The female Tourette patient: Sex differences in Tourette Disorder

Jordan Garris; Mark Quigg

doi:10.1016/j.neubiorev.2021.08.001

The female Tourette patient: Sex differences in Tourette Disorder

Neurosci Biobehav Rev. 2021 Oct:129:261-268. doi: 10.1016/j.neubiorev.2021.08.001. Epub 2021 Aug 5.

Authors

Jordan Garris¹, Mark Quigg²

Affiliations

¹ Department of Neurology, University of Virginia, Box 800394, Charlottesville, VA 22908-0394, United States; Department of Pediatrics, University of Virginia, United States. Electronic address: jfg3h@virginia.edu.
² Department of Neurology, University of Virginia, Box 800394, Charlottesville, VA 22908-0394, United States.

PMID: 34364945
DOI: 10.1016/j.neubiorev.2021.08.001

Abstract

Tourette Disorder (TD) is a male predominant neurodevelopmental disorder characterized by tics and frequent psychiatric comorbidities. Girls with TD have later peak symptoms, less remission with age, and worse impairment from tics, particularly in adulthood. Female TD patients are less likely to have Attention Deficit Hyperactivity Disorder and more likely to have anxiety and mood disorders. Hyperandrogenism is associated with TD in both sexes, and neuroanatomic sexual dimorphism is reduced in adult TD patients. Some women report catamenial tics, which may relate to estrogen withdrawal or rises in allopregnanolone. Limited data suggest that several neuroanatomic alterations present in boys with TD are not present in girls with TD. Female sex predicts better response to haloperidol. Further research into female tic pathophysiology may influence sex-specific treatment development.

Keywords: Course; Female; Girls; Neuroanatomy; Neurosteroids; Prognosis; Sex; Tics; Tourette Disorder; Treatment; Women.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Adult
Attention Deficit Disorder with Hyperactivity*
Female
Humans
Male
Obsessive-Compulsive Disorder*
Sex Characteristics
Tic Disorders*
Tics*
Tourette Syndrome*