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OCD

Microglial Dysregulation in OCD, Tourette Syndrome, and PANDAS
Luciana Frick, Christopher Pittenger, “Microglial Dysregulation in OCD, Tourette Syndrome, and PANDAS”, Journal of Immunology Research, vol. 2016, Article ID 8606057, 8 pages, 2016. https://doi.org/10.1155/2016/8606057

Mechanisms by which microglial abnormalities contribute to disease are likely to be shared across distinct etiologies and traditional diagnoses. For instance, abnormal synaptic pruning was observed both in animals inoculated with GAS (which may capture key elements of the pathophysiology of PANDAS) and in mice that develop excessive grooming after inactivation of the progranulin gene. In both cases, increased synaptic pruning cooccurs with microglia activation.

N-acetyl cysteine in the treatment of obsessive compulsive and related disorders: a systematic review
Oliver G, Dean O, Camfield D, Blair-West S, Ng C, Berk M, Sarris J. N-acetyl cysteine in the treatment of obsessive compulsive and related disorders: a systematic review. Clin Psychopharmacol Neurosci. 2015 Apr 30;13(1):12-24. doi: 10.9758/cpn.2015.13.1.12. PMID: 25912534; PMCID: PMC4423164.
    • 4 clinical trials, 5 case reports/series.
    • NAC (2,400-3,000 mg/day) showed symptom reduction and good tolerability.
    • 3 ongoing trials for OCD (2 adult, 1 pediatric) and 1 for excoriation.
  • Conclusions: Promising results from pilot studies, with potential for future research.
Case Study: A New Infection-Triggered, Autoimmune Subtype of Pediatric OCD and Tourette’s Syndrome
Allen AJ, Leonard HL, Swedo SE. Case study: a new infection-triggered, autoimmune subtype of pediatric OCD and Tourette’s syndrome. J Am Acad Child Adolesc Psychiatry. 1995 Mar;34(3):307-11. doi: 10.1097/00004583-199503000-00015. PMID: 7896671.

A review of clinical observations and literature reports leads to the hypothesis that, via a process analogous to Sydenham’s chorea, infections with group A β-hemolytic streptococci, among others, may trigger autoimmune responses that cause or exacerbate some cases of childhood-onset obsessive-compulsive disorder (OCD) or tic disorders (including Tourette’s syndrome).