Cognitive and psychiatric phenotypes of movement disorders in children: a systematic review

Aim The cognitive and psychiatric aspects of adult movement disorders are well established, but specific behavioural profiles for paediatric movement disorders have not been delineated. Knowledge of non-motor phenotypes may guide treatment and determine which symptoms are suggestive of a specific movement disorder and which indicate medication effects. METHOD The goal of this review is to outline the known cognitive and psychiatric symptoms associated with paediatric movement disorders. We used a systematic approach, via PubMed, and reviewed over 400 abstracts of studies of selected disorders, of which 88 papers reporting paediatric non-motor symptoms are summarized. RESULTS Obsessive-compulsive disorder wasmanifest in children with paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and Sydenhamchorea. Children with opsoclonus-myoclonus syndrome had, for themost part, cognitive and behavioural problems, and attention-deficit-hyperactivity disorder was reported as a major comorbidity in Tourette syndrome, stereotypies, and restless legs syndrome. Symptoms of depression and anxiety weremore frequent in individuals with idiopathic dystonia. Affective disorders were suggestive ofWilson disease. Cognitive decline was common in children with juvenile Huntington disease. A limitation of this review was the lack of systematic assessment in paediatricmovement disorders for evaluation and uniform definitions. INTERPRETATION Although the literature in non-motor phenomena is still emerging, recognition of salient cognitive and psychiatric phenomena may facilitate management of paediatricmovement disorders.