Is Tourette's syndrome an autoimmune disease?

Tourette's syndrome is a childhood-onset neuropsychiatric disorder characterized by the presence of both multiple motor and vocal tics. While its pathogenesis at a molecular and cellular level remains unknown, recent research findings point to the possible involvement of autoimmunity in at least a subgroup of patients. These include the presence of antineuronal autoantibodies, findings of D8/17 B lymphocyte overexpression (a marker of chorea associated with streptococcal infection), reported associations of symptom severity fluctuations over time with preceding infections, and possible beneficial effects of immuno-modulatory intervention. We will critically review these findings, leading us to conclude that Tourette's syndrome is a heterogeneous disorder, and that immune factors may be involved in some patients.