Maternal Autoimmunity and Inflammation are associated with Childhood Tics and Obsessive-Compulsive Disorder

Although genetic variation is a major risk factor of neurodevelopmental disorders (NDDs) such as tics and childhood obsessive-compulsive disorder (OCD), environmental factors during pregnancy and early life are important in disease expression. Epidemiological studies and animal models indicate maternal inflammation is one potential environmental factor. In my thesis, I compared the frequency of proinflammatory states in mothers of 200 children with tics/OCD with 100 autoimmune neurological controls and 100 age- and sex-matched healthy controls. I prospectively recruited children with tics/OCD aged ≤16 years sequentially referred to the Children’s Hospital at Westmead, and used a structured interview to capture data, focusing on maternal autoimmunity. Children with tics/OCD were phenotyped to identify associations with maternal autoimmunity, and exploratory biomarker testing and transcriptome analysis were performed in a subgroup of mothers to identify immune pathways potentially relevant to neurodevelopment in offspring. A total of 61 (30.5%) mothers of children with tics/OCD had autoimmune disease compared with 20 (20%) mothers of children with autoimmune neurological conditions (p=0.054) and 12 (12%) mothers of healthy controls (p=0.0004, adj OR 2.7 (95th CI 1.28-5.68)). Other proinflammatory states were also more common in mothers of children with tics/OCD than mothers of healthy controls (p