Journal of the American Academy of Child & Adolescent Psychiatry
New researchStreptococcal Upper Respiratory Tract Infections and Exacerbations of Tic and Obsessive-Compulsive Symptoms: A Prospective Longitudinal Study
Section snippets
Subjects
All subjects were sequentially enrolled at one of six clinical settings (Yale University, Cincinnati Children's Hospital Medical Center, New York University Child Study Center, Johns Hopkins University School of Medicine, University of Alabama at Birmingham, and University of Rochester School of Medicine) during a 4-year 6-month period from July 2002 to December 2006. Approval by the institutional review boards was obtained at all sites.
Case subjects met all five of the published diagnostic
Description of Study Cohort
Apart from age, the PANDAS cases and the non-PANDAS comparison group had similar demographic and clinical characteristics (Table 1). As a consequence, all case and control comparisons included age as a covariate.
Exacerbations
The PANDAS cases and the non-PANDAS cases had very similar rates of tic and/or OC symptom exacerbations (PANDAS: 0.45 per person per year; non-PANDAS: 0.42 per person per year; Table 2). The relative risk for PANDAS versus non-PANDAS after controlling for age was 1.27 (95% confidence
Discussion
In this prospective, blinded, case-control study of children who met published diagnostic criteria for PANDAS, there was no temporal association between clinical exacerbations and antecedent GABHS infections documented by microbiologic and/or immunologic criteria. The number of hits was larger in the non-PANDAS cases than in the PANDAS cases, although this difference was not statistically significant. Our findings support those from earlier previous prospective, blinded, case-control study in
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2020, Journal of Clinical NeuroscienceCitation Excerpt :The correlation between the pathophysiology of TS/CTD and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) remains unclear [40,41]. However, a prospective longitudinal study reported no evidence for a temporal association between group A β hemolytic streptococcal infections and tic symptom exacerbations in children [42]. A possible confounder of the relationship between TS/CTD and PANDAS could be oral respiration, which is associated with both tics and upper respiratory infection [43].
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2020, Rosenberg’s Molecular and Genetic Basis of Neurological and Psychiatric Disease: Volume 2
This article was reviewed under and accepted by Ad Hoc Editor Daniel S. Pine, M.D.
This research was funded in part by the Tourette Syndrome Association and the National Institutes of Health, grants (R01MH061940 (J.F.L.); K05 MH076273 (J.F.L.); K02 MH01527 (P.J.L.); M01RR006022; and RR00125).
Disclosure: Dr. Leckman has received research support from the National Institutes of Health and the Tourette Syndrome Association. He has received salary support from the National Institutes of Health. He has received support from the Klingenstein Third Generation Foundation from the medical student fellowship program. He has received royalties from John Wiley and Sons, McGraw Hill, and Oxford University Press. Dr. Coffey receives research support from Boehringer Ingelheim, Bristol-Myers Squibb, Eli Lilly and Co., the National Institute of Mental Health, the National Institute of Neurological Disorders and Stroke, and the Tourette Syndrome Association. She has served on the advisory board for Jazz Pharmaceuticals, Eli Lilly and Co., Novartis, and the Tourette Syndrome Association. She has served on the speakers' bureau for the Tourette Syndrome Association. Dr. Singer has received research and salary support from the National Institutes of Health. He has received royalties from Elsevier and has served as an editor for the journal Neurolograd. Dr. Gilbert has received honoraria from the American Academy of Pediatrics, the Tourette Syndrome Association/Center for Disease Control, the Movement Disorder Society, and the American Academy of Neurology. He has served on the advisory board for the Tourette Syndrome Association. He has received research support from the National Institutes of Health, Cincinnati Children's Hospital Research Foundation, the University of Cincinnati, and the Tourette Syndrome Association. He will receive salary support for clinical research from the Genzyme Corporation, Otsuka Pharmaceuticals, and Psyadon Pharmaceuticals. Dr. Kurlan has received research support from the National Institutes of Health, the Centers for Disease Control, the Michael J. Fox Foundation, Neurologix, Boehringer Ingelheim, and Kyowa. He has received salary support from the National Institutes of Health, Neurologix, Boehringer Ingelheim, and Kyowa. Dr. Lombroso has received research and salary support from the National Institute of Mental Health, the Institute for the Study of Aging, the American Health Assistant Foundation, and the Fragile X Foundation. Drs. King, Dure, Lin, Kawikova, and Kaplan, Ms. Grantz, Mr. Johnson, and Ms. Katsovich report no biomedical financial interests or potential conflicts of interest.