Antineuronal antibody status and phenotype analysis in Tourette's syndrome

Mov Disord. 2007 Jul 30;22(10):1424-9. doi: 10.1002/mds.21454.

Abstract

The Gilles de la Tourette syndrome (GTS) spectrum includes psychiatric comorbidities, mainly obsessive-compulsive disorder (OCD) and attention-deficit-hyperactivity disorder (ADHD). The role of environmental factors, e.g., antineuronal antibodies (ANeA), remains unclear. We compared the clinical features of ANeA-positive and ANeA-negative patients in 53 children and 75 adults with GTS. All diagnoses were made according to DSM-IV-TR criteria. A positive ANeA Western immunoblot showed bands for at least 1 of 3 reported striatal antigens (40, 45, and 60 kDa). Twelve children (23%) and 18 adults (25%) with GTS were ANeA-positive. Disease duration, tic phenomenology and severity, frequency of echo/pali/coprophenomena, self-injurious and aggressive behavior, or frequency of OCD comorbidity did not significantly differ between ANeA-positive and negative patients. Similar findings were obtained analyzing separately the three different antibody reactivities. A comorbid diagnosis of ADHD was significantly less frequent in GTS patients positive for the anti-60 kDa antibody only. Using a multivariate logistic regression model, adjusting for age, gender, and age at disease onset, a comorbid diagnosis of ADHD remained inversely associated with anti-60 kDa antibodies (odds ratio = 0.14; P = 0.002; 95% confidence interval 0.04-0.49). ANeA status does not differentiate a specific phenotype of GTS.

MeSH terms

  • Adolescent
  • Adult
  • Antibodies / metabolism*
  • Blotting, Western / methods
  • Child
  • Enzyme-Linked Immunosorbent Assay / methods
  • Female
  • Humans
  • Logistic Models
  • Male
  • Molecular Weight
  • Nerve Tissue Proteins / immunology*
  • Phenotype*
  • Retrospective Studies
  • Tourette Syndrome / immunology*
  • Tourette Syndrome / pathology
  • Tourette Syndrome / physiopathology

Substances

  • Antibodies
  • Nerve Tissue Proteins