Journal of Neural Transmission

, Volume 119, Issue 5, pp 621–626 | Cite as

Involvement of immunologic and biochemical mechanisms in the pathogenesis of Tourette’s syndrome

  • Yuval Eliahu Landau
  • Tamar Steinberg
  • Brian Richmand
  • James Frederick Leckman
  • Alan Apter
Biological Child and Adolescent Psychiatry - Original Article


Tourette’s syndrome is a neurodevelopmental disorder clinically characterized by multiple motor and phonic tics. It is likely that a neurobiological susceptibility to the disorder is established during development by the interaction of genetic, biochemical, immunological, and environmental factors. This study sought to investigate the possible correlation of several immunological and biochemical markers with Tourette’s syndrome. Children with Tourette’s syndrome attending a tertiary pediatric medical center from May 2008 to April 2010, and healthy age-matched control subjects underwent a comprehensive biochemical and immunological work-up. Demographic data were abstracted from the medical records. Findings were compared between the groups and analyzed statistically. Sixty-eight children with Tourette’s syndrome (58 males, 85.3%) and 36 healthy children (25 males, 69.4%) were recruited. Compared with the control group, the Tourette’s syndrome group had significantly higher levels of ferritin (p = 0.01) and hemoglobin (p = 0.02), a lower level of zinc (p = 0.05), and a lower percentage of non-ceruloplasmin copper (p = 0.01). Analysis of the immunological markers revealed no significant between-group differences in IgA, IgM or IgG; however, IgE and IgG-4 levels were significantly higher in the Tourette’s syndrome group (p = 0.04 and p = 0.02, respectively). Children with Tourette’s syndrome have high levels of biochemical indices of oxidative stress and the quantitative immunoglobulins. These findings add to the still-limited knowledge on the pathogenesis of Tourette’s syndrome and may have implications for the development of novel therapeutic modalities.


Tourette syndrome Oxidative stress Heavy metals metabolism Autoimmunity Immunoglobulins 



The authors thank Pearl Lilos of the Department of Statistics, Schneider Children’s Medical Center of Israel, Tel Aviv University, for the statistical analysis of the data.

Conflict of interest

Authors Y. E. Landau, T. Steinberg, and A. Apter declare that they have no conflicts of interest. B. Richmand: the funding for this study was provided by Brian and Linda Richmand, and Scott and Amy Horwitz. J. F. Leckman: support for the past three years: NIH (salary and research funding), Tourette Syndrome Association (research funding), Talecris Biotherapeutics (research funding), Klingenstein Third Generation Foundation (medical student fellowship program), John Wiley and Sons (book royalties), McGraw Hill (book royalties), Oxford University Press (book royalties).


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Yuval Eliahu Landau
    • 1
  • Tamar Steinberg
    • 1
  • Brian Richmand
    • 2
  • James Frederick Leckman
    • 3
  • Alan Apter
    • 1
  1. 1.The Freund Tourette Syndrome Clinic, Department of Psychological Medicine, and Department of Child Development and NeurologySchneider Children’s Medical Center of Israel, Tel Aviv UniversityPetah TiqwaIsrael
  2. 2.The Richmand Foundation for the Study of Pediatric Autoimmune Neuropsychiatric and Developmental Disorders, LtdChappaquaUSA
  3. 3.Child Study Center and the Departments of Pediatrics and PsychologyYale University School of MedicineNew HavenUSA

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