Abstract
Genetic predisposition, autoimmunity and environmental factors [e.g. pre- and perinatal difficulties, Group A Streptococcal (GAS) and other infections, stress-inducing events] might interact to create a neurobiological vulnerability to the development of tics and associated behaviours. However, the existing evidence for this relies primarily on small prospective or larger retrospective population-based studies, and is therefore still inconclusive. This article describes the design and methodology of the EMTICS study, a longitudinal observational European multicentre study involving 16 clinical centres, with the following objectives: (1) to investigate the association of environmental factors (GAS exposure and psychosocial stress, primarily) with the onset and course of tics and/or obsessive–compulsive symptoms through the prospective observation of at-risk individuals (ONSET cohort: 260 children aged 3–10 years who are tic-free at study entry and have a first-degree relative with a chronic tic disorder) and affected individuals (COURSE cohort: 715 youth aged 3–16 years with a tic disorder); (2) to characterise the immune response to microbial antigens and the host’s immune response regulation in association with onset and exacerbations of tics; (3) to increase knowledge of the human gene pathways influencing the pathogenesis of tic disorders; and (4) to develop prediction models for the risk of onset and exacerbations of tic disorders. The EMTICS study is, to our knowledge, the largest prospective cohort assessment of the contribution of different genetic and environmental factors to the risk of developing tics in putatively predisposed individuals and to the risk of exacerbating tics in young individuals with chronic tic disorders.
| Original language | English |
|---|---|
| Journal | European Child and Adolescent Psychiatry |
| Volume | 28 |
| Issue number | 1 |
| Pages (from-to) | 91-109 |
| Number of pages | 19 |
| ISSN | 1018-8827 |
| DOIs | |
| Publication status | Published - 30.01.2019 |
Funding
The authors are deeply grateful to all children and their parents who willingly participated to make this research possible. This project has received funding from the European Union?s Seventh Framework Programme for research, technological development and demonstration under Grant agreement no. 278367. Schrag was supported by the National Institute for Health Research UCLH Biomedical Research Centre, and M?ller, Burger, Schnell and Weidinger by Stiftung Immunit?t und Seele. This research was supported by the National Institute for Health Research Biomedical Research Centre at Great Ormond Street Hospital for Children NHS Foundation Trust and University College London (Heyman); partially sponsored by GSK Vaccines (Margarit, Bartolini); and Deutsche Forschungsgemeinschaft (DFG): projects 1692/3-1, 4-1 (M?nchau). We thank all members of the EMTICS collaborative group for their continued commitment to this project and in particular all colleagues at the various study centres who contributed to data collection and/or management: Julie E Bruun, Judy Grejsen, Christine L Ommundsen, Mette Rub?k (Capital Region Psychiatry, Copenhagen, Denmark); Stephanie Enghardt (TUD Dresden, Germany); Stefanie Bokemeyer, Christiane Driedger-Garbe, Cornelia Reichert (MHH Hannover, Germany); Thomas Duffield (LMU M?nchen, Germany); Jennifer T?bing, Jenny Schmalfeld (L?beck University, Germany); Franciska Gergye, Margit Kovacs, Reka Vidomusz (Vadaskert Budapest, Hungary); Miri Carmel, Silvana Fennig, Ella Gev, Nathan Keller, Elena Michaelovsky, Matan Nahon, Chen Regev, Tomer Simcha, Gill Smollan, Avi Weizman (Tel Aviv, Petah-Tikva, Israel); Giuseppe Gagliardi (Bari, Italy); and Marco Pataracchia, Simona Recchia, Giovanna Alfarone (ISS Rome, Italy); Mascha van den Akker, Marieke Messchendorp, Florianne Rademaker, Anne Marie Stolte (UMCG Groningen, Netherlands); Maria Teresa C?ceres, F?tima Carrillo, Pilar G?mez-Garre, ?ngela Peria?ez Vasco, Laura Vargas (Seville, Spain); and all who may not have been mentioned. We also express our gratitude to the advisory board Danielle Cath, James Leckman, and Angela Vincent; as well as Mary Robertson; and the laboratories of Raf Berghmans (ApDia), Adrian Urwyler (Cytolab) and Andrew Waller and Nikolai Schwabe (ProImmune) for their support.
Research Areas and Centers
- Academic Focus: Center for Brain, Behavior and Metabolism (CBBM)
