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Lack of Association of Group A Streptococcal Infections and Onset of Tics: European Multicenter Tics in Children Study

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European Multicentre Tics in Children Study (EMTICS). / Lack of Association of Group A Streptococcal Infections and Onset of Tics : European Multicenter Tics in Children Study. In: Neurology. 2022 ; Vol. 98, No. 11. pp. e1175-e1183.

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@article{17863f3ac87a425f936197c32920bb7d,
title = "Lack of Association of Group A Streptococcal Infections and Onset of Tics: European Multicenter Tics in Children Study",
abstract = "BACKGROUND AND OBJECTIVES: The goal of this work was to investigate the association between group A streptococcal (GAS) infections and tic incidence among unaffected children with a family history of chronic tic disorders (CTDs).METHODS: In a prospective cohort study, children with no history for tics who were 3 to 10 years of age with a first-degree relative with a CTD were recruited from the European Multicentre Tics in Children Study (EMTICS) across 16 European centers. Presence of GAS infection was assessed with throat swabs, serum anti-streptolysin O titers, and anti-DNAse titers blinded to clinical status. GAS exposure was defined with 4 different definitions based on these parameters. Cox regression analyses with time-varying GAS exposure were conducted to examine the association of onset of tics and GAS exposure during follow-up. Sensitivity analyses were conducted with Cox regression and logistic regression analyses.RESULTS: A total of 259 children were recruited; 1 child was found to have tic onset before study entry and therefore was excluded. Sixty-one children (23.6%) developed tics over an average follow-up period of 1 (SD 0.7) year. There was a strong association of sex and onset of tics, with girls having an ≈60% lower risk of developing tics compared to boys (hazard ratio [HR] 0.4, 95% confidence interval [CI] 0.2-0.7). However, there was no statistical evidence to suggest an association of any of the 4 GAS exposure definitions with tic onset (GAS exposure definition 1: HR 0.310, 95% CI 0.037-2.590; definition 2: HR 0.561, 95% CI 0.219-1.436; definition 3: HR 0.853, 95% CI 0.466-1.561; definition 4: HR 0.725, 95% CI 0.384-1.370).DISCUSSION: These results do not suggest an association between GAS exposure and development of tics.CLASSIFICATION OF EVIDENCE: This study provides Class I evidence that group A streptococcal exposure does not associate with the development of tics in children with first-degree relatives with chronic tic disorder.",
keywords = "Health Sciences",
author = "Schrag, {Anette Eleonore} and Davide Martino and Hanyuying Wang and Gareth Ambler and Noa Benaroya-Milshtein and Maura Buttiglione and Francesco Cardona and Roberta Creti and Androulla E and Tammy Hedderly and Isobel Heyman and Chaim Huyser and Pablo Mir and Astrid Morer and Natalie Moll and Mueller, {Norbert E} and Muller-Vahl, {Kirsten R} and {von Plessen}, Kerstin and Cesare Porcelli and Renata Rizzo and Veit Roessner and Schwarz, {Markus J} and Zsanett Tarnok and Susanne Walitza and Andrea Dietrich and Hoekstra, {Pieter J} and {European Multicentre Tics in Children Study (EMTICS)}",
note = "{\textcopyright} 2022 American Academy of Neurology.",
year = "2022",
month = mar,
day = "15",
doi = "10.1212/WNL.0000000000013298",
language = "English",
volume = "98",
pages = "e1175--e1183",
journal = "Neurology",
issn = "0028-3878",
publisher = "Lippincott Williams & Wilkins",
number = "11",

}

RIS

TY - JOUR

T1 - Lack of Association of Group A Streptococcal Infections and Onset of Tics

T2 - European Multicenter Tics in Children Study

AU - Schrag, Anette Eleonore

AU - Martino, Davide

AU - Wang, Hanyuying

AU - Ambler, Gareth

AU - Benaroya-Milshtein, Noa

AU - Buttiglione, Maura

AU - Cardona, Francesco

AU - Creti, Roberta

AU - E, Androulla

AU - Hedderly, Tammy

AU - Heyman, Isobel

AU - Huyser, Chaim

AU - Mir, Pablo

AU - Morer, Astrid

AU - Moll, Natalie

AU - Mueller, Norbert E

AU - Muller-Vahl, Kirsten R

AU - von Plessen, Kerstin

AU - Porcelli, Cesare

AU - Rizzo, Renata

AU - Roessner, Veit

AU - Schwarz, Markus J

AU - Tarnok, Zsanett

AU - Walitza, Susanne

AU - Dietrich, Andrea

AU - Hoekstra, Pieter J

AU - European Multicentre Tics in Children Study (EMTICS)

N1 - © 2022 American Academy of Neurology.

PY - 2022/3/15

Y1 - 2022/3/15

N2 - BACKGROUND AND OBJECTIVES: The goal of this work was to investigate the association between group A streptococcal (GAS) infections and tic incidence among unaffected children with a family history of chronic tic disorders (CTDs).METHODS: In a prospective cohort study, children with no history for tics who were 3 to 10 years of age with a first-degree relative with a CTD were recruited from the European Multicentre Tics in Children Study (EMTICS) across 16 European centers. Presence of GAS infection was assessed with throat swabs, serum anti-streptolysin O titers, and anti-DNAse titers blinded to clinical status. GAS exposure was defined with 4 different definitions based on these parameters. Cox regression analyses with time-varying GAS exposure were conducted to examine the association of onset of tics and GAS exposure during follow-up. Sensitivity analyses were conducted with Cox regression and logistic regression analyses.RESULTS: A total of 259 children were recruited; 1 child was found to have tic onset before study entry and therefore was excluded. Sixty-one children (23.6%) developed tics over an average follow-up period of 1 (SD 0.7) year. There was a strong association of sex and onset of tics, with girls having an ≈60% lower risk of developing tics compared to boys (hazard ratio [HR] 0.4, 95% confidence interval [CI] 0.2-0.7). However, there was no statistical evidence to suggest an association of any of the 4 GAS exposure definitions with tic onset (GAS exposure definition 1: HR 0.310, 95% CI 0.037-2.590; definition 2: HR 0.561, 95% CI 0.219-1.436; definition 3: HR 0.853, 95% CI 0.466-1.561; definition 4: HR 0.725, 95% CI 0.384-1.370).DISCUSSION: These results do not suggest an association between GAS exposure and development of tics.CLASSIFICATION OF EVIDENCE: This study provides Class I evidence that group A streptococcal exposure does not associate with the development of tics in children with first-degree relatives with chronic tic disorder.

AB - BACKGROUND AND OBJECTIVES: The goal of this work was to investigate the association between group A streptococcal (GAS) infections and tic incidence among unaffected children with a family history of chronic tic disorders (CTDs).METHODS: In a prospective cohort study, children with no history for tics who were 3 to 10 years of age with a first-degree relative with a CTD were recruited from the European Multicentre Tics in Children Study (EMTICS) across 16 European centers. Presence of GAS infection was assessed with throat swabs, serum anti-streptolysin O titers, and anti-DNAse titers blinded to clinical status. GAS exposure was defined with 4 different definitions based on these parameters. Cox regression analyses with time-varying GAS exposure were conducted to examine the association of onset of tics and GAS exposure during follow-up. Sensitivity analyses were conducted with Cox regression and logistic regression analyses.RESULTS: A total of 259 children were recruited; 1 child was found to have tic onset before study entry and therefore was excluded. Sixty-one children (23.6%) developed tics over an average follow-up period of 1 (SD 0.7) year. There was a strong association of sex and onset of tics, with girls having an ≈60% lower risk of developing tics compared to boys (hazard ratio [HR] 0.4, 95% confidence interval [CI] 0.2-0.7). However, there was no statistical evidence to suggest an association of any of the 4 GAS exposure definitions with tic onset (GAS exposure definition 1: HR 0.310, 95% CI 0.037-2.590; definition 2: HR 0.561, 95% CI 0.219-1.436; definition 3: HR 0.853, 95% CI 0.466-1.561; definition 4: HR 0.725, 95% CI 0.384-1.370).DISCUSSION: These results do not suggest an association between GAS exposure and development of tics.CLASSIFICATION OF EVIDENCE: This study provides Class I evidence that group A streptococcal exposure does not associate with the development of tics in children with first-degree relatives with chronic tic disorder.

KW - Health Sciences

UR - http://www.scopus.com/inward/record.url?scp=85127908247&partnerID=8YFLogxK

U2 - 10.1212/WNL.0000000000013298

DO - 10.1212/WNL.0000000000013298

M3 - Journal article

C2 - 35110379

VL - 98

SP - e1175-e1183

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 11

ER -

ID: 75213381