An immunoassay for anti-neuronal antibodies associated with involuntary repetitive movement disorders

Tourette's syndrome (TS) is a complex neurobehavioral disorder emerging in childhood and is characterized by motor and vocal tics of at least one year in duration. In a portion of patients with TS, environmental (non-genetic) factors may either have an etiologic role or act to modulate the phenotype. One possible environmental factor may be antibodies to central nervous system cells, as sera from several children diagnosed with either TS or Sydenham's chorea contained anti-neuronal antibodies. Using enriched membrane preparations isolated from HTB-10 neuroblastoma cells, a sensitive and specific assay was developed for the determination of human anti-neuronal antibodies associated with involuntary repetitive movement disorders. This assay exhibited between-run and within-run precision of 11.3 percent and 5.9 percent, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of this assay for the diagnosis of TS and TS or chorea are 79.1 percent, 61.2 percent, 61.6 percent, 78.8 percent, and 71.1 percent, 60.9 percent, 68.6 percent, and 63.6 percent, respectively. In addition, there was a significant difference (p < 0.0001) between the mean optical density in the patients with TS and children determined to be clinically normal.