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抽动秽语综合征及其他抽动障碍的新兴治疗方法——当前临床试验的系统评价

Emerging therapeutic approaches for Tourette syndrome and other tic disorders - a systematic review of current clinical trials.

作者信息

Häge Alexander, Krämer Robert, Dunlap Michele, Mechler Konstantin, Müller-Vahl Kirsten R, Nagy Peter

机构信息

Department of Child & Adolescent Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, J5, Mannheim, 68159, Germany.

Tics and Tourette Across the Globe (TTAG), A Global Non-Profit Advocacy Organization, Hannover Medical School, 30625, Hannover, Germany.

出版信息

Eur Child Adolesc Psychiatry. 2024 Dec 23. doi: 10.1007/s00787-024-02637-x.

Abstract

Tourette syndrome and other tic disorders are prevalent neurodevelopmental disorders typically treated with behavioral techniques or pharmacological interventions, primarily antipsychotics. However, many patients do not achieve sufficient response to conventional treatments, underscoring the need for further research in this area. To provide a comprehensive overview of ongoing research activities, we systematically searched the clinical registries of the World Health Organization (WHO) and of the United States National Institutes of Health (NIH) for currently planned or ongoing registered clinical studies. Our search identified 21 registered studies, of which seven focus specifically on pharmacological interventions. Potential candidates include the dopamine D1 antagonist ecopipam, the phosphodiesterase inhibitor gemlapodect, and cannabis-based therapies. Additionally, several studies are exploring behavioral interventions including Comprehensive Behavioral Interventions for Tics (CBIT) and mindfulness training, neurostimulation including MRI-navigated transcranial stimulation, theta burst stimulation, and deep brain stimulation, traditional Chinese medicine, and other approaches such as microbiota transplantation. Despite the range of research activities underway, the overall landscape remains limited. In this report we will discuss the findings, current developments, and relevant aspects concerning future research including clinical, scientific, and patient perspectives.

摘要

抽动秽语综合征和其他抽动障碍是常见的神经发育障碍,通常采用行为技术或药物干预进行治疗,主要是使用抗精神病药物。然而,许多患者对传统治疗的反应并不充分,这凸显了该领域进一步研究的必要性。为了全面概述正在进行的研究活动,我们系统地检索了世界卫生组织(WHO)和美国国立卫生研究院(NIH)的临床注册库,以查找当前计划或正在进行的注册临床研究。我们的检索发现了21项注册研究,其中7项专门关注药物干预。潜在的候选药物包括多巴胺D1拮抗剂依可哌胺、磷酸二酯酶抑制剂吉拉泊德克,以及基于大麻的疗法。此外,多项研究正在探索行为干预,包括抽动综合行为干预(CBIT)和正念训练;神经刺激,包括磁共振成像导航经颅刺激、theta爆发刺激和深部脑刺激;传统中医,以及其他方法,如微生物群移植。尽管正在进行一系列研究活动,但总体情况仍然有限。在本报告中,我们将讨论研究结果、当前进展以及与未来研究相关的方面,包括临床、科学和患者视角。

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