Session Information
Date: Tuesday, June 21, 2016
Session Title: Hyperkinetic Movement Disorders, RLS, Sleep
Session Time: 12:30pm-2:00pm
Objective: Evaluate the relationship between serum ferritin levels and tic severity, as well as consequent impact on life, in children with Tourette Syndrome.
Background: There is evidence that iron deficiency is an etiology for restless leg syndrome (RLS), and correcting that deficiency improves the condition. Tics, the defining feature of Tourette Syndrome, can be considered hyperkinetic movements akin to RLS. It is thus conceivable that iron deficiency may underlie or worsen tics, which are the primary feature of Tourette Syndrome.
Methods: All consecutive children, <18 years of age with a confirmed diagnosis of Tourette Syndrome at Nationwide Children’s Hospital, Columbus, Ohio during 2009-2015 were reviewed. Only the patients who had serum ferritin testing were included. The following data was collected: Tic severity and impact of tics on life, relevant medication, comorbidities, blood count, serum ferritin levels at diagnosis and during follow up.
Results: 57 patients, M:F = 2:1, mean serum ferritin level was 48.0 ng/mL +/-33.28 (median 39 ng/mL), mean tic severity scale was 2.3 +/- 0.80, impact on life score was 2.2 +/- 0.93, composite score 4.57+/- 1.6. Serum ferritin in this cohort was not influenced by the presence of comorbidities of anxiety, OCD or ADHD (P > 0.16). 38% of children with low serum ferritin (< 50 ng/mL) (n=37) had severe tics (>5 composite score) compared with 25% in normal ferritin group (n=20). On follow up over 12-18 months, iron treated group (n=11) fared better (tic score improved from 5.23 to 4.4) compared with the other group (n=15) with normal ferritin level (score worsened from 4.5 to 4.7) over the same period.
Conclusions: Our data suggests that iron deficiency, as indicated by low serum ferritin level, may in fact be linked to more severe tics with more impact on life in children with Tourette syndrome, independent of the presence of anxiety, OCD or ADHD. Iron supplementation showed a trend towards improvement of tic severity on follow up. We suggest a double blind placebo-controlled prospective study to reach a definite conclusion.
To cite this abstract in AMA style:
D. Ghosh, E.L. Burkman. Relationship of serum ferritin level and tic severity in children with Tourette syndrome [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/relationship-of-serum-ferritin-level-and-tic-severity-in-children-with-tourette-syndrome/. Accessed June 14, 2025.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/relationship-of-serum-ferritin-level-and-tic-severity-in-children-with-tourette-syndrome/