Streptococcal Upper Respiratory Tract Infections and Exacerbations of Tic and Obsessive-Compulsive Symptoms: A Prospective Longitudinal Study
James F. Leckman,Robert A. King,Donald L. Gilbert,Barbara J. Coffey,Harvey S. Singer,Leon S. Dure,Heidi Grantz,Liliya Katsovich,Haiqun Lin,Paul J. Lombroso,Ivana Kawikova,Dwight R. Johnson,Roger Kurlan,Edward L. Kaplan +13 more
TLDR
This study provides no evidence for a temporal association between GABHS infections and tic/OC symptom exacerbations in children who meet the published PANDAS diagnostic criteria.Abstract:
Objective The objective of this blinded, prospective, longitudinal study was to determine whether new group A β hemolytic streptococcal (GABHS) infections are temporally associated with exacerbations of tic or obsessive-compulsive (OC) symptoms in children who met published criteria for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS). A group of children with Tourette syndrome and/or OC disorder without a PANDAS history served as the comparison (non-PANDAS) group. Method Consecutive clinical ratings of tic and OC symptom severity were obtained for 31 PANDAS subjects and 53 non-PANDAS subjects. Clinical symptoms and laboratory values (throat cultures and streptococcal antibody titers) were evaluated at regular intervals during a 25-month period. Additional testing occurred at the time of any tic or OC symptom exacerbation. New GABHS infections were established by throat swab cultures and/or recent significant rise in streptococcal antibodies. Laboratory personnel were blinded to case or control status, clinical (exacerbation or not) condition, and clinical evaluators were blinded to the laboratory results. Results No group differences were observed in the number of clinical exacerbations or the number of newly diagnosed GABHS infections. On only six occasions of a total of 51 (12%), a newly diagnosed GABHS infection was followed, within 2 months, by an exacerbation of tic and/or OC symptoms. In every instance, this association occurred in the non-PANDAS group. Conclusions This study provides no evidence for a temporal association between GABHS infections and tic/OC symptom exacerbations in children who meet the published PANDAS diagnostic criteria.read more
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Disease Manifestations and Pathogenic Mechanisms of Group A Streptococcus
Mark J. Walker,Timothy C. Barnett,Jason D. McArthur,Jason N. Cole,Jason N. Cole,Christine M. Gillen,Anna Henningham,Anna Henningham,Kadaba S. Sriprakash,Martina L. Sanderson-Smith,Victor Nizet,Victor Nizet +11 more
TL;DR: Genomic and molecular analyses have now characterized a large number of GAS virulence determinants, many of which exhibit overlap and redundancy in the processes of adhesion and colonization, innate immune resistance, and the capacity to facilitate tissue barrier degradation and spread within the human host.
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Practice Parameter for the Assessment and Treatment of Children and Adolescents With Obsessive-Compulsive Disorder
Daniel A. Geller,John S. March +1 more
TL;DR: The present article highlights the clinical assessment and reviews and summarizes the evidence base for treatment and specific recommendations are provided for assessment, cognitive behavioral therapy, pharmacotherapy, combined treatment, and other interventions.
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From Research Subgroup to Clinical Syndrome: Modifying the PANDAS Criteria to Describe PANS (Pediatric Acute-onset Neuropsychiatric
TL;DR: Modifying the PANDAS criteria to eliminate etiologic factors and to clarify the initial clinical presentation produced three potential diagnostic criteria for PANS, which are discussed in detail.
Journal ArticleDOI
Clinical evaluation of youth with pediatric acute-onset neuropsychiatric syndrome (PANS): recommendations from the 2013 PANS Consensus Conference.
Kiki D. Chang,Jennifer Frankovich,Michael Cooperstock,Madeleine W. Cunningham,M. Elizabeth Latimer,Tanya K. Murphy,Mark S. Pasternack,Margo Thienemann,Kyle Williams,Jolan E. Walter,Susan E. Swedo +10 more
TL;DR: A consensus statement is presented proposing recommendations for the diagnostic evaluation of youth presenting with PANS and the most urgently needed studies in this field are set forth.
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Neurobiology of Tourette Syndrome: Current Status and Need for Further Investigation
Ryan J. Felling,Harvey S. Singer +1 more
TL;DR: Evidence supports TS being an inherited disorder; however, the precise genetic abnormality remains unknown and a dopaminergic dysfunction is considered a leading candidate.
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