Immune dysfunction and tic disorders in adults

The late-onset of tic disorders in adults is uncommon. Tic disorders are thought to be childhood syndromes. In some cases, the onset may be a recurrence of a tic disorder from childhood. Several studies indicate that tic disorders in adults may be more prevalent than we recognize.

“We cannot estimate the prevalence of adult onset tic disorders in the general population,” state the authors of a large case series, “but the number of patients we have encountered suggests that the phenomenon is more common than previously reported.” 1

Why do tic disorders suddenly develop in adults?

So, why might tic disorders suddenly develop in adults? The authors reported, 1 in 3 patients who developed tics in adulthood reported having an inciting event just prior to the onset of symptoms. These precipitating events included head injuries, neck strain, cocaine binge usage, exposure to neuroleptic drugs and infections. 1

A growing body of research indicates that infections can trigger an immune dysfunction, which elicits neuropsychiatric symptoms, including motor and vocal tics. A dysfunctional immune response and signs of inflammation in the central nervous system (CNS) have been identified in some patients with Tourette’s syndrome. 2

The authors report that providing these patients with immunological treatments “improves and prevents the re-occurrence of clinical symptoms in Tourette’s syndrome.” 2

The role of immune dysfunction and anti-neuronal antibodies in tic disorders

In fact, multiple studies have examined the role of immune dysfunction and anti-neuronal antibodies in tic disorders in children and adults. One study’s findings support the “hypothesis that binding of an anti-neuronal antibody from some children with [Tourette’s syndrome] induced striatal dysfunction and suggests a possible cause for the basal ganglia alterations observed in children with TS.” 3

“The body of evidence in favor of a contribution of the immune system on the pathophysiology of [Tourette’s syndrome] and related disorders is constantly growing.” 4

Researchers believe that some children and adults are genetically predisposed to develop an abnormal immune response following an infection(s). In these cases, the immune system produces antibodies to kill a harmful germ. But, in addition to killing harmful bacteria, these antibodies can attack healthy cells in a certain region of the brain which controls movement. This autoimmune attack can trigger brain inflammation and the onset of tics.

  1. Chouinard S, Ford B. Adult onset tic disorders. J Neurol Neurosurg Psychiatry. 2000;68(6):738–743. doi:10.1136/jnnp.68.6.738. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1736950
  2. Krause DL, Müller N. The Relationship between Tourette's Syndrome and Infections. Open Neurol J. 2012;6:124–128. doi:10.2174/1874205X01206010124 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3514747/
  3. Hallett JJ. et al. Anti-striatal antibodies in Tourette syndrome cause neuronal dysfunction. J Neuroimmunol. 2000 Nov 1;111(1-2):195-202. https://www.ncbi.nlm.nih.gov/pubmed/11063838
  4. Martino D, Dale RC, Gilbert DL, Giovannoni G, Leckman JF. Immunopathogenic mechanisms in tourette syndrome: A critical review. Mov Disord. 2009;24(9):1267–1279. doi:10.1002/mds.22504. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3972005/
Infections can cause tic disorders in adults

Immune dysfunction has been linked to tic disorders, including Tourette’s syndrome.

Infections may result in tic disorders in adults
How can an infection cause tic disorders in adults

Learn more about how infections can trigger neuropsychiatric symptoms

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The association between streptococcus pyogenes and tics/OCD

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In this book chapter, Dr. Madeleine Cunningham explains the association between Group A strep and the onset of tics and/or OCD and their clinical manifestations in children with the autoimmune neuropsychiatric disorder, PANDAS.

Childhood infections can increase risk of mental illness in kidss

Childhood infections can increase risk of mental illness in kids

Nationwide study finds both mild and severe infections can increase risk of mental disorders in children and adolescents..

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    The Cunningham Panel™ – Antibody testing that helps determine whether an autoimmune response may be triggering neurologic and/or psychiatric symptoms. 

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