Quick Take: Association of Tourette Syndrome and Chronic Tic Disorder With Metabolic and Cardiovascular Disorders

Individuals with Tourette syndrome (TS) and other chronic tic disorders (CTD) are at an increased of developing cardiometabolic disorders, in part due to the adverse effects of pharmacologic treatment, including antipsychotics. In this cohort study, investigators analyzed data from 7804 individuals with a diagnosis of TS or CTD in order to examine the association between these conditions and the diagnosis of metabolic and cardiovascular disorders. Affected individuals were compared to siblings discordant for these disorders. Investigators found that individuals with TS or CTD had almost double the risk of developing a cardiometabolic disorder compared to individuals who did not (hazard ratio adjusted for sex and age (aHR) 1.99, 95% CI 1.90 to 2.09). In terms of specific disorders, individuals with TS and CTD had higher a risk of obesity (aHR 2.76, 95% CI 2.47 to 3.09), type 2 diabetes (HR 1.67, 95% CI 1.42 to 1.96), circulatory system diseases (aHR 1.76, 95% CI 1.67 to 1.86). There was no associated increase in risk of dyslipidemia (aHR 0.87, 95% CI 0.75 to 1.00). The risk of cardiometabolic disorders was greater in males (aHR 2.13, 95% CI 2.01 to 2.26) than in females (aHR 1.79, 95% CI 1.64 to 1.96). The cumulative incidence of any cardiometabolic disorder was 52.5% for individuals with TS or CTD (95% CI 47.7% to 57.4%) in comparison to 29.5% for the general population (95% CI 29.3% to 29.6%). In terms of antipsychotic use, investigators found that the use of antipsychotic medication for more than 1 year was associated with a decreased risk of metabolic and cardiovascular disorders (aHR 0.27, 95% CI 0.17 to 0.43). Antipsychotic use for less than one year was not associated with a significant change in risk (aHR 0.83, 95% CI 0.56 to 1.24). Taken together, results from this study suggest that individuals with TS and CTD are at higher risk for cardiometabolic disorders. This study is limited in that it did not include information on behavioral variables such as sedentary lifestyle or smoking, or on non-pharmacologic strategies used for treating TS/CTD.

Click to read the study in JAMA Neurology

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