Posts by:
Gabriella True

The Story of Emily The Great
The Story of Emily The Great

This is the journey of Emily, who is now 16. She began experiencing PANS symptoms in 2020 during the height of COVID-19; before that, Emily was a typical kid and did all the things that girls her age...

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Obsessive Compulsive Disorder and Other Specified Anxiety Disorder in an 8-Year-Old Post-respiratory Infection: A Case Report

Tran, Michael; Amador, Alcides; and Camacho Bermudez, Sofia, “Obsessive Compulsive Disorder and Other Specified Anxiety Disorder in an 8-Year-Old Post-respiratory Infection: A Case Report” (2024). Research Colloquium. 91.https://scholarworks.utrgv.edu/colloquium/2024/posters/91

Conclusions: This case underscores the importance of considering infectious etiologies in the differential diagnosis of sudden-onset psychiatric symptoms in pediatric patients. The positive response to Sertraline and the proposed CBT highlights the potential benefits of a combined pharmacological and therapeutic approach in managing OCD and anxiety disorders. Continued follow-up and treatment adaptation is essential to ensure sustained improvement and quality of life for pediatric patients with similar presentations.

A population-based multigenerational family co-aggregation study of severe infections and obsessive-compulsive disorder

Pol-Fuster J., Fernández de la Cruz L., Beucke J., Hesselmark E., Crowley J.J., de Schipper E., Brikell I., Chang Z., D’Onofrio B.M., Larsson H., Lichtenstein P., Kuja-Halkola, R. & Mataix-Cols D., A population-based multigenerational family co-aggregation study of severe infections and obsessive-compulsive disorder, Biological Psychiatry (2024), doi: https://doi.org/10.1016/ j.biopsych.2024.09.004.

This large population-based study in Sweden investigated the potential link between severe infections and obsessive-compulsive disorder (OCD) through a familial co-aggregation approach. By analyzing data from over 4.9 million individuals born between 1960 and 2008, researchers explored the risk of OCD among relatives of those with severe infections, spanning varying degrees of genetic relatedness. The study found that the risk of OCD increased with closer genetic ties, with monozygotic twins showing the highest correlation. A dose-response relationship between the number of infections and the odds of OCD was also identified. These findings remained robust even after adjusting for comorbid autoimmune disorders and infections in relatives. The results suggest that genetic factors play a significant role in the observed association, pointing to shared genetic susceptibilities between infections and OCD. This supports the idea that genetic pleiotropy—where the same genes influence multiple traits—may contribute to both infection susceptibility and OCD risk. The study highlights the importance of considering both genetic and environmental factors in understanding OCD development.

Reliability and validity of a newly developed PANDAS/PANS questionnaire
Bleibach A, Sørensen CB, Skov L, Christensen KB, Debes NM. Reliability and validity of a newly developed PANDAS/PANS questionnaire. Eur J Paediatr Neurol. 2024 Sep;52:109-130. doi: 10.1016/j.ejpn.2024.07.008. Epub 2024 Jul 15. PMID: 39232358.
The validity and clinical feasibility of the PANDAS/PANS questionnaire were confirmed as an effective tool for screening symptoms, assessing symptom severity, and evaluating comorbidity and daily life impairment in individuals with PANDAS/PANS. These findings can potentially enhance the management of PANDAS/PANS patients in both clinical and research settings.
Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS): Immunological Features Underpinning Controversial Entities

Leonardi L, Perna C, Bernabei I, Fiore M, Ma M, Frankovich J, Tarani L, Spalice A. Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS): Immunological Features Underpinning Controversial Entities. Children. 2024; 11(9):1043. https://doi.org/10.3390/children11091043

 

 

 

Cerebrospinal fluid characteristics of patients presenting for evaluation of pediatric acute-neuropsychiatric syndrome

Pooni R, Zheng W, Ma M, Silverman M, Xie Y, Farhadian B, Thienemann M, Mellins E, Frankovich J. Cerebrospinal fluid characteristics of patients presenting for evaluation of pediatric acute-neuropsychiatric syndrome. Front Behav Neurosci. 2024 Aug 19;18:1342486. doi: 10.3389/fnbeh.2024.1342486. PMID: 39224487; PMCID: PMC11367679.

This study found that about a quarter of patients meeting strict PANS criteria who underwent lumbar punctures (LP) had cerebrospinal fluid (CSF) abnormalities, with the most common being elevated CSF protein and albumin quotient. These patients also exhibited signs of inflammation and autoimmunity, such as low complement levels, high immune complexes, non-specific autoantibodies, vasculopathy, and arthritis.

Interestingly, the “other psychiatric deterioration” group—those referred for PANS but not meeting strict criteria—had an even higher frequency (45%) of CSF abnormalities. Many of these patients also showed systemic inflammation, with conditions like thyroiditis and arthritis, and had symptoms overlapping with PANS, including obsessive-compulsive behaviors and food restrictions.

Both groups demonstrated a notable prevalence of arthritis, emphasizing systemic inflammation’s potential role, possibly affecting the blood-brain barrier (BBB). While the study was not designed to assess the significance of these differences, it suggests an overlap in psychiatric symptoms and inflammatory features across the groups, which may involve complement activation and vascular inflammation, similar to what’s seen in Long Covid.