title: Increased antistreptococcal antibody titers and anti-basal ganglia antibodies in patients with Tourette syndrome: controlled cross-sectional study.
abstract: The association between Tourette syndrome, attention-deficit hyperactivity disorder (ADHD), and obsessive-compulsive disorder following streptococcal infections has been documented, but with conflicting reports. We thus felt it was important to investigate this association in a group of Italian patients not previously documented. We took blood on 69 patients with Tourette syndrome and 72 age- and sex-matched tic-free controls. Laboratory staff were blind to the diagnostic status of the subjects. Evidence of recent streptococcal infection was defined using antistreptolysin titers. Anti-basal ganglia antibodies were determined using human basal ganglia sections. Statistical analysis was conducted using analysis of variance and chi-square tests. Raised antistreptolysin titers were found in 41 of 69 (59%) patients with Tourette syndrome and 14 of 72 (19%) controls (P = .000). Positive anti-basal ganglia antibodies were found in 22 of 69 (32%) subjects with Tourette syndrome compared with 7 of 72 (10%) controls, which was also significant (P = .002). Raised antistreptolysin titers were detected in 18 of 22 (82%) patients with Tourette syndrome with positive anti-basal ganglia antibodies and 22 of 47 (47%) patients with negative anti-basal ganglia antibodies (P = .01). These results support the reported association between streptococcal infection and anti-basal ganglia antibodies and some patients with Tourette syndrome.
authors.affiliation: Section of Child Neuropsychiatry, Department of Pediatrics, Catrania University, Via S. Sofia 78, 95125 Catania, Italy. rerizzo@unict.it
authors.forename: Renata
authors.initials: R
authors.lastname: Rizzo
authors.forename: Mariangela
authors.initials: M
authors.lastname: Gulisano
authors.forename: Piero
authors.initials: P
authors.lastname: Pavone
authors.forename: Fabia
authors.initials: F
authors.lastname: Fogliani
authors.forename: Mary M
authors.initials: MM
authors.lastname: Robertson
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D000907:Antibodies, Bacterial / Q000097:blood*; D001323:Autoantibodies / Q000097:blood*; D001479:Basal Ganglia / Q000276:immunology*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D012016:Reference Values; D016037:Single-Blind Method; D013291:Streptococcus / Q000276:immunology*; D013301:Streptolysins / Q000276:immunology; D005879:Tourette Syndrome / Q000097:blood / Q000276:immunology*
chemical_list: D000907:Antibodies, Bacterial; D001323:Autoantibodies; D013301:Streptolysins