Author: Brandon Copping
In recent decades childhood psychiatric disorders, such as ADHD and autism, have become increasingly prevalent topics in terms of pediatric research and clinical interest. Of particular interest to clinicians and scientists alike are the causes of these disorders. If we are able to determine the root causes of these disorders, then developing treatments, cures, or possibly preventative measure might become all that much more probable. One of the hypothetical causes of certain psychiatric disorders has been called PANDAS. PANDAS, which stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections, is a category of psychiatric disorders that present in childhood that are all hypothesized to have the same root cause. That cause is the body’s overreaction to infection by group A beta-hemolytic Streptococcal bacteria (abbreviated as GABHS), a class of the same group of bacteria that cause diseases like strep throat. What is believed to happen during a pediatric infection with GABHS is that the immune system creates antibodies, as it would for any invading pathogen (foreign disease-causing agent), but something goes wrong. Some of these antibodies cross the blood-brain barrier (a special structure that provides special protection to the brain) and end up targeting different cells in a brain region known as the basal ganglia. This causes inflammation in the brain, leading to damage that results in the onset of symptoms of disorders such as OCD and Tourette’s Syndrome to develop. As scary as brain inflammation may sound, there is a sort of morbid silver lining to PANDAS. Namely, the inflammation present in cases of PANDAS tends to decrease in severity over time after the infection with GABHS is cleared up. Contrary to this, the inflammation observed in cases of Tourette’s Syndrome not associated with PANDAS does not decrease over time.
Since PANDAS is a possible root cause of disorders such as OCD, Tourette’s Syndrome, and possibly more, understanding as much about it as possible could provide insights into how many different kinds of psychiatric disorders develop. Given that a general version of the mechanism is fairly well understood and agreed upon, the main target of future research on PANDAS going forward is more than likely going to focus on risk factors as well as potential treatments, especially since these would be the top concern of parents whose children have been diagnosed with PANDAS. For instance, a parent who has an autoimmune disorder may wonder if their child is at a higher risk for developing PANDAS. As it turns out, there has been shown to be a correlation between the presence of autoimmune disorders in immediate family members and the risk of a child being diagnosed with PANDAS after a GABHS infection. Luckily, however, there does not appear to be a high rate of comorbidity (having multiple diseases simultaneously) between PANDAS and any other specific autoimmune disorders.
Once their child has been diagnosed with PANDAS, parents will certainly begin to wonder what their options are for treatment. Unfortunately, there has yet to be a treatment discovered specifically for treating PANDAS. Until such treatments are available, the current best course of action is to treat the disorders that manifest as one would with any other case of them. This often includes cognitive behavioral therapy and possibly medications if the psychiatric disorder that manifests is severe enough to warrant such treatment. There is still hope, however, because there have been some treatments that have been shown to work specifically on PANDAS patients. Unfortunately, these treatments do not work for everyone with PANDAS so what worked for one patient may not necessarily work for another.
Overall, PANDAS is a very important topic for not only pediatric clinical research but also as a way to learn more about how autoimmune disorders crop up throughout one’s lifetime. What makes PANDAS especially interesting is that, as can be seen in its name, it is purely a pediatric disorder. As far as my research has found, there is no adult version of PANDAS, suggesting that being a child must have some important role to play in the onset of these associated disorders that changes when maturing. Luckily for parents, there is nothing life threatening about PANDAS, and treatments already in use for treating OCD and Tourette’s Syndrome can be applied to treating children with PANDAS making this disorder manageable given proper care.
For more information, please visit the PANDAS theme pages!
Why PANDAS is important:
What is PANDAS and Why is it an Important Disorder to Study?
Risk Factors for Developing PANDAS:
Mechanism of PANDAS:
Treatment of PANDAS:
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