Screening of tuberous sclerosis-associated neuropsychiatric disorders in korea using the tand checklist

Purpose: The present study aimed to elucidate the clinical characteristics of children with tuberous sclerosis complex (TSC) in Korea using the Tuberous Sclerosis-Associated Neuropsychiatric Disorders (TAND) checklist to evaluate the comorbidities of neurocognitive and socioemotional problems in the Korean clinical setting. Methods: A survey based on the TAND checklist was administered to 58 children with TSC receiving treatment on an outpatient basis. Their medical records and test results were retrospectively examined. Results: At the time of TAND administration, 35 (64.8%) of the participants had focal epilepsy, three (5.6%) had generalized epilepsy, six (11.1%) had infantile spasms, and seven (13.0%) had Lennox–Gastaut syndrome. The most frequently reported behavioral problem was difficulty getting on with other people of similar age (38/58, 65.5%). Twenty patients had received previous diagnoses of psychiatric disorders, six of whom had received two or more concurrent diagnoses. A further evaluation after testing with the TAND checklist identified new psychiatric disorders in two patients. Among the 35 children who underwent a formal evaluation of intelligence, 27 (77.1%) exhibited intellectual disability. Of the school-aged patients, 65.6% (21/32) experienced difficulties with mathematics and 56.3% (18/32) with spelling. Difficulty dual-/multi-tasking (27/58, 46.6%) and low self-esteem (18, 31.0%) were the most frequent neuropsychological and psychosocial issues, respectively. Conclusion: Our findings indicate that patients with TSC tend to experience neurocognitive and socioemotional difficulties, and regular screening for TAND using the TAND checklist can be helpful for managing children with TSC in the clinical setting.