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. © 2007 Movement Disorder Society