Monthly Archives:
September 2021

Clinical Features in Patients With PANDAS/PANS and Therapeutic Approaches: A Retrospective Study

Rea I, Guido CA, Spalice A. Clinical Features in Patients With PANDAS/PANS and Therapeutic Approaches: A Retrospective Study. Frontiers in Neurology. Vol. 12, 2021. DOI=10.3389/fneur.2021.741176  

  • 62 patients with a clinical diagnosis of PANDAS/PANS.
    • 15 with PANS. 47 with PANDAS
  • Mean age at onset of PANDAS/PANS symptoms was 6.2 ± 1.2 years
    • 6.2 for PANDAS. 6.0 for PANS
  • Neurological and psychiatric symptoms were mostly evident in both groups with little difference
  • 93.5% had vocal tics
  • 79% had OCD
  • PANS kids had more irritability, aggressivity, and food restriction
  • PANDAS kids had 10 times higher levels of anti-streptolysin O and anti-DNAse B
  • PANS kid had a higher percentage of metabolic disorders
  • Psychotherapy significantly relieved OCD the most and reduced stress in patients and parents
  • Antibiotic prophylaxis was the most frequently used (90%) for acute neurological symptoms

 

 

Postnatal immune activation causes social deficits in a mouse model of tuberous sclerosis: Role of microglia and clinical implications

Manuel F. López-Aranda, Ishanu Chattopadhya, Gayle M. Boxx, Elizabeth R. Fraley, Tawnie K. Silva, Miou Zhou, Miranda Phan, Isaiah Herrera, Sunrae Talomam Rochelle Mandanas, Karen Bach and Michael Gandal and Daniel H. Geschwind, Genhong Cheng, Andrey Rzhetsky and Stephanie A. White, Alcino J. Silva. Postnatal immune activation causes social deficits in a mouse model of tuberous sclerosis: Role of microglia and clinical implications. Science Advances, vol 7. 38, 2021. DOI:10.1126/sciadv.abf2073

There is growing evidence that prenatal viral infections triggering immune activation contributes to neuropsychiatric disorders, including schizophrenia and autism spectrum disorders

Kids who had severe infections and are genetically predisposed to autism were more likely to develop the condition. So, the genetic factors don’t trigger autism but environmental factors play a significant role. One of the scientists said that childhood infections may be linked to higher instances of depression m, anxiety, schizophrenia.
  • Study links significant childhood infections to developing autism later.
  • In mouse models, mice that had an immune response later were no longer able to recognize familiar faces. This study was replicated with a focus on social interactions and the mice whose immune system was activated had increased difficulty communicating.
  • A different study reinforces the mouse model that tracked 3.6 million hospitalized children shoeing that hospitalizations due to infections during early childhood can predict a future diagnosis of ASD
Recent progress on Tourette syndrome

Ueda K, Black KJ. Recent progress on Tourette syndrome. Fac Rev. 2021;10:70. Published 2021 Sep 7. DOI:10.12703/r/10-70

“Recent years have seen increasing information about the relationship between tics and comorbidities and about new genetic findings. Inflammatory processes have also been a topic of continued interest.

“The prevalence and characteristics of tics in patients with encephalitis were reviewed in a systematic study, which found that sporadic cases of tics were associated with encephalitis, particularly during a post-encephalitis period, and with basal ganglia involvement. A case-control autopsy study (of nine individuals with TS) using basal ganglia transcriptome by RNA sequencing in the caudate and putamen found disrupted basal ganglia neuronal signaling. The study also found a significant increase in immune and inflammatory transcripts. These results suggest metabolic alterations and inflammatory involvement in TS pathophysiology.”

“Inflammation has been extensively discussed in tic pathophysiology. A recent review article on immunological mechanisms in the pathophysiology of tic disorders argues that innate and adaptive systemic immune pathways and neuroinflammatory mechanisms play an important role in the pathogenesis of at least some patients with TS.”

“Complementary and alternative medicines—including dietary or nutritional supplements (calcium, magnesium, coenzyme Q10, fish oil, gastrodin, and vitamins B, C, D, and E), chiropractic manipulations, meditation, acupuncture, hypnosis, homeopathy, and biofeedback—have been reported for the treatment of tics,; however, the evidence is limited because of a lack of randomized control studies. The efficacy and safety of a Chinese herbal medicine (5-Ling granule) in the treatment of TS were evaluated in a multicenter, double-blind randomized controlled trial, finding it as effective as tiapride in improving tic symptoms.”

GAPS Nutritional Protocol as a Treatment for PANDAS: A Case Study

Delaunay-Vagliasindi S, Seneff S, Coro S & Campbell-McBride N (2021) GAPS Nutritional Protocol as a treatment for PANDAS: A case study. J Orthomol Med. 36(3). 6 September 2021 

“Growing research is calling attention to the role of poor gut health in autoimmune conditions, psychological conditions, and neurological conditions – all of which are relevant to PANDAS. The gut microbiome is a perfect target for treatment as it is flexible and adapts quickly to changes. Currently, the first-line treatments for PANDAS are antibiotics and mood stabilizers. The GAPS Nutritional Protocol aims to heal the gut lining, and restore microbial balance in the gut flora. After 18 months, George saw all his PANDAS-related symptoms disappear – tics, anxiety, hypersensitivity to noise and odours, sleep issues, concentration issues, fine motor issues, digestive issues, restricted eating habits, and quality of eye-contact – to the point where his diagnosis was officially removed. In addition, the abnormal blood test results that were indicative of the PANDAS condition – EO, NEUT, LYMPH, NLR, MPV – were restored to normal ranges after the GAPS intervention.”