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

Get treated for treatment-resistant symptoms

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

Cunningham Panel helps identify an autoimmune disorder in child initially diagnosed with schizophrenia

Cunningham Panel™ helps identify an autoimmune disorder in child initially diagnosed with schizophrenia

Researchers describe a complex case involving a 15-year-old girl, who abruptly developed multiple neurologic and psychiatric symptoms.

The association between streptococcus pyogenes and tics/OCD

The association between streptococcus pyogenes and tics/OCD

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. 

B. Robert Mozayeni, MD

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B. Robert Mozayeni MD

Dr. B. Robert Mozayeni was trained in Internal Medicine and Rheumatology at Yale and at NIH. He has had pre- and post-doctoral Fellowships in Molecular Biophysics and Biochemistry at Yale, and also at NIH where he was a Howard Hughes Research Scholar at LMB/DCBD/NCI and later, Senior Staff Fellow at LMMB/NHLBI/NIH. Editorial board of Infectious Diseases – Surveillance, Prevention and Treatment. Past President of the International Lyme and Associated Diseases Society (ILADS).

He is an expert in Translational Medicine, the science and art of advancing medical science safely and efficiently. He is a Fellow of the non-profit Think Lead Innovate Foundation and is a co-founder of the Foundation for the Study of Inflammatory Diseases. He is a Founder of the Foundation for the Study of Inflammatory Diseases to crowd-source medical solutions for complex conditions using existing knowledge, diagnostic methods, and therapies to meet patient needs immediately. He is the Chief Medical Officer of Galaxy Diagnostics, LLC. He is a Board member of the Human-Kind Alliance. Dr. Mozayeni has held admitting privileges (since 1994) on the clinical staff of Suburban Hospital, a member of Johns Hopkins Medicine and an affiliate of the National Institutes of Health Clinical Center.

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Sajo Baqaj, PhD

Dr. Sajo Beqaj is board certified in molecular pathology and genetics and licensed as a Bioanalyst and High Complexity Laboratory Director. He has been practicing as a laboratory director since 2005.

Dr. Beqaj served as a technical director and was part of the initial management team for several well-known laboratories in the clinical lab industry including PathGroup, Nashville, TN; DCL Medical Laboratories, Indianapolis, IN, and Pathology, Inc, Torrance, CA. He is currently serving as off-side CLIA laboratory director for BioCorp Clinical Laboratory, Whittier, CA and Health360 Labs, Garden Grove, CA.

Dr. Beqaj received his Ph.D. in Pathology from Wayne State University Medical School, Detroit, Michigan. He performed his post-doctoral fellowship at Abbott Laboratories from 2001-2003 and with Children’s Hospital and Northwestern University from 2003-2005.

Dr. Beqaj has taught in several academic institutions and has published numerous medical textbook chapters and journal articles. He has served as a principal investigator in clinical trials for several well-known pharmaceutical and diagnostic companies such as Roche HPV Athena, Merck HPV vaccine, BD vaginitis panel, Roche (Vantana) CINtec® Histology clinical trials, and has presented various scientific clinical abstracts and presentations.

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Rodney Cotton, MBA

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Rod is an independent director for Orchard Software, a private equity-backed health technology company owned by Francisco Partners; an advisory board member to Flo2 Ventures, a venture capital-backed healthcare and health equity accelerator; and a member of the board of directors and three board committees (Audit, Compliance & Finance; Governance & Equity; and Quality of Care) for Community Health Network.

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In the face of the COVID-19 pandemic, Rod and his team at Roche accelerated six ground breaking products in 11 months, including the first launch of the market’s most accurate and in demand molecular diagnostic test. He also solved extraordinary challenges of product scarcity, supply chain, product allocation, and logistics to achieve accelerated global sourcing and self manufacturing in line with testing guidelines.

A frequent public speaker on health equity and other topics, Rod was named one of the Most Influential Black Executives in Corporate America by Savoy Magazine and one of the Top Blacks in Healthcare by BlackDoctor.org. He also received The Sagamore of the Wabash Award, one of the highest Indiana State honors, bestowed by Indiana Governor Eric J. Holcomb.

Rod holds an M.B.A. from California State University, Dominguez Hills, an M.S. in Strategic Management from the University of Southern California, and a B.A. in Biological Sciences & Technology from the University of California at Santa Barbara.