Bai Lu, Jin Mei, Zhang Qi, Sun Suzhen
Primary Child Care Department (Psychological Behavior Department), Children's Hospital of Hebei Province, Shijiazhuang City, Hebei, China.
Department of Pediatric Neurology, Children's Hospital of Hebei Province, Shijiazhuang City, Hebei, China.
Front Pediatr. 2025 May 20;13:1526117. doi: 10.3389/fped.2025.1526117. eCollection 2025.
Tic disorders (TD) represent a prevalent neurodevelopmental condition in children, characterised by involuntary, sudden motor or vocal tics. Dysfunction of the dopamine system plays a pivotal role in the pathogenesis of TD. Recent findings indicate that deep brain stimulation, by modulating striatal dopamine release, substantially alleviates tic symptoms. Neuroimaging studies have shown increased dopamine transporter binding and decreased serotonin levels in patients with TD. The presence of anti-dopamine D2 receptor autoantibodies, which correlate with disease severity, suggests immune involvement in the onset of TD. Nutritional factors influence the dopaminergic system's functionality by affecting neurotransmitter synthesis and metabolism, modulating gut microbiota and contributing to neuroinflammation. Clinical studies have demonstrated that interventions combining probiotics and fructooligosaccharides can help regulate neurotransmitter metabolism, whereas dietary patterns such as the ketogenic, Mediterranean and Mediterranean-DASH intervention for neurodegenerative delay diets exhibit anti-inflammatory and neuroprotective effects. The risk of TD in offspring is significantly associated with maternal autoimmune diseases and inflammatory states, with metabolic syndrome further affecting the dopaminergic system via AT1 receptor autoantibodies. Nutritional intervention-based treatment strategies present promising directions for TD management, warranting further investigation into the nutrition-immune-neurotransmitter network, the development of personalised nutritional plans and the validation of their clinical efficacy through large-scale randomised controlled trials. This review summarises the alterations in the dopaminergic system in TD, the regulatory effects of nutritional factors on dopamine levels, the interactions between neuroinflammation and the dopaminergic system and treatment strategies based on nutritional interventions, laying a theoretical foundation for understanding TD pathogenesis and advancing novel therapeutic approaches.
抽动障碍(TD)是儿童中一种常见的神经发育疾病,其特征为不自主、突发的运动或发声抽动。多巴胺系统功能障碍在TD的发病机制中起关键作用。最近的研究结果表明,深部脑刺激通过调节纹状体多巴胺释放,可显著减轻抽动症状。神经影像学研究显示,TD患者的多巴胺转运体结合增加,血清素水平降低。抗多巴胺D2受体自身抗体的存在与疾病严重程度相关,提示免疫因素参与了TD的发病。营养因素通过影响神经递质的合成和代谢、调节肠道微生物群以及导致神经炎症,影响多巴胺能系统的功能。临床研究表明,益生菌和低聚果糖联合干预有助于调节神经递质代谢,而生酮饮食、地中海饮食和地中海-DASH延缓神经退行性饮食等饮食模式具有抗炎和神经保护作用。后代患TD的风险与母亲的自身免疫性疾病和炎症状态显著相关,代谢综合征还可通过AT1受体自身抗体进一步影响多巴胺能系统。基于营养干预的治疗策略为TD的管理提供了有前景的方向,有必要进一步研究营养-免疫-神经递质网络、制定个性化营养计划,并通过大规模随机对照试验验证其临床疗效。本综述总结了TD中多巴胺能系统的改变、营养因素对多巴胺水平的调节作用、神经炎症与多巴胺能系统之间的相互作用以及基于营养干预的治疗策略,为理解TD的发病机制和推进新的治疗方法奠定了理论基础。