Neuroinflammation in Obsessive-Compulsive Disorder : Sydenham Chorea, Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, and Pediatric Acute Onset Neuropsychiatric Syndrome - 04/02/23

Doi : 10.1016/j.psc.2022.11.004

Allison Vreeland, PhD ^a,^b,^{^{1
Present address: Stanford Univeristy, School of Medicine, 700 Welch Road, Suite 301, Palo Alto, CA 94304.},}^⁎ , Margo Thienemann, MD ^a,^b,^{^{1
Present address: Stanford Univeristy, School of Medicine, 700 Welch Road, Suite 301, Palo Alto, CA 94304.}}, Madeleine Cunningham, PhD ^c,^{^{2
Present address: University of Oklahoma Helath Sciences Center, Biomedical Research Center Room 217, 975 NE 10th Street, Oklahoma City, OK 73104.}}, Eyal Muscal, MD, MS ^d,^{^{3
Present address: Texas Medical Center, 6701 Fannin Street, 11th Floor, Houston, TX, 77030.}}, Christopher Pittenger, MD, PhD ^e,^{^{4
Present address: Connecticut Mental Health Center, 34 Park Street, W333b, New Haven, CT 06519.}}, Jennifer Frankovich, MD, MS ^b,^f,^{^{1
Present address: Stanford Univeristy, School of Medicine, 700 Welch Road, Suite 301, Palo Alto, CA 94304.}}
^a Division of Child and Adolescent Psychiatry and Child Development, Department of Psychiatry, Stanford University School of Medicine, Stanford, CA, USA
^b Stanford Children's Health, PANS Clinic and Research Program, Stanford University School of Medicine, Stanford, CA, USA
^c Department of Microbiology and Immunology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
^d Department of Rheumatology, Texas Children’s Hospital, Houston, TX, USA
^e Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
^f Division of Pediatrics, Department of Allergy, Immunology, Rheumatology, Stanford University School of Medicine, Stanford, CA, USA

^∗Corresponding author. 700 Welch Road, Suite 301, Palo Alto, CA 94304.700 Welch Road, Suite 301Palo AltoCA94304

Résumé

Sydenham chorea (SC), pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) and pediatric acute-onset neuropsychiatric syndrome (PANS) are postinfectious neuroinflammatory diseases that involve the basal ganglia and have obsessive-compulsive disorder as a major manifestation. As is true for many childhood rheumatological diseases and neuroinflammatory diseases, SC, PANDAS and PANS lack clinically available, rigorous diagnostic biomarkers and randomized clinical trials. Research on the treatment of these disorders depend on three complementary modes of intervention including: treating the symptoms, treating the source of inflammation, and treating disturbances of the immune system. Future studies should aim to integrate neuroimaging, inflammation, immunogenetic, and clinical data (noting the stage in the clinical course) to increase our understanding and treatment of SC, PANDAS, PANS, and all other postinfectious/immune-mediated behavioral disorders.

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Keywords : Pediatric acute-onset neuropsychiatric syndrome, Pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections, Obsessive compulsive disorder