Scientists propose explanation for baffling form of childhood OCD

Date:
June 16, 2020
Source:
Yale University
Summary:
Scientists may have found a cause for the sudden onset of obsessive-
compulsive disorder (OCD) in some children, they report. Pediatric
autoimmune neuropsychiatric disorders, or PANDAS, were first
proposed in the 1990s. Thought to be triggered by streptococcal
infections, they account for an unknown portion of youth OCD
cases. But the biology underpinning this disorder has baffled
scientists.



FULL STORY ==========================================================================
Yale scientists may have found a cause for the sudden onset of obsessive- compulsive disorder (OCD) in some children, they report.


========================================================================== Pediatric autoimmune neuropsychiatric disorders, or PANDAS, were
first proposed in the 1990s. Thought to be triggered by streptococcal infections, they account for an unknown portion of youth OCD cases. But
the biology underpinning this disorder has baffled scientists.

The new Yale research, published June 16 in the American Journal of
Psychiatry, identifies antibodies that bind to particular brain cells
called interneurons as an explanation.

"It is really OCD plus," said senior author Christopher Pittenger,
assistant chair for translational research, associate professor of
psychiatry and a researcher in the Yale Child Study Center. "These
children have OCD, but they can also have severe separation anxiety,
subtle motor symptoms, and show frequent need to urinate. Many refuse
to eat." While 1% to 3% of children will be diagnosed with OCD by the
age of 17, the fraction of OCD cases that can be attributed to PANDAS
is unknown. Some doctors say there is not enough evidence to support
PANDAS as a distinct diagnosis from OCD. Others, including many parents
of children with the syndrome, argue it may account for a large subset
of children with OCD.

Pittenger and his team decided to explore the biology of the disorder
in a series of experiments involving 27 children who met the strictest
criteria for a PANDAS diagnosis and 23 control subjects.

They found that many children with a PANDAS diagnosis possess high
levels of an antibody that can attack specific interneurons -- neurons
that modify the signaling of other nearby cells. These antibodies are concentrated in the striatum, an area of the brain that is associated
with voluntary motor control, among other functions, and is known to be involved in OCD. When the antibody binds to these neurons, it reduces
their activity.

PANDAS is "real, but probably rare," Pittenger said.

Adults with Tourette syndrome, a related syndrome characterized by vocal
and motor tics, lack the same specific striatal interneurons, suggesting
that problems with these cells may play a role in several conditions,
Pittenger noted.

His lab aims to explore this biology in other children with OCD and
Tourette syndrome to see how widespread interneuron-binding antibodies
are in this group of related conditions.

Yale's Jian Xu is the paper's first author. The work was principally
funded by the National Institute of Mental Health.


========================================================================== Story Source: Materials provided by Yale_University. Original written
by Bill Hathaway. Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Jian Xu, Rong-Jian Liu, Shaylyn Fahey, Luciana Frick, James Leckman,
Flora Vaccarino, Ronald S. Duman, Kyle Williams, Susan Swedo,
Christopher Pittenger. Antibodies From Children With PANDAS Bind
Specifically to Striatal Cholinergic Interneurons and Alter Their
Activity. American Journal of Psychiatry, 2020; appi.ajp.2020.1 DOI:
10.1176/ appi.ajp.2020.19070698 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/06/200616083222.htm

--- up 21 weeks, 2 hours, 34 minutes
* Origin: -=> Castle Rock BBS <=- Now Husky HPT Powered! (1337:3/111)