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Nongenetic Factors in Gilles de la Tourette's Syndrome

James F. Leckman, MD; R. Arlen Price, PhD; John T. Walkup, MD; Sharon Ort, RN, MPH; David L. Pauls, MD; Donald J. Cohen, MD
Arch Gen Psychiatry. 1987;44(1):100. doi:10.1001/archpsyc.1987.01800130112025.
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To the Editor.—  Interest in a possible hereditary component in the transmission and expression of Gilles de la Tourette's syndrome (TS) is longstanding. Although no specific genetic mechanism has been identified, several studies have reported a pattern of transmission that is consistent with an incompletely penetrant autosomal gene (D.L.P., J.F.L., unpublished data, 1985).1-4 The importance of nongenetic factors has also recently been emphasized by a twin study of TS reported by Price et al5 in which seven (23%) of the 30 monozygotic pairs were fully discordant for TS.In preparing for a more extensive evaluation of these discordant twin pairs, we recently examined unpublished data from the original study and found that in each case the unaffected co-twin had a higher birth weight than the affected twin (Table). These data must be considered as preliminary, since detailed case histories of the twin pregnancies were not obtained as part

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