Posts by:
Gabriella True

TIC-TOC: PANDAS syndrome (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection) and psychiatric pathology in children and adolescents

Hilario Blasco-Fontecilla, Victor del Rio-Peña, Ping Wang, Chao Li, Marina Martin-Moratinos, Marcos Bella-Fernández, Trastorno por tics y trastorno obsesivo compulsivo: Trastornos neuropsiquiátricos pediátricos autoinmunes asociados a infecciones por estreptococos (PANDAS) y enfermedades psiquiátricas en niños y adolescentes, Psiquiatría Biológica, Volume 31, Supplement 1, 2024,100554, ISSN 1134-5934,https://doi.org/10.1016/j.psiq.2024.100554.

  • Study Overview: Compared 801 children with and without ASLO positivity (Antistreptolysin O, a marker of past strep infection).
  • ASLO-positive kids are 7x more likely to have tics & OCD.
  • More ER visits and higher trauma/fracture rates.
  • No link to ADHD or academic performance.
Dopamine receptor autoantibody signaling in infectious sequelae differentiates movement versus neuropsychiatric disorders
Menendez CM, Zuccolo J, Swedo SE, Reim S, Richmand B, Ben-Pazi H, Kovoor A, Cunningham MW. Dopamine receptor autoantibody signaling in infectious sequelae differentiates movement versus neuropsychiatric disorders. JCI Insight. 2024 Nov 8;9(21):e164762. doi: 10.1172/jci.insight.164762. PMID: 39325550; PMCID: PMC11601707.

  • Autoantibodies (AAbs) to different dopamine receptors can differentiate movement disorders and neuropsychiatric disorders following Group A streptococcal (GAS) infection. GAS-induced cross-reactive AAbs promote autoimmune encephalitis of the basal ganglia, a region with high dopamine receptor density. 
  • The research provides insights into the mechanisms by which neuropsychiatric syndromes are distinguished from movement disorders through differences in D1R and D2R AAb titers, signaling, and immunoreactivity. 
  • This study could inform new diagnostic and treatment options for GAS sequelae and related disorders.
Occupational performance patterns in children with paediatric acute-onset neuropsychiatric syndrome.

Newby MJ, Lane SJ, Haracz K, et al. Occupational performance patterns in children with paediatric acute-onset neuropsychiatric syndrome. Australian Occupational Therapy Journal. 2024;72:e12995. doi:10.1111/1440-1630.12995

Read more in a deeper dive Occupational Performance Fluctuates With PANS Disease State

  • Children with PANS show significant declines in occupational performance and socialisation during symptom exacerbations
  • Adaptive Behaviour Composite and socialisation scores were significantly lower during exacerbation compared with remission
  • During remission, occupational performance returned to age-typical ranges across all measured domains
  • Findings highlight the episodic, relapsing–remitting nature of functional impairment in PANS
  • Authors emphasize the importance of occupational therapy during flare-ups and caution against assessment-based misinterpretation during exacerbations
IVIG response in pediatric acute-onset neuropsychiatric syndrome correlates with reduction in pro-inflammatory monocytes and neuropsychiatric measures
Melamed, Isaac, et al.“IVIG Response in Pediatric Acute-onset Neuropsychiatric Syndrome Correlates with Reduction in Pro-inflammatory Monocytes and Neuropsychiatric Measures.”Frontiers in Immunology, vol. 15, 2024, p. 1383973, https://doi.org/10.3389/fimmu.2024.1383973. Accessed 3 Oct. 2024.
  • Study aimed to investigate the pro-inflammatory state in PANS patients before and after IVIG treatment.
  • Ten male PANS patients (ages 6–16) received six IVIG infusions over 3 weeks.
  • Blood samples and psychiatric assessments were taken before treatment and at follow-up points (4 and 11 weeks post-treatment).
  • Myeloid cell activation was analyzed using flow cytometry.* Significant improvement in all psychiatric assessments and parent-reported outcomes (CY-BOCS, YGTSS, and PANS rating scales; all p<0.001).
  • Pro-inflammatory monocytes and dendritic cells significantly decreased after IVIG.
  • Reduction in pro-inflammatory monocytes was observed both proportionally and in absolute numbers.
Bennett’s PANS PANDAS Story
Bennett’s PANS PANDAS Story

  Bennett was a typically developing 7-year-old boy when he started second grade, the first year back to school full time after COVID-19, without masks. That December, he came down...

Read Story