Abstract Details

Title Clinical Characteristics Shaping TAND Manifestations in Adult TSC: Insights for Targeted Screening

Topic General Neurology

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 4-005

Background

TAND is a multifaceted complex of symptoms spanning cognitive, behavioral, and psychiatric that occur in patients with TSC. While TAND is well-documented, comprehensive evaluation in adults remains critical. This study endeavors to identify clinical characteristics that warrant heightened screening for specific TAND manifestations, particularly in adults who face unique challenges.

Objective

This study aims to delineate clinical markers associated with TSC-Associated Neuropsychiatric Disorders (TAND) symptoms in adult Tuberous Sclerosis Complex (TSC) patients, aiming to enhance TAND evaluation and interventions.

Design/Methods

Adults with TSC were enrolled in a cross-sectional study of TAND symptoms. The TAND Checklist was utilized to screen. Stratification was based on clinical attributes including epilepsy, subependymal nodules (SEN), subependymal giant cell astrocytoma (SEGA), verbal status, impaired language (non-verbal or simple language), intellectual disability (ID), and multisystem TSC disease burden. TAND frequencies and impact ratings were examined and compared across these strata. Significance was defined as p<0.05; multiple comparison correction was performed.

Results 26 patients were enrolled and completed TAND screening (age range: 22-70, 65% female). The most frequent TAND manifestations were behavioral difficulties, anxiety disorder, intellectual development challenges, academic difficulties, and neuropsychological difficulties. TAND symptoms were similarly prevalent in patients with and without a diagnosis of epilepsy. Patients with a history of SEGA exhibited higher frequencies of autism spectrum disorder (ASD) diagnosis. Patients with impaired language exhibited significantly higher frequencies of TAND manifestations across multiple levels. Patients with ID exhibited markedly elevated frequencies of behavioral, academic, and neuropsychological level TAND manifestations compared to those without ID.

Conclusions Impaired language and intellectual disability emerged as the most pertinent indicators for patients who may benefit from heightened TAND screening. Focusing on these characteristics could optimize resource allocation and target interventions at behavioral, academic, and neuropsychological level difficulties, thereby enhancing the quality of care for adults with TSC.

Authors/Disclosures
Sameh W. Almousa, PhD (1 Medical Center Blvd) PRESENTER	Dr. Almousa has nothing to disclose.
Nicholas Mallett, MD	Dr. Mallett has nothing to disclose.
Mary T. Silvia, MD (Wake Forest University Baptist Medical Center)	Dr. Silvia has nothing to disclose.
Jane Boggs, MD (Wake Forest University neurology)	The institution of Dr. Boggs has received research support from Liva Nova. Dr. Boggs has a non-compensated relationship as a Chairman PAB with Epilepsy Alliance North Carolina that is relevant to AAN interests or activities.
Theodore Stem	No disclosure on file
Gagan Deep (Wake Forest University School of Medicine)	No disclosure on file
Kimberly Raab Graham (Wake Forest University School of Medicine)	No disclosure on file
Roy E. Strowd III, MD, FAAN (Wake Forest School Of Medicine)	Dr. Strowd has received personal compensation for serving as an employee of Kaplan. Dr. Strowd has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Monteris Medical, Inc. Dr. Strowd has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novocure. Dr. Strowd has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Academy of Neurology. The institution of Dr. Strowd has received research support from Southeastern Brain Tumor Foundation. The institution of Dr. Strowd has received research support from Jazz Pharmaceuticals. The institution of Dr. Strowd has received research support from National Institutes of Health. The institution of Dr. Strowd has received research support from Alpha Omega Alpha. The institution of Dr. Strowd has received research support from American Board of Psychiatry and Neurology. Dr. Strowd has received publishing royalties from a publication relating to health care. Dr. Strowd has received publishing royalties from a publication relating to health care.