international perspective on Tourette syndrome: selected findings from 3500 individuals in 22 countries. Developmental Medicine and Child Neurology 2000, 42: 7: 436—447.
9. Hirschtritt. M.E.; Lee, P.C.; Pauls, D.L.; Dion, Y.; Grados, M.A.; Illmann, C.; King, R.A.; Sandor, P.; McMahon, W.M.; Lyon, G.J. Lifetime prevalence, age of risk, and genetic relationships of comorbid psychiatric disorders in Tourette syndrome. JAMA Psychiatry 2015, 72:325–333. https://doi.org/10.1001/jamapsychiatry.2014.2650
10. Ferrãol, Y.A.; Miguel, E.; Stein, D.J. Tourette’s syndrome, trichotillomania, and obsessive-compulsive disorder: How closely are they related? Psychiatry Res 2009, 170:32–42. https://doi.org/10.1016/j.psychres.2008.06.008
11. Hirschtritt, M.E.; Lee, P.C.; Pauls, D.L.; Dion, Y.; Grados, M.A.; Illmann, C.; King, R.A.; Sandor, P.; McMahon, W.M.; Lyon, G.J. Lifetime prevalence, age of risk, and genetic relationships of comorbid psychiatric disorders in Tourette syndrome. JAMA Psychiatry 2015, 72:325–333. https://doi.org/10.1001/jamapsychiatry.2014.2650
12. Carter, A.S.; O’Donnell, D.A.; Schultz, R.T.; Scahill, L.; Leckman, J.F.; Pauls, D.L. Social and emotional adjustment in children affected with Gilles de la Tourette’s syndrome: Associations with ADHD and family functioning. J of Child Psychology and Psychiatry and Allied Disciplines 2000, 41: 215—223.
13. Rizzo, R.; Gulisano, M.; Martino, D.; Robertson, M.M. Gilles de la Tourette syndrome, depression, depressive illness, and correlates in a child and adolescent population. J. Child Adolesc. Psychopharmacol 2017, 27:243–249. https://doi.org/10.1089/cap.2016.0120
14. Johnco, C.; McGuire, J.F.; McBride, N.M.; Murphy, T.K.; Lewin, A.B.; Storch, E.A. Suicidal ideation in youth with tic disorders. J. Affect. Disord 2016, 200:204–211. https://doi.org/10.1016/j.jad.2016.04.027
15. Storch, E.A.; Hanks, C.E.; Mink, J.W.; McGuire, J.F.; Adams, H.R.; Augustine, E.F.; Vierhile, A.; Thatcher, A.; Bitsko, R.; Lewin, A.B. Suicidal thoughts and behaviors in children and adolescents with chronic tic disorders. Depress. Anxiety 2015, 32:744–753. https://doi.org/10.1002/da.22357
16. Fernández de la Cruz, L.; Rydell, M.; Runeson, B.; Brander, G.; Rück, C.; D’Onofrio, B.M.; Larsson, H.; Lichtenstein, P.; Mataix-Cols, D. Suicide in Tourette’s and chronic tic disorders. Biol. Psychiatry 2017, 82:111–118. https://doi.org/10.1016/j.biopsych.2016.08.023
17. Nurmatova, D.A.; Zhukova, N.G.; Sayfitdinkhuzhaev, Z.F.; Okhunbaev, J.M. Morphometric characteristics of cerebral structures in Gilles de la Tourette syndrome. Personalized Psychiatry and Neurology 2025, 5(1):2-9. https://doi.org/10.52667/2712-9179-2025-5-1-2-9
Review
For citations:
Nurmatova D.A., Sayfitdinkhuzhaev Z.F., Zhukova N.G., Bustanov O.Ya., Nasriddinova N.A., Okhunbaev J.M. Combined Neurometabolic Therapy in Various Clinical Forms of Tic Hyperkinesis in Children: Effects on Motor and Non-Motor Symptoms. Personalized Psychiatry and Neurology. 2025;5(3):34-40. https://doi.org/10.52667/2712-9179-2025-5-3-34-40