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Association of Pediatric Acute-Onset Neuropsychiatric Syndrome With Microstructural Differences in Brain Regions Detected via Diffusion-Weighted Magnetic Resonance Imaging

Study: Zheng J, Frankovich J, McKenna ES, et al. Association of Pediatric Acute-Onset Neuropsychiatric Syndrome With Microstructural Differences in Brain Regions Detected via Diffusion-Weighted Magnetic Resonance Imaging. JAMA Network Open. 2020;3(5):e204063. doi:10.1001/jamanetworkopen.2020.4063 

For a more in-depth examination of this study see – Association of PANS With Microstructural Brain Differences on Diffusion MRI Blog

  • Sample: 34 patients with PANS vs 64 controls.
  • Main finding: Higher diffusivity (ADC) across all examined brain regions in PANS, most pronounced in deep gray matter (thalamus, basal ganglia, amygdala).
  • What did not differ: No significant group differences in brain volume; cerebral blood flow differences were limited.
  • Clinical takeaway (authors): DWI may provide quantitative information that could assist the diagnostic workup; further prospective study needed.
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Benefits of IVIG in Pediatric Acute-Onset Neuropsychiatric Syndrome

Benefits of IVIG in Pediatric Acute-Onset Neuropsychiatric Syndrome

Isaac Melamed, Roger Kobayashi, Maeve O’Connor, Ai Lan Kobayashi, Andrew Schechterman, Melinda Heffron, Sharon Canterberry, Holly Miranda, Nazia Rashid Neurology Apr 14 2020, 94

“Conclusions: In PANS, which may be associated with an underlying immune dysregulation, IVIG [Octagam 5%] successfully ameliorated psychological symptoms and dysfunction, with sustained benefits for at least 8 weeks, and up to 46 weeks, following the final infusion. In addition, baseline immune and autoimmune profiles demonstrated significant elevations in a majority of subjects, which requires further evaluation, characterization, and study to clarify the potential immune dysfunction by which PANS manifests and progresses.”