MIND-BODY LINK? More research supports a link between pediatric strep throat and obsessive disorders
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Can a case of strep throat lead to a mental disorder? Some children seem to acquire behaviors associated with obsessive-compulsive disorder (OCD) after being infected with the Streptococcus bacterium, but for decades skeptics have claimed the connection is nothing but a coincidence. Now a new study in mice offers compelling evidence that strep can indeed affect the mind.
In the 1980s Susan Swedo, a pediatrician at the National Institute of Mental Health, came across several cases of children who seemed to have developed tics and behaviors resembling OCD, such as excessive hand washing, overnight. Swedo noticed that the children in all the cases had recently recovered from strep throat. The traditional strep symptoms were gone, but when she did laboratory tests, Swedo found the children’s blood still contained high levels of strep antibodies. Perhaps most compelling, the symptoms seemed to abate after renewed treatment with antibiotics. Swedo became convinced that the symptoms were the result of an overactive immune response to strep bacteria. She suggested a new diagnosis called “pediatric autoimmune neuropsychiatric disorders associated with strep,” or PANDAS.
Because strep throat is quite common in youngsters, many people claimed Swedo’s evidence was more coincidence than fact. Still, she has amassed a fair amount of clinical data over the years and has managed to win over many of her critics. The new study, conducted by researchers at Columbia University’s Center for Infection and Immunity, promises to sway many of the holdouts by providing the first conclusive evidence that strep antibodies can induce neurological and psychiatric symptoms in healthy animals.
The researchers started by injecting mice with strep bacteria. Then they injected a new set of mice with strep antibodies from the infected mice. The researchers found that not only did both sets of mice exhibit the same behavioral symptoms—including anxiety and compulsive rearing and flipping—but that the behaviors appeared to be linked to antibody deposits in brain areas that have been implicated in human studies. Other groups have attempted to induce PANDAS in animals, says James Leckman, a pediatric psychiatry researcher at Yale University, who was not involved in the study, but the results from those studies were inconsistent. “The design they used for this paper was much clearer,” he says.
Mady Hornig, the principal researcher behind the Columbia study, is now working with Swedo to apply the animal findings to a clinical setting. “We hope the mouse PANDAS model can help refine the diagnostics for the human disorder,” Hornig says. A more accurate method of diagnosing PANDAS could help get affected kids the right treatment—and Swedo estimates that these kids may make up as much as 25 percent of children diagnosed with OCD and tic disorders, such as Tourette syndrome. Farther down the road, the newly developed PANDAS mice could allow researchers to devise better or more specific treatments than the antibiotic regimens currently being used.
This article was originally published with the title From Throat to Mind.
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21 Comments
Add CommentPerhaps this will put a damper on those who advocate against the use of antibiotics for strep throat.
Reply | Report Abuse | Link to thisPANDAS is cute but doesn't convey the nature of the thing. How about Streptocuckoo? ;)
Reply | Report Abuse | Link to thisI predict that autoimmune dysfunction will eventually be determined a significant underlying factor in a variety of psychiatric conditions, ranging from OCD to Tourette's and forms of mild autism. This is an important study, and hopefully revive broader interest in PANDAS - a condition too many dismissed without adequate consideration or investigation.
Reply | Report Abuse | Link to thisRead "Saving Sammy: Curing the Boy Who Caught OCD" by Beth Alison Maloney. This is exactly what happened to Sammy. He was diagnosed mental illness without thought of an infection being in the mix. After long term antibiotic treatment Sammy's fully recovered, off all meds, and a successful college student at Carnegie Mellon. www.savingsammy.net
Reply | Report Abuse | Link to thisHeaven forbid this is true of everyone who has had strep! I had it in it's severest form at age 5 after having a succession of illnesses, (German measles, red measles, whooping cough) then strep. I had a fever of 105 degrees up and down for a total of five days and didn't know my own parents during that time. I did have learning disabilities for which I was punished severely by my second grade teacher. I do sometimes have panic attacks but I have a very active mind and a strong desire to learn and help others. (Is that being mentally challenged?) I love people but at times do not feel able to socialize, having a fear that is unreasonable. Does this all relate to what is being talked about here?
Reply | Report Abuse | Link to thisThere exist significant individual differences between us people. They exist in respect of our individual genetic make-up and by that we are being influenced by and get to interact with - hence become in every known (and unknown) way 'conditioned' by - different environmental sources of lifetime challenges (not just different kinds of "adversities" but "opportunities" too).
Reply | Report Abuse | Link to thisThe by you mentioned unwanted personal symptoms may be best explained, and may (or may not) be more possible to recover from or remedy, if one consider the possibility that they are neural ('psychophysiological') aftereffects of 'traumatizing' predicaments that you have been in;
IOW "specific hibernation imploring (and inducing) type" stressors that you've became challenged by and did automatically cope with by means of (thanks to the evolved inhibitory neural functions responsible for) "specific hibernation".
["Specific (/synaptic) hibernation" is best understood through a comparison with "general hibernation" - i.e. mainly hibernation and aestivation. ]
I'm in my 60s & suffered from strep throat for many years; given penicillin until age 16 when my throat swelled so much I couldn't eat; may have resulted in heart murmur. I'm not so sure that makes the connection for me.
Reply | Report Abuse | Link to thiswhat Haemophilus did to strep http://blog.donnawilliams.net/2010/01/11/when-haemophilus-met-strep/
Reply | Report Abuse | Link to thisWhen Haemophilus met Strep – a black widow love story http://blog.donnawilliams.net/2010/01/11/when-haemophilus-met-strep/
Reply | Report Abuse | Link to thiswhat's more, if you have IgG deficiency you can't fight Strep or Haemophilus bugs.
Reply | Report Abuse | Link to thisstrep is widely known to jump to the heart (rheumatoid fever) and the kidneys (nephritis). I've been there and you don't want (your kids) to go there.
Reply | Report Abuse | Link to thisstrep is widely known to jump to the heart (rheumatoid fever) and the kidneys (nephritis). I've been there and you don't want (your kids) to go there.
Reply | Report Abuse | Link to thisYou don't want to skip antibiotics. Strep also jumps to heart (rheumatoid fever) and kidneys (nephritis). I've been there and you don't want (your kids) to go there.
Reply | Report Abuse | Link to thisIf you are IgG deficient you cannot fight Strep or Haemophilus
Reply | Report Abuse | Link to thisIf you recognize rheumatic fever; ie. carditis,arthritis,chorea .....then accepting PANDAS should not be that implausible.
Reply | Report Abuse | Link to thisDUH
our 7, 8, and 10 year old sons all were sick while my husband and I were out of town. Grandma treated with Advil and when we returned in 2 days, it appeared as though they just had soar throats and we never went to the doctor.....2 weeks later the 8 year old had body parts swelling and a strange rash. Doctors recognized it as HSP: a rare autoimmune followed by Strep illness. However at the same exact time our 10 year old seemed to have become OCD over night! 2 months later and we are just finding that he may have PANDAS. If HSP is a recognized autoimmune illness from strep then why the hesitation to believe that PANDAS may be real? I guess you need to have a body part swell or a rash...is seeing always believing?......
Reply | Report Abuse | Link to thisOur 7, 8, and 10 year old sons were ill while my husband and I were out of town. Grandma gave them Advil and 2 days later we returned to find that they seemed to just have mild soar throats. Never went to the doctor... two weeks later and the 8 year old had body parts swell, a strange rash and could not walk. Doctors found the cause to be HSP: a rare autoimmune illness followed by Strep. Found that he did still have a bit of strep in his system. At the exact same time our 10 year old seemed to become OCD overnight and have strange thoughts and behaviors. 2 months later and we are learning about PANDAS. What is the hesitation to accept that this could be a real illness. If odd things like HSP can be an autoimmune followed by strep illness...why is it so hard to believe that PANDAS can be real? Do you need to SEE body parts swell or weird rashed? Is seeing really the only way to believe?
Reply | Report Abuse | Link to thisI agree with this research from recent personal experience. My sister's grandson 17 developed heart valve symptoms and I noticed OCD symptoms. He had sore throat in his adolosence
Reply | Report Abuse | Link to thisI was able to help him with his heart problem with homeopathy but did not see any improvement in his OCD situation. This was some 3 months ago.
Refresh the Research! Vote Project P.A.N.D.A.S.
Reply | Report Abuse | Link to thishttp://www.refresheverything.com/PANDAS
A very nice article. Somehow folks seem to forget Scarlet Fever (or Acute Rheumatic Fever). About 3-5% of the population are genetically predisposed to ARF. Of those, about 20% are exposed to a Rheumatic strain of strep. Of those about 20% go "untreated". Of those, about 30% get Sydenham Chorea and of those about 70% get OCD. Generally kid 5-14 have the highest incidence of exposure. So for ~39M children, this means about 10,000 are susceptible to OCD following ARF.
Reply | Report Abuse | Link to thisI am very interested in this. My daughter who is normally carefree and relaxed has recently been exhibiting high anxiety and worry about school. We finally just had her diagnosed with strep throat. She also has Celiac Disease so I am wondering if there is a connection there. We are hoping the antibiotics will clear things up.
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