Understanding PANS PANDAS: Insights from Those Who Live It
Straight from the Heart: Students and Young Adults Share About PANS PANDAS Download PDF version: What I Want My Friends to Know About PANS PANDAS ASPIRE surveyed students and...
PANS PANDAS Triumphs!
Recent PANS/PANDAS Triumphs Thank you to everyone who took a moment to celebrate your recent success. Your stories provide hope to other families and patients! Would you like to share...
Elevated antibody binding to striatal cholinergic interneurons in patients with pediatric acute-onset neuropsychiatric syndrome
Xu J, Frankovich J, Liu RJ, Thienemann M, Silverman M, Farhadian B, Willet T, Manko C, Columbo L, Leibold C, Vaccarino FM, Che A, Pittenger C. Elevated antibody binding to striatal cholinergic interneurons in patients with pediatric acute-onset neuropsychiatric syndrome. Brain Behav Immun. 2024 Jul 29:S0889-1591(24)00515-4. doi: 10.1016/j.bbi.2024.07.044. Epub ahead of print. PMID: 39084540.
- Children with PANS had lower levels of IgG antibodies (a type of immune protein) in their plasma during a symptom flare compared to matched controls.
- PANS IgG drawn at flare shows elevated binding to CINs in both mouse and human brain.
- PANS IgG binding to CINs reduces their activity using p-rpS6 as a marker.
- Reduction of PANS IgG binding to CINs parallels symptom improvement during recovery.
- Elevated IgG binding to CINs is resolved in the same subject during symptom recovery.
- The study suggests that at least a subset of PANS cases have a neuroimmune pathogenesis.
Strep Throat and the Backstory for PANS and PANDAS
Whelan JP. Strep Throat and the Backstory for PANS and PANDAS. JAMA Netw Open. 2024;7(7):e2421636. doi:10.1001/jamanetworkopen.2024.21636
- Longitudinal analysis (Ma et al.) of 193 children with PANS revealed that 28% developed arthritis over 4 years, showing unusual rheumatic profiles like Achilles enthesitis (56%), inflammatory back pain (64%), and sacroiliac joint tenderness (69%). Only 2% had typical childhood arthritis.
- Back pain is a common concern among Whelan’s 600 families, often challenging to differentiate true spondyloarthropathy from pain amplification due to poor sleep, which almost all PANS patients experience.
- Ultrasonography in 40 children found effusions or synovitis, suggesting real back arthritis in many.
- A high prevalence of antihistone antibodies (20%) may result from multiple medications. 55% of children with PANS also had a coincident eating disorder.
- Frequent infections in two-thirds of these children may explain elevated inflammatory markers and the abrupt onset of tics, OCD, and behavioral issues, possibly due to “PANDA-genic” bacterial strains in genetically susceptible hosts.
Enuresis as a presentation of paediatric autoimmune neuropsychiatric disorders associated with streptococcus (PANDAS)
See Poster.
- Out of the total cohort of 109 children, 56 patients (51%) had enuresis as a presenting symptom alongside their PANDAS symptoms.
- Enuresis is a common presentation of children with PANDAS (observed in 51% of cases). Early recognition of enuresis is important in promptly identifying PANDAS cases, allowing prompt investigation and treatment.
July 22, 2024
World Brain Day 2024
World Brain Day 2024 (WBD 2024), Monday, July 22, is dedicated to Brain Health and Prevention. World Brain Day must include a discussion on PANS/PANDAS. Help us by empowering individuals,...
July 12, 2024
Working Memory Supports with for Students with PANS PANDAS
Strategies and Accommodations for Supporting Students with Working Memory Challenges Students with PANS/PANDAS often face working memory, focus, and processing challenges. These strategies and...
There is HOPE for Healing
My name is Kyra Dugan. I’m 23 now, and five years ago, I would never have been able to guess what was about to happen. Life as I knew...
The human VGLUT3-pT8I mutation elicits uneven striatal DA signaling, food or drug maladaptive consumption in male mice
Favier M, Martin Garcia E, Icick R, de Almeida C, Jehl J, Desplanque M, Zimmermann J, Henrion A, Mansouri-Guilani N, Mounier C, Ribeiro S, Henderson F, Geoffroy A, Mella S, Poirel O, Bernard V, Fabre V, Li Y, Rosenmund C, Jamain S, Vorspan F, Mourot A, Duriez P, Pinhas L, Maldonado R, Pietrancosta N, Daumas S, El Mestikawy S. The human VGLUT3-pT8I mutation elicits uneven striatal DA signaling, food or drug maladaptive consumption in male mice. Nat Commun. 2024 Jul 7;15(1):5691. doi: 10.1038/s41467-024-49371-1. PMID: 38971801; PMCID: PMC11227582.
Read article in McGill Newsroom
“Working with mice, the researchers discovered that a deficit in the acetylcholine, a neurotransmitter in an area of the brain called the striatum, which is associated with the reward system, can lead to excessive habit formation and precipitate the compulsive self-starvation seen in people who suffer from anorexia nervosa.”
They investigated whether, “donepezil, a medication which is known to increase the presence of acetylcholine in the brain, could have an effect on these compulsive self-destructive behaviours.
““We found that it fully reversed the anorexia-like behaviour in mice, and we believe that it could potentially offer the first mechanism-based treatment of anorexia nervosa. In fact, we are already seeing its effects on some patients with the disease.”
PANDAS: Twenty-Five Years Later
Cardelle-Pérez, Federico & Greciano, María. (2024). PANDAS: Twenty-Five Years Later. Adolescent Psychiatry. 14. 10.2174/0122106766298492240320044542.
Discussion: A comprehensive approach, including interdisciplinary management and urgent evaluation of potential organic causes, is crucial for effective treatment. Treatment decisions should consider severity, symptoms, and available evidence. Collaboration with neuropediatric or neurological services is needed. ASLO/anti-DNase B and 25-OH-Vitamin D tests are valuable for atypical OCD/Tic presentations, always maintaining a broader organic screening.
Development of Autoimmune Diseases Among Children With Pediatric Acute-Onset Neuropsychiatric Syndrome
Ma M, Masterson EE, Gao J, Karpel H, Chan A, Pooni R, Sandberg J, Rubesova E, Farhadian B, Willet T, Xie Y, Tran P, Silverman M, Thienemann M, Mellins E, Frankovich J. Development of Autoimmune Diseases Among Children With Pediatric Acute-Onset Neuropsychiatric Syndrome. JAMA Netw Open. 2024 Jul 1;7(7):e2421688. doi: 10.1001/jamanetworkopen.2024.21688. PMID: 39078633; PMCID: PMC11289697.
Conclusions and relevance: This study found that patients with PANS show signs of immune activation and vasculopathy during psychiatric symptom flares and have an increased risk of developing arthritis and other autoimmune diseases compared with the general pediatric population. The most common arthritis subtype was enthesitis-related arthritis. These findings suggest that PANS may be part of a multisystem inflammatory condition rather than an isolated psychiatric or neuroinflammatory disorder.
June 26, 2024
IVIG Trial Recruitment is Closed
Octapharma/PACE Foundation IVIG Trial Update: 6-26-24 Read the Announcement from the PACE Foundation. Given the recent changes posted on ClinicalTrials.Gov, we wanted to update...