Study on the clinical characteristics of Chinese and Western medicine in 474 children with genetically-related tic disorder.

Objective: This study aimed to analyze the impact of genetic factors on the clinical presentation of tic disorder and investigate the pathogenesis of tic disorder considering different sources of genetic influence and generations, along with the distribution characteristics of evidence from Chinese medicine. Methods: Inclusion of 474 cases of tic disorder was assembled(from October, 2020 to October, 2023), and clinical data on the children, including gender, age of onset, disease duration, initial symptoms, severity, comorbidities, and family history, and TCM patterns were collected. Firstly, the children were divided into genetic and nongenetic groups based on family history, and their clinical manifestations were observed. Secondly, the age of peak incidence of tic disorder in China(6 or 9 years) was used as the age segmentation point to explore the influence of heredity on clinical manifestations at different ages and the distribution of TCM patterns. Finally, children with genetically-related tic disorder were selected as probands to carry out family studies. The morbidity of the first-degree, second-degree and third-degree relatives of the probands were investigated to analyze the morbidity characteristics and distribution of TCM patterns of children with tic disorder under different genetic types. Results: Out of 474 children, 226 cases (47.7%) belonged to the genetic group, and 248 cases (52.3%) to the nongenetic group. Compared with the non-genetic group, the genetic group had a younger age of onset (P = 0.013), a longer duration of illness (P = 0.011), a higher degree of severity (P < 0.01), and more comorbid conditions (P = 0.016). Children in the genetic group with an age of onset under 6 years accounted for a larger proportion of the liver-hyperactive and wind-driven pattern(26.5%) and a smaller proportion of the qi depression transforming into fire pattern(17.1%), which were significantly different from those in the non-genetic group (P = 0.016).In the genetic group, 146 cases (64.6%) were inherited from the father, 80 cases (35.4%) from the mother, and there was no significant difference in the developmental characteristics of children with tic disorder from different sources of genetic influence. Furthermore, 183 cases (81.0%) were inherited from the parent-child generation, 26 cases (11.5%) from the second generation, and 17 cases (7.5%) from the third generation; the difference in initial symptoms between different genetic generations was statistically significant (P = 0.042). Conclusion: Children with genetically related tic disorder have a younger age of onset, their condition is more severe, and they are more likely to be comorbid with other psychiatric disorders. The variation in the distribution of Chinese medicine patterns among children with tic disorder of different ages of onset. [ABSTRACT FROM AUTHOR]