Pediatric neuropsychiatric syndromes associated with infection and microbiome alterations: clinical findings, possible role of the mucosal epithelium, and strategies for the development of new animal models
Hoffman KL, Cano-Ramírez H. Pediatric neuropsychiatric syndromes associated with infection and microbiome alterations: clinical findings, possible role of the mucosal epithelium, and strategies for the development of new animal models. Expert Opin Drug Discov. 2022 May 11. doi: 10.1080/17460441.2022.2074396. Epub ahead of print. PMID: 35543072.
“Although data from existing animal models are consistent with an important role for anti-neuronal antibodies in PANS triggered by GAS infection, we lack models for identifying pathophysiological mechanisms of PANS associated with other infectious and non-infectious triggers. The authors propose a strategy for developing such models that incorporates known vulnerability and triggering factors for PANS into the modeling process. This novel strategy should expand our understanding of the pathophysiology of PANS, as well as facilitate the development of new pharmacological treatments for PANS and related syndromes.”
Bowel and Bladder Dysfunction Is Associated with Psychiatric Comorbidities and Functional Impairment in Pediatric Obsessive-Compulsive Disorder
Clara Westwell-Roper, John R. Best, Zainab Naqqash, Kourosh Afshar, Andrew E. MacNeily, and S. Evelyn Stewart.Journal of Child and Adolescent Psychopharmacology. Published Online: ahead of printhttp://doi.org/10.1089/cap.2021.0059

“Neuropsychiatric disorders are common in children with bowel and bladder dysfunction (BBD), a syndrome associated with urinary frequency, urgency, holding, incontinence, and constipation. We evaluated BBD symptom severity in children and youth attending a tertiary care obsessive-compulsive disorder (OCD) clinic….. BBD symptoms are common and associated with high OCD-related impairment and psychiatric comorbidities. Standardized assessment may facilitate identification of BBD symptoms in this population and is critical to mitigating long-term physical and mental health impacts. Further studies are required to assess the relationship between BBD and OCD treatment outcomes.”

Reader Response: Lack of Association of Group A Streptococcal Infections and Onset of Tics

Reader Response: Lack of Association of Group A Streptococcal Infections and Onset of Tics

“Schrag et al. reported that Group A streptococcal (GAS) exposure is unrelated to tics in children at risk for tic disorders.1 The critical limitations of this study are that only children with genetic risks for tics were studied and information about risk for autoimmunity, infection susceptibility, and antibiotics use are absent.1 The EMTICS home page states that many patients refused to participate when told that antibiotic use would be limited. This would introduce a negative selection bias against families who perceive themselves as high risk and patients procuring antibiotics outside the trial.2

In response to:

Schrag AE, Martino D, Wang H, Ambler G, Benaroya-Milstein N, Buttiglione M, Cardona F, Creti R, Efstratiou A, Hedderly T, Heyman I, Huyser C, Mir P, Morer A, Moll N, Müller NE, Müller-Vahl KR, Plessen KJ, Porcelli C, Rizzo R, Roessner V, Schwarz M, Tarnok Z, Walitza S, Dietrich A, Hoekstra PJ; European Multicentre Tics in Children Study (EMTICS). Lack of Association of Group A Streptococcal Infections and Onset of Tics: European Multicenter Tics in Children Study. Neurology. 2022 Mar 15;98(11):e1175-e1183. doi: 10.1212/WNL.0000000000013298. Epub 2022 Feb 2. PMID: 35110379.