The research landscape of tuberous sclerosis complex-associated neuropsychiatric disorders (TAND)-a comprehensive scoping review.

Journal: Journal of neurodevelopmental disorders

Volume: 14

Issue: 1

Year of Publication: 2022

Affiliated Institutions:  Department of Public Health, Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel, Brussels, Belgium. Cerebra Network for Neurodevelopmental Disorders, University of Birmingham, Birmingham, UK. Emma Children's Hospital, Amsterdam University Medical Center, Amsterdam, The Netherlands. Division of Child & Adolescent Psychiatry, Centre for Autism Research in Africa (CARA), University of Cape Town, Cape Town, South Africa. Department of Paediatric Neurology, University Hospitals Leuven, Leuven, Belgium. Department of Pediatrics, Division of Neurology, Cincinnati Children's Hospital Medical Center/University of Cincinnati College of Medicine, Cincinnati, OH, USA. Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Argentine Program for Children, Adolescents and Adults with Autism Spectrum Disorders (PANAACEA), Buenos Aires, Argentina. Department of Neurology, Harvard Medical School & Boston Children's Hospital, Boston, MA, USA. TSC Canada, Mississauga, Ontario, Canada. Stellenbosch University, Stellenbosch, South Africa. Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, USA. TSC Alliance, Silver Spring, MD, USA. St. George's University of London, London, UK. TSC Clinic Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. Department of Neurology, Translational Neuroscience Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA. Belgian TSC Association (Be-TSC), Mortsel, Belgium. Japanese Society of Tuberous Sclerosis Complex, Tokyo, Japan. Child and Adolescent Psychiatry, University Medical Center Göttingen, Georg-August University, Göttingen, Germany. Division of Child & Adolescent Psychiatry, Centre for Autism Research in Africa (CARA), University of Cape Town, Cape Town, South Africa. Petrus.devries@uct.ac.za.

Abstract summary 

Tuberous sclerosis complex (TSC)-associated neuropsychiatric disorders (TAND) is an umbrella term for the behavioural, psychiatric, intellectual, academic, neuropsychological and psychosocial manifestations of TSC. Although TAND affects 90% of individuals with TSC during their lifetime, these manifestations are relatively under-assessed, under-treated and under-researched. We performed a comprehensive scoping review of all TAND research to date (a) to describe the existing TAND research landscape and (b) to identify knowledge gaps to guide future TAND research.The study was conducted in accordance with stages outlined within the Arksey and O'Malley scoping review framework. Ten research questions relating to study characteristics, research design and research content of TAND levels and clusters were examined.Of the 2841 returned searches, 230 articles published between 1987 and 2020 were included (animal studies = 30, case studies = 47, cohort studies = 153), with more than half published since the term TAND was coined in 2012 (118/230; 51%). Cohort studies largely involved children and/or adolescents (63%) as opposed to older adults (16%). Studies were represented across 341 individual research sites from 45 countries, the majority from the USA (89/341; 26%) and the UK (50/341; 15%). Only 48 research sites (14%) were within low-middle income countries (LMICs). Animal studies and case studies were of relatively high/high quality, but cohort studies showed significant variability. Of the 153 cohort studies, only 16 (10%) included interventions. None of these were non-pharmacological, and only 13 employed remote methodologies (e.g. telephone interviews, online surveys). Of all TAND clusters, the autism spectrum disorder-like cluster was the most widely researched (138/230; 60%) and the scholastic cluster the least (53/200; 27%).Despite the recent increase in TAND research, studies that represent participants across the lifespan, LMIC research sites and non-pharmacological interventions were identified as future priorities. The quality of cohort studies requires improvement, to which the use of standardised direct behavioural assessments may contribute. In human studies, the academic level in particular warrants further investigation. Remote technologies could help to address many of the TAND knowledge gaps identified.

Authors & Co-authors:  Vanclooster Stephanie S Bissell Stacey S van Eeghen Agnies M AM Chambers Nola N De Waele Liesbeth L Byars Anna W AW Capal Jamie K JK Cukier Sebastián S Davis Peter P Flinn Jennifer J Gardner-Lubbe Sugnet S Gipson Tanjala T Heunis Tosca-Marie TM Hook Dena D Kingswood J Christopher JC Krueger Darcy A DA Kumm Aubrey J AJ Sahin Mustafa M Schoeters Eva E Smith Catherine C Srivastava Shoba S Takei Megumi M Waltereit Robert R Jansen Anna C AC de Vries Petrus J PJ

Study Outcome 

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Statistics
Citations :  Curatolo P, Moavero R, de Vries PJ. Neurological and neuropsychiatric aspects of tuberous sclerosis complex. Lancet Neurol. 2015;14(7):733–745.
Authors :  25
Identifiers
Doi : 13
SSN : 1866-1955
Study Population
Male,Female
Mesh Terms
Adolescent
Other Terms
Autism;Behaviour;Intellectual;Neuropsychological;Psychiatric;Psychosocial;Scholastic;Scoping review;TSC-associated neuropsychiatric disorders;Tuberous sclerosis complex
Study Design
Cohort Study,Case Study,Cross Sectional Study
Study Approach
Country of Study
Publication Country
England