Anti-dopamine D2 receptor antibodies in chronic tic disorders

Francesco Addabbo, Valentina Baglioni, Anette Schrag, Markus J Schwarz, Andrea Dietrich, Pieter J Hoekstra, Davide Martino, Maura Buttiglione, EMTICS Collaborative Group


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.

Original languageEnglish
JournalDevelopmental Medicine and Child Neurology
Issue number10
Pages (from-to)1205-1212
Number of pages8
Publication statusPublished - Oct 2020


  • Adolescent
  • Autoantibodies/blood
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Male
  • Receptors, Dopamine D2/immunology
  • Tic Disorders/blood


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