Neurobiology of Tourette's syndrome: the autoimmune post-streptococcal hypothesis

• Autor(a) principal: Dias, Fernando Machado Vilhena
• Data de Publicação: 2008
• Outros Autores: Kummer, Arthur, Hounie, Ana Gabriela, Teixeira, Antônio Lúcio
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Archives of Clinical Psychiatry
• Texto Completo: https://www.revistas.usp.br/acp/article/view/17157
• topic: Síndrome de Tourette; coréia de Sydenham; infecção estreptocócica; auto-imune; PANDAS; febre reumática; tiques; Tourette's syndrome; Sydenham's chorea; streptococcal infection; autoimmune; PANDAS; rheumatic fever; tics

BACKGROUND: Tourette's syndrome (TS) is characterized by the presence of motor tics and at least one phonic tic. Some clinical similarities with Sydenham's chorea (SC) lead to the hypothesis of a new group of disorders associated with an autoimmune process due to a streptococcal infection (PANDAS). Objective: To review the literature in search of evidence on the existence of post-streptococcal autoimmune mechanisms involved with the etiopathogenesis of TS. METHODS: A systematic review with the terms "Tourette", "tic", "PANDAS", "antibodies", "streptococcal" and "rheumatic" was carried on using the MedLine. RESULTS: The search found 238 articles. Fifty and three articles were selected which also had their references reviewed. The results of studies that investigated autoimmune aspects of TS, including anti-streptococcal and anti-basal ganglia anti-bodies, and immune-based therapy, were presented and discussed. DISCUSSION: The evidences to date are not satisfactory regarding a post-streptococcal auto-immune process in ST. The improvement on investigative methods and sample selection might contribute to this question.