ABSTRACT
Autonomic cardiovascular regulation has been assessed in patients aged 4-15 years with Tourette syndrome (n = 22) and other tic disorders (n = 48). Symptom significance was estimated by a number of hyperkinetic episodes per 20 minutes, tic scale and variants of the disease course. The functional condition of autonomic nervous system was studied clinically and using spectral analysis of heart rate variability in both upright and supine positions. Negative correlation between the ratio of sympathetic and vagus influences and severity of the disease was found: the severer were tic symptoms, the stronger was a trend to vagotonia (beta = -0.36; p < 0.0025; F > 4.0). In orthostatic test, patients with Tourette syndrome demonstrated an unfavorable hypersympathicotonic type of cardiovascular system reaction. Patients were treated during 4 weeks with glycinum (0.2 +/- 0.1 mg/day), phenibutum (0.5 +/- 0.25 mg/day), clonazepam (1.5 +/- 0.5 mg/day), tiapride (200 +/- 100 mg/day), haloperidol (1-1.5 mg/day), rispolept (2 mg/day). There was no negative effect of the drugs on heart rate variability. On the contrary, the therapy reduced hyperkinetic symptoms and corrected autonomic influences on the sinus rhythm. It is suggested that changes in autonomic cardiovascular regulation might be of secondary character and do not need any special correction.
Subject(s)
Autonomic Nervous System Diseases/epidemiology , Autonomic Nervous System Diseases/physiopathology , Tics/epidemiology , Tics/physiopathology , Tourette Syndrome/epidemiology , Tourette Syndrome/physiopathology , Anti-Dyskinesia Agents/pharmacology , Anti-Dyskinesia Agents/therapeutic use , Anticonvulsants/pharmacology , Anticonvulsants/therapeutic use , Autonomic Nervous System Diseases/drug therapy , Child , Clonazepam/pharmacology , Clonazepam/therapeutic use , Female , Glycine/pharmacology , Glycine/therapeutic use , Glycine Agents/pharmacology , Glycine Agents/therapeutic use , Heart Rate/drug effects , Humans , Male , Tiapamil Hydrochloride/pharmacology , Tiapamil Hydrochloride/therapeutic use , Tics/drug therapy , Tourette Syndrome/drug therapy , Vagus Nerve Diseases/drug therapy , Vagus Nerve Diseases/epidemiology , Vagus Nerve Diseases/physiopathology , gamma-Aminobutyric Acid/analogs & derivatives , gamma-Aminobutyric Acid/pharmacology , gamma-Aminobutyric Acid/therapeutic useABSTRACT
Ninety-four patients with tick hyperkinesis (57) and Tourette's syndrome (37) were studied. Neuropsychological examination revealed memory, attention and audio-motor disturbances and symptoms of dysgraphia and dyslexia. Cognitive impairment may develop before ticks appearance and aggravate during hyperkinesis exacerbation. In the patients with Tourette's syndrome, cortical dysfunctions were mostly pronounced. These cognitive disturbances correlated with the indices of spectral analysis of bioelectrical brain activity in frontal and temporal areas. In 83 patients, an efficacy of encephabol treatment combined with basic therapy was studied. Encephabol given in dosage 200-300 mg daily to patients aged 5-7 years and 600 mg--to those aged over 7 years during 6 weeks significantly improved memory, attention and praxis function.
