Association of Group A Streptococcus Exposure and Exacerbations of Chronic Tic Disorders

From the Department of Clinical Neurosciences (D.M.), Cumming School of Medicine & Hotchkiss Brain Institute, University of Calgary, Canada; Department of Clinical Neuroscience (A.S., Z.A.), UCL Institute of Neurology, University College London, UK; Child and Adolescent Psychiatry Department (A.A., N.B.-M., T.S.), Schneider Children's Medical Center of Israel, Petah-Tikva, Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Israel; Department of Biomedical Sciences and Human Oncology (M.B.), University of Bari “Aldo Moro”; Department of Human Neurosciences (F.C.), University La Sapienza of Rome; Department of Infectious Diseases (R.C.), Istituto Superiore di Sanità, Rome, Italy; WHO Global Collaborating Centre for Reference and Research on Diphtheria and Streptococcal Infections (A.E.), Reference Microbiology, Directorate National Infection Service, Public Health England; Evelina London Children's Hospital GSTT (T.H.), Kings Health Partners AHSC; Psychological Medicine (I.H.), Great Ormond Street Hospital NHS Foundation Trust, London, UK; Department of Child and Adolescent Psychiatry (C.H.), De Bascule, Amsterdam UMC, the Netherlands; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED) (M.M.), Seville; Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica (P.M.), Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville; Department of Child and Adolescent Psychiatry and Psychology (A. Morer), Institute of Neurosciences, Hospital Clínic; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) (A. Morer), Barcelona; Centro de Investigación en Red de Salud Mental (CIBERSAM) (A. Morer), Instituto Carlos III, Madrid; Department of Medicine (A. Morer), University of Barcelona, Spain; Child and Adolescent Mental Health Center (N.M.D., K.J.P., L.S.), Mental Health Services, Capital Region of Denmark and University of Copenhagen, Denmark; Institute of Laboratory Medicine (N. Moll, M.S.) and Department of Psychiatry and Psychotherapy (N. Müller, J.S.), University Hospital LMU Munich; Department of Psychiatry, Social Psychiatry and Psychotherapy (K.M.-V.), Hannover Medical School; Institute of Neurogenetics (A. Munchau), University of Lübeck, Germany; Vadaskert Child and Adolescent Psychiatric Hospital (P.N., Z.T.), Budapest, Hungary; Division of Child and Adolescent Psychiatry, Department of Psychiatry (K.J.P.), Lausanne University Hospital, Switzerland; ASL BA, Mental Health Department (C.P.), Adolescence and Childhood Neuropsychiatry Unit, Bari; Child and Adolescent Neurology and Psychiatry, Department of Clinical and Experimental Medicine (R.R.), University of Catania, Italy; Department of Child and Adolescent Psychiatry (V.R.), Medical Faculty Carl Gustav Carus, TU Dresden, Germany; Clinic of Child and Adolescent Psychiatry and Psychotherapy (S.W.), University of Zurich, Switzerland; and Department of Child and Adolescent Psychiatry (A.D., P.J.H.), University of Groningen, University Medical Center Groningen, the Netherlands.