Bilineal transmission in Tourette syndrome

Philip A. Hanna · Fatima N. Janjua · Charles F. Contant · Joseph J. Jankovic

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Obsessive-Compulsive Spectrum Disorders Psychoanalysis and Psychopathology Research Stuttering Research and Treatment

Abstract

OBJECTIVE: To investigate the frequency and pattern of bilineal transmission in families of patients with Tourette syndrome (TS) compared with normal control subjects. METHODS: The study population consisted of two groups: 1) consecutive patients with TS with both parents (51 family sets; 153 individuals), and 2) normal control subjects randomly selected from public schools (20 family sets; 60 individuals). All patients with TS, normal control subjects, and their parents were evaluated for evidence of TS and associated features. Structured interviews and detailed questionnaires designed to assess tics, obsessive-compulsive behavior (OCB), and attention deficit disorder (ADD) were administered to all people in both groups. RESULTS: In addition to tics, 43 (84.3%) patients with TS had ADD, 33 (64.7%) had OCB, and 31 (60.8%) had both ADD and OCB. In 42 (82.4%) of the 51 patients, at least one parent exhibited features of TS; unilineal transmission (only one parent with tics, OCB, or ADD) was present in 29 (56.9%) TS families and an additional 13 (25.5%) TS families manifested evidence of bilineal transmission (both parents affected). More fathers than mothers of patients with TS had tics (31.4% versus 15.7%), whereas more mothers had OCB than did fathers (33.3% versus 15.7%). Features of ADD were equally distributed among fathers (35.3%) and mothers (33.3%) of patients with TS. Eight of 1,142 (0.7%) children in the general school population had some evidence of TS. One of 40 parents of the normal control subjects (2.5%) had symptoms of ADD, but none of the parents of normal control subjects manifested any features of TS or OCB. CONCLUSIONS: This study found evidence for bilineal transmission in one fourth of TS families. Features of the TS spectrum were rare in normal control families. Evidence of tics, OCB, and ADD should be investigated in both parents of patients with TS.

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References

1989The Yale-Brown Obsessive Compulsive Scale 2021Gilles de la Tourette Syndrome 1986The Inheritance of Gilles de la Tourette's Syndrome and Associated Behaviors 1993Definitions and Classification of Tic Disorders 1997PHENOMENOLOGY AND CLASSIFICATION OF TICS 1986Obsessions and compulsions in Gilles de la Tourette's syndrome 1992Relationship of birth weight to the phenotypic expression of Gilles de la Tourette's syndrome in monozygotic twins 1996Family study and segregation analysis of Tourette syndrome: evidence for a mixed model of inheritance.

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2003PANDAS 2000Current issues in Tourette syndrome 2016Putting the Pieces Together in Gilles de la Tourette Syndrome: Exploring the Link Between Clinical Observations and the Biological Basis of Dysfunction

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