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Wu, X., Hao, J., Jiang, K. et al. Neuroinflammation and pathways that contribute to tourette syndrome. Ital J Pediatr 51, 63 (2025). https://doi.org/10.1186/s13052-025-01874-3

Read a deeper dive: Neuroinflammation and Immune Pathways in Tourette Syndrome

• Tourette Syndrome (TS): A neurodevelopmental disorder characterized by motor and vocal tics, often co-occurring with ADHD, OCD, and other psychological issues.
• Neurotransmitter Imbalances: TS is traditionally linked to neurotransmitter disruptions, especially within the cortex-striatum-thalamus-cortex circuit, involving dopamine and glutamate.
• Neuroinflammation: Emerging research shows neuroinflammation, often triggered by infections or allergies, contributes to neurotransmitter imbalances that may induce tics.
• Infectious Triggers: Streptococcal infections (e.g., PANDAS), viral infections (e.g., enterovirus, COVID-19), and other pathogens (e.g., Chlamydia, Mycoplasma) are linked to TS exacerbation.
• Immune Mechanisms: Inflammatory responses activate microglia and the peripheral immune system, disrupting neurotransmitter balance and leading to tics.

Hilario Blasco-Fontecilla, Victor del Rio-Peña, Ping Wang, Chao Li, Marina Martin-Moratinos, Marcos Bella-Fernández, Trastorno por tics y trastorno obsesivo compulsivo: Trastornos neuropsiquiátricos pediátricos autoinmunes asociados a infecciones por estreptococos (PANDAS) y enfermedades psiquiátricas en niños y adolescentes, Psiquiatría Biológica, Volume 31, Supplement 1, 2024,100554, ISSN 1134-5934,https://doi.org/10.1016/j.psiq.2024.100554.

• Study Overview: Compared 801 children with and without ASLO positivity (Antistreptolysin O, a marker of past strep infection).
• ASLO-positive kids are 7x more likely to have tics & OCD.
• More ER visits and higher trauma/fracture rates.
• No link to ADHD or academic performance.

Neuroinflammation in a Rat Model of Tourette Syndrome, Zhongling Ke, Yanhui Chen, Guofeng Chen, Yanyan Liu, Neuroinflammation in a Rat Model of Tourette Syndrome, Frontiers in Behavioral Neuroscience, Vol 16, Front. Behav. Neurosci., 10 March 2022, DOI: 10.3389/fnbeh.2022.710116   

Conclusion: The IDPN-induced TS rats had significant neuroinflammation in the brain, and the interaction between dopamine (DA) dysregulation and immune dysfunction may play a vital role in the pathogenic mechanisms of TS.

Ueda K, Black KJ. Recent progress on Tourette syndrome. Fac Rev. 2021;10:70. Published 2021 Sep 7. DOI:10.12703/r/10-70

“Recent years have seen increasing information about the relationship between tics and comorbidities and about new genetic findings. Inflammatory processes have also been a topic of continued interest.

“The prevalence and characteristics of tics in patients with encephalitis were reviewed in a systematic study, which found that sporadic cases of tics were associated with encephalitis, particularly during a post-encephalitis period, and with basal ganglia involvement⁵⁴. A case-control autopsy study (of nine individuals with TS) using basal ganglia transcriptome by RNA sequencing in the caudate and putamen found disrupted basal ganglia neuronal signaling⁵⁵. The study also found a significant increase in immune and inflammatory transcripts. These results suggest metabolic alterations and inflammatory involvement in TS pathophysiology.”

“Inflammation has been extensively discussed in tic pathophysiology. A recent review article on immunological mechanisms in the pathophysiology of tic disorders argues that innate and adaptive systemic immune pathways and neuroinflammatory mechanisms play an important role in the pathogenesis of at least some patients with TS⁵³.”

“Complementary and alternative medicines—including dietary or nutritional supplements (calcium, magnesium, coenzyme Q₁₀, fish oil, gastrodin, and vitamins B, C, D, and E), chiropractic manipulations, meditation, acupuncture, hypnosis, homeopathy, and biofeedback—have been reported for the treatment of tics^116,117; however, the evidence is limited because of a lack of randomized control studies. The efficacy and safety of a Chinese herbal medicine (5-Ling granule) in the treatment of TS were evaluated in a multicenter, double-blind randomized controlled trial, finding it as effective as tiapride in improving tic symptoms¹¹⁸.”

Badenoch, J., Searle, T., Watson, I. et al. Tics in patients with encephalitis. Neurol Sci (2021). DOI: 10.1007/s10072-021-05065-w

“Tics were most commonly reported in the post-encephalitic period and involvement of the basal ganglia was frequently observed….Despite these limitations, the first literature review evaluating the presence of tics in reported cases of encephalitis showed that tics have been sporadically reported in cases of encephalitis resulting from autoimmune, infective, and unknown aetiology. Specifically, tics have been more commonly reported in the post-encephalitic period and involvement of the basal ganglia was frequently found. Furthermore, the association of new-onset tics and encephalitis, in the background of other neuropsychiatric abnormalities, has clinical implications in potentially improving the detection of encephalitis based on clinical features. Future research should focus on the categorisation and treatment of hyperkinetic movement disorders associated with encephalitis.”