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Do Infections Play a Role in Development of Tourette Syndrome?
ST. PAUL, MN (June 22, 1998) A recent study looks at whether Tourette syndrome may be triggered by an infection in children who are genetically predisposed to the disease. The study is published in the June issue of Neurology, the scientific journal of the American Academy of Neurology.
Tourette syndrome is a neurological disorder characterized by chronic involuntary repetitive movements or vocalizations, called tics. The disorder is believed to be genetic, but only a small percentage of those with one copy of the gene ever develop the disease, according to neurologist and study author Harvey Singer, MD, of Johns Hopkins University School of Medicine.
"There's got to be something else to explain why some people develop it and others don't -- some type of trigger," said Singer.
One theory is that following a streptococcal infection antibodies are formed that start attacking the child's own brain cells, triggering the disorder. This theory is based on reports of the severe, acute onset or worsening of tics in children following strep infections.
"If this theory is proven correct, it could have significant impact," Singer said. "It could lead to new ways to treat the disease and clues about the disease's development."
Singer and his colleagues tested the theory by looking for antibodies targeted against brain tissue, called antineuronal antibodies, in the blood of 41 children with Tourette syndrome and 39 healthy children. They found that the children with Tourette's had higher levels on average of these antibodies fighting against the area of the brain called the putamen, which helps control movement and is believed to play a role in Tourette's and other movement disorders.
Among the children with Tourette's, those with a family history of Tourette's or other tic disorders had a higher level of the antibodies than those with no such family history.
Singer said the study adds weight to the idea that non-genetic factors may trigger Tourette's, but that more work needs to be done to prove the strep infection theory. Since blood was drawn only once from the participants, researchers do not know if antibody levels were stagnant or changing. Drawing blood several times over a period of time would help researchers chart a relationship between strep infections and the level of antibodies.
Also, in setting up the study researchers did not look for children whose tics got worse after a strep infection. Singer hopes to conduct a study that includes a group of children with regular Tourette's and a group whose Tourette's gets worse with a strep infection.
The current study was supported by grants from the National Institutes of Health and the National Tourette Syndrome Association.
Improving care for patients with neurological disorders through education and research is the goal of the American Academy of Neurology, an association of more than 15,000 neurologists and neuroscience professionals.
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