Abstract

AIM To evaluate the relationship between diagnosis and clinical course of Tourette syndrome and group A Streptococcus (GAS). METHOD GAS infections, anti-streptococcal, and anti-basal ganglia antibodies (ABGA) were compared between 168 patients (136males, 32 females) with Tourette syndrome; (median [range] age [25th–75th centile] 10y [8–11y]);median Tourette syndrome duration (25th–75th centile), 3y (1y 3mo–5y 9mo) and a comparison group of 177 patients (117males, 60 females) with epileptic or sleep disorders median age [25th–75th centile], 10y [8y–1y 6mo]). One hundred and forty-four patients with Tourette syndrome were followed up at 3-month intervals; exacerbations of tics, obsessive–compulsive symptoms, and other psychiatric comorbidities were defined by a bootstrap procedure. The effect of new GAS infections and identification of new ABGA upon risk of exacerbation was assessed using logistic regression analysis. RESULTS Cross-sectionally, patients with Tourette syndrome exhibited a higher frequency of GAS infection (8% vs 2%; p=0.009), higher anti-streptolysin O (ASO) titres (246 [108–432] vs 125 [53–269]; p<0.001), and higher ABGA frequency (25% vs 8%; p<0.001) than the comparison group. On prospective analysis, ASO titres were persistently elevated in 57% of patients with Tourette syndrome; however, new infections or newly identified ABGA did not predict clinical exacerbations (all p>0.05). INTERPRETATION Patients with Tourette syndromemight be more prone to GAS infections and develop stronger antibody responses to GAS, probably as a result of underlying immune dysregulation. New GAS infections are unlikely to exert, years after their onset, a major effect upon the severity of neuropsychiatric symptoms.

Autore Pugliese

• Troiano Maria , Buttiglione Maura

Tutti gli autori

• TROIANO M.;BUTTIGLIONE M.;LIVREA P.

Titolo volume/Rivista

Non Disponibile

Anno di pubblicazione

2011

ISSN

0012-1622

ISBN

Non Disponibile

Numero di citazioni Wos

35

Ultimo Aggiornamento Citazioni

Non Disponibile

Numero di citazioni Scopus

38

Ultimo Aggiornamento Citazioni

Non Disponibile

Settori ERC

Non Disponibile

Codici ASJC

Non Disponibile