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Tic Disorders: Neural Circuits, Neurochemistry, and Neuroimmunology

Departments of Neurology and Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD

Harvey S. Singer, MD

Departments of Neurology and Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, hsinger{at}jhmi.edu

The neuroanatomy and neurochemistry underlying tic disorders are thought to involve corticostriatothalamocortical circuits and dysregulation of their component neurotransmitter systems. Tourette syndrome is a tic disorder that begins in childhood and follows a waxing and waning course of tic severity. Although it is generally believed to have a genetic component, its etiology has not been fully elucidated. The clinical entity pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS) has led some to suggest that the pathophysiology of tics in some individuals might involve a postinfectious autoimmune component. We review the neural circuits and neurochemistry of Tourette syndrome and evaluate the evidence for and against a role for autoimmunity in the expression of tics. (J Child Neurol 2006;21:678—689; DOI 10.2310/7010.2006.00166).

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				H. S. Singer, C. Gause, C. Morris, P. Lopez, and and the Tourette Syndrome Study Group Serial Immune Markers Do Not Correlate With Clinical Exacerbations in Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections Pediatrics, June 1, 2008; 121(6): 1198 - 1205. [Abstract] [Full Text] [PDF]