Anti-dopamine D2 receptor antibodies in chronic tic disorders

Addabbo, F.; Baglioni, V.; Schrag, A.; Schwarz, M. J.; Dietrich, A.; Hoekstra, P. J.; Martino, D.; Buttiglione, M.; Anastasiou, Z.; Apter, A.; Ball, J.; Bartolini, E.; Benaroya-Milshtein, N.; Bodmer, B.; Bognar, E.; Burger, B.; Buse, J.; Cardona, F.; Correa Vela, M.; Creti, R.; Debes, N. M.; Efstratiou, A.; Ferro, M. C.; Fremer, C.; Garcia-Delgar, B.; Gariup, M.; Georgitsi, M.; Gulisano, M.; Hagen, A.; Hagstrom, J.; Hedderly, T. J.; Heyman, I.; Huyser, C.; Imperi, M.; Karagiannidis, I.; Laviola, G.; Macri, S.; Madruga-Garrido, M.; Margarit, I.; Marotta, A.; Meier, U. C.; Mir, P.; Moll, N.; Morer, A.; Muller-Vahl, K.; Munchau, A.; Nagy, P.; Neri, V.; Openneer, T. J. C.; Orefici, G.; Paschou, P.; Perianez, A.; Pellico, V. A.; Petruzzelli, O.; Plessen, K.; Porcelli, C.; Redondo, M.; Rizzo, R.; Roazzi, P.; Roessner, V.; Ruhrman, D.; Schnell, J. M. L.; Schutze, G. A.; Silvestri, P. R.; Skov, L.; Steinberg, T.; Stober, S.; Tallon, M.; Gloor, F. T.; Walitza, S.; Tubing, J.; Turner, V.; Weidinger, E.; Tarnok, Z.

doi:10.1111/dmcn.14613

Aim: To investigate the association between circulating anti-dopamine D2 receptor (D2R) autoantibodies and the exacerbation of tics in children with chronic tic disorders (CTDs). Method: One hundred and thirty-seven children with CTDs (108 males, 29 females; mean age [SD] 10y 0mo [2y 7mo], range 4–16y) were recruited over 18 months. Patients were assessed at baseline, at tic exacerbation, and at 2 months after exacerbation. Serum anti-D2R antibodies were evaluated using a cell-based assay and blinded immunofluorescence microscopy scoring was performed by two raters. The association between visit type and presence of anti-D2R antibodies was measured with McNemar’s test and repeated-measure logistic regression models, adjusting for potential demographic and clinical confounders. Results: At exacerbation, 11 (8%) participants became anti-D2R-positive (‘early peri-exacerbation seroconverters’), and nine (6.6%) became anti-D2R-positive at post-exacerbation (‘late peri-exacerbation seroconverters’). The anti-D2R antibodies were significantly associated with exacerbations when compared to baseline (McNemar’s odds ratio=11, p=0.003) and conditional logistic regression confirmed this association (Z=3.49, p<0.001) after adjustment for demographic and clinical data and use of psychotropic drugs. Interpretation: There is a potential association between immune mechanisms and the severity course of tics in adolescents with CTDs.

Anti-dopamine D2 receptor antibodies in chronic tic disorders / Addabbo, F.; Baglioni, V.; Schrag, A.; Schwarz, M. J.; Dietrich, A.; Hoekstra, P. J.; Martino, D.; Buttiglione, M.; Anastasiou, Z.; Apter, A.; Ball, J.; Bartolini, E.; Benaroya-Milshtein, N.; Bodmer, B.; Bognar, E.; Burger, B.; Buse, J.; Cardona, F.; Correa Vela, M.; Creti, R.; Debes, N. M.; Efstratiou, A.; Ferro, M. C.; Fremer, C.; Garcia-Delgar, B.; Gariup, M.; Georgitsi, M.; Gulisano, M.; Hagen, A.; Hagstrom, J.; Hedderly, T. J.; Heyman, I.; Huyser, C.; Imperi, M.; Karagiannidis, I.; Laviola, G.; Macri, S.; Madruga-Garrido, M.; Margarit, I.; Marotta, A.; Meier, U. C.; Mir, P.; Moll, N.; Morer, A.; Muller-Vahl, K.; Munchau, A.; Nagy, P.; Neri, V.; Openneer, T. J. C.; Orefici, G.; Paschou, P.; Perianez, A.; Pellico, V. A.; Petruzzelli, O.; Plessen, K.; Porcelli, C.; Redondo, M.; Rizzo, R.; Roazzi, P.; Roessner, V.; Ruhrman, D.; Schnell, J. M. L.; Schutze, G. A.; Silvestri, P. R.; Skov, L.; Steinberg, T.; Stober, S.; Tallon, M.; Gloor, F. T.; Walitza, S.; Tubing, J.; Turner, V.; Weidinger, E.; Tarnok, Z.. - In: DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY. - ISSN 0012-1622. - 62:10(2020), pp. 1205-1212. [10.1111/dmcn.14613]