Response to Comment on: Tics in the Pediatric Population: Pragmatic Management
Notice bibliographique
Résumé
We thank Dr. Neri and colleagues for their letter highlighting the importance of learning disorders in children with Tourette syndrome and the added contribution of such disorders on global functioning.1 This is indeed an important comorbidity in children with Tourette syndrome that deserves attention and consideration by clinicians. As Neri and colleagues discuss in their letter, learning disorders can be present in a significant proportion of children with Tourette syndrome. In the Tourette Syndrome International Database Consortium (TIC database), the largest database studying individuals with tic disorders worldwide, comorbid learning disorders were present in 1494 of 6805 individuals (22%) in the data set.2 The presence of learning disorders was significantly influenced by the presence of comorbid attention-deficit/hyperactivity disorder (ADHD), and 33% of children who had Tourette syndrome plus ADHD had a learning disorder compared with 12% of children who had Tourette syndrome without ADHD (P < 0.001). Similarly, in a case-control study of adolescents with Tourette syndrome, a significantly higher proportion of learning disorders was observed in individuals who had Tourette syndrome compared with controls (odds ratio. 7.9; 95% confidence interval, 2.2–28.2; P < 0.001); however, this relationship was no longer significant after controlling for a lifetime diagnosis of ADHD.3 Therefore, the presence of learning disorders in children with Tourette syndrome appears to be very significantly influenced by comorbid ADHD. A recent population-based study of the prevalence of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition-specific learning disorders in children from the second to sixth grades found a prevalence of 7.6% for global impairment, 5.4% for writing, 6.0% for arithmetic, and 7.5% for reading impairment.4 The prevalence of comorbidities, including any tic disorder and ADHD, also was studied. Those authors observed an overall prevalence in their sample of 1.1% for tic disorders and no evidence of a higher prevalence of tic disorders in individuals who had learning disorders of any type. ADHD, however, was significantly more common in individuals who had global impairment and arithmetic impairment than in those without learning disorders. As Neri et al. suggest, children with Tourette syndrome, and especially those with comorbid ADHD, should be carefully evaluated for the presence of learning disorders, although this may be beyond the expertise of many physicians. Clinicians should ask specifically about problems with school and academic achievement. Several ADHD screening questionnaires, such as the Conners 3, include subscales devoted to learning problems, and these can help physicians identify significant learning issues that require further inquiry. Psychoeducational testing by a qualified psychologist is often necessary to make a formal diagnosis of a learning disorder; and, where possible, clinicians are encouraged to make appropriate referrals. Once diagnoses are confirmed, appropriate educational interventions can be initiated. 1. Research Project: A. Conception, B. Organization, C. Execution; 2. Statistical Analysis: A. Design, B. Execution, C. Review and Critique; 3. Manuscript Preparation: A. Writing the First Draft, B. Review and Critique. T.P.: 1C, 3B D.M.: 1C, 3B C.G.: 1C, 3B Ethical Compliance Statement: We confirm that we have read the Journal's position in issues involved in ethical publication and affirm that this work is consistent with those guidelines. Funding Sources and Conflicts of Interest: The authors report no sources of funding and no conflicts of interest. Financial Disclosures for the previous 12 months: Christos Ganos reports academic research support from the German Parkinson Society. Tamara Pringsheim and Davide Martino report no sources of funding and no conflicts of interest.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,006 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; les deux têtes enseignantes s’accordent sur ce qui est montré ici.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».