Zhang Wenyan, Jiang Zhongliang, Zhang Anyi, Yu Liping, Wang Xianbin, Hong Xu, Cui Yonghua, Lei Tianyuan
Department of Psychiatry, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
Laboratory for Clinical Medicine, Capital Medical University, Beijing, 100045, China.
Child Adolesc Psychiatry Ment Health. 2024 Sep 16;18(1):118. doi: 10.1186/s13034-024-00810-3.
While Tourette syndrome (TS) and attention-deficit/hyperactivity disorder (ADHD) often co-occur, the nature of the relationship between their symptoms is not well understood. Network analysis of psychopathology allow for detailed examinations of symptom interactions, providing an effective approach to explore the patterns of comorbidity between TS and ADHD symptoms.
This study included 3,958 participants (male/female = 3,004/954, age mean ± SD = 8.60 ± 2.25 years). We collected data on TS symptoms using the Motor Tic, Obsessions and Compulsions, Vocal Tic Evaluation Survey (MOVES), and ADHD symptoms using the Swanson, Nolan, and Pelham Rating Scale-IV (SNAP-IV). Network analysis was employed to construct a combined network of TS and ADHD symptoms at the symptom level. We utilized the expected influence (EI) and bridge EI metrics to explore the core and bridge symptoms within the network.
The network structure demonstrated a moderate number of non-zero connections between TS and ADHD symptoms, constituting 23.06% of all potential connections. Core symptoms in the comorbidity network included "Often has difficulty sustaining attention in tasks or play activities," "Certain bad words or thoughts keep going through my mind," and "Words come out that I can't stop or control." Bridging symptoms identified were "Words come out that I can't stop or control," "I do certain things like jumping or clapping over and over," "I can't control all my movements," and "Often talks excessively."
The core and bridging symptoms identified in this study serve as potential therapeutic targets for the treatment of TS and ADHD comorbidity in clinical children and adolescents.
虽然抽动秽语综合征（TS）和注意力缺陷多动障碍（ADHD）常同时出现，但其症状之间关系的本质尚未得到充分理解。精神病理学的网络分析能够详细检查症状间的相互作用，为探索TS与ADHD症状的共病模式提供了一种有效方法。
本研究纳入3958名参与者（男/女 = 3004/954，平均年龄±标准差 = 8.60±2.25岁）。我们使用运动抽动、强迫观念和强迫行为、发声抽动评估量表（MOVES）收集TS症状数据，使用斯旺森、诺兰和佩勒姆评定量表第四版（SNAP-IV）收集ADHD症状数据。采用网络分析在症状层面构建TS和ADHD症状的联合网络。我们利用预期影响（EI）和桥梁EI指标来探索网络中的核心症状和桥梁症状。
网络结构显示TS和ADHD症状之间存在一定数量的非零连接，占所有潜在连接的23.06%。共病网络中的核心症状包括“在任务或游戏活动中常常难以持续保持注意力”、“某些脏话或想法不断在我脑海中浮现”以及“说出一些我无法停止或控制的话语”。识别出的桥梁症状有“说出一些我无法停止或控制的话语”、“我反复做某些动作，如跳跃或拍手”、“我无法控制自己所有的动作”以及“常常说话过多”。
本研究中识别出的核心症状和桥梁症状可作为临床儿童和青少年中治疗TS与ADHD共病的潜在治疗靶点。
