SummarySeveral lines of evidence suggest that certain subtypes of obsessive-compulsive and tic disorders might be pediatric manifestations of post-streptococcal autoimmunity caused by cross-reactive auto-antibodies. As tumor necrosis factor (TNF) is known to play a seminal role in coordinating the humoral immune response, TNF gene polymorphisms have been proposed as genetic risk factors both in obsessive-compulsive disorder (OCD) and Tourette syndrome (TS). The aim of present study was to investigate two TNF promoter polymorphisms (-238 A/G: rs361525 and -308 A/G: rs1800629) on the genetic susceptibility to OCD and TS in a child psychiatric sample (102 OCD and 117 TS patients). In the case-control setup the genotype and allele frequencies were compared to a control group from the general population (n=405). As a control child psychiatric sample, 194 children with attention deficit hyperactivity disorder were also genotyped. Our results revealed that the TNF -308 G-allele was more frequent in children with TS compared to controls (90.2% vs 84.8%, p=0.037). For confirmation of this genetic association a family based analysis, the Transmission Disequilibrium Test was used, which showed preferential transmission of the G-allele to TS patients (nominal p-value 0.011). Moreover, this allele was also transmitted more frequently to children with tic symptoms (nominal p-value 0.039). No association was found between OCD or obsessive, compulsive symptoms and the studied TNF polymorphisms. Based on these findings, the TNF -308 G-allele can be associated with Tourette syndrome, highlighting the potential pathophysiological role of TNF dysregulation.3