Leckman J F, Zhang H, Vitale A, Lahnin F, Lynch K, Bondi C, Kim Y S, Peterson B S
Child Study Center, Children's Clinical Research Center, Yale University School of Medicine, New Haven, CT 06520-7900, USA.
Pediatrics. 1998 Jul;102(1 Pt 1):14-9. doi: 10.1542/peds.102.1.14.
Prevalence studies indicate a 10-fold higher rate of Tourette syndrome (TS) among children compared with adults. The purpose of this investigation was to examine the course of tic severity during the first 2 decades of life.
A birth-year cohort of 42 TS patients followed at the Yale Child Study Center was recontacted an average of 7.3 years after their initial clinical evaluation. Data concerning the onset and course of tic severity until 18 years of age were available on 36 TS patients. A variety of statistical techniques were used to model aspects of the temporal patterning of tic severity.
Mean (SD) tic onset at 5.6 (2. 3) years of age was followed by a progressive pattern of tic worsening. On average, the most severe period of tic severity occurred at 10.0 (2.4) years of age. In eight cases (22%), the frequency and forcefulness of the tics reached a severe level during the worst-ever period such that functioning in school was impossible or in serious jeopardy. In almost every case this period was followed by a steady decline in tic severity. By 18 years of age nearly half of the cohort was virtually tic-free. The onset of puberty was not associated with either the timing or severity of tics.
A majority of TS patients displayed a consistent time course of tic severity. This consistency can be accurately modeled mathematically and may reflect normal neurobiological processes. Determination of the model parameters that describe each patient's course of tic severity may be of prognostic value and assist in the identification of factors that differentially influence the course of tic severity.
患病率研究表明，儿童抽动秽语综合征（TS）的发病率比成人高10倍。本研究的目的是调查生命最初20年中抽动严重程度的变化过程。
耶鲁儿童研究中心随访的42例TS患者出生队列在首次临床评估后平均7.3年再次接受联系。有36例TS患者提供了有关抽动严重程度直至18岁的发病和病程数据。使用了多种统计技术对抽动严重程度的时间模式进行建模。
平均（标准差）抽动起病年龄为5.6（2.3）岁，随后抽动严重程度呈逐渐加重模式。平均而言，抽动最严重的时期出现在10.0（2.4）岁。在8例（22%）患者中，抽动的频率和力度在最严重时期达到严重程度，以至于无法上学或上学受到严重影响。几乎在每种情况下，这一时期之后抽动严重程度都稳步下降。到18岁时，近一半的队列实际上已无抽动。青春期的开始与抽动的时间或严重程度均无关。
大多数TS患者表现出一致的抽动严重程度时间进程。这种一致性可以通过数学方法准确建模，可能反映了正常的神经生物学过程。确定描述每位患者抽动严重程度进程的模型参数可能具有预后价值，并有助于识别对抽动严重程度进程有不同影响的因素。
