PANDAS, PANS, Pediatric Acute-Onset Neuropsychiatric Syndrome, Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections
Conditions
Keywords
PANS, PANDAS
Brief summary
This study is an investigation of the neurologic, immunologic, and rheumatologic markers of Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS). PANS is a condition characterized by the abrupt, dramatic onset of obsessive compulsive disorder (OCD) and/or eating restriction accompanied by equally abrupt and severe co-morbid neuropsychiatric symptoms, which include anxiety, emotional lability, depression, irritability, aggression, oppositionality, deterioration in school performance, behavioral (developmental) regression, sensory amplification, movement abnormalities, sleep disturbance, and urinary frequency. PANS is thought to be caused by infection, inflammation, or alternate triggers that is associated with a brain response that leads to these symptoms. The purpose of this study is to examine specific neurologic, immunologic, rheumatologic, and genomic, components in children with the acute-onset of psychiatric symptoms. This research may begin to uncover a much larger story of autoimmune processes that are involved in psychiatric disorders of childhood. By better understanding the etiologic components of psychiatric phenomenon, future treatments may be better targeted to underlying causes.
Detailed description
The investigators will recruit 500 children, 1-18 years old at onset with PANS/PANDAS. They will be treatment naive and within one month of onset/exacerbation. The 500 children with PANS will be gender- and age-matched to 100 healthy children, to allow examination of immunologic, neurologic, genomic, and behavioral differences between these two groups of children.
Interventions
None listed
Sponsors
Stanford University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
4 Years to 18 Years
Healthy volunteers
Yes
Inclusion criteria
* Children with PANS 1. Age 1-18 at onset of PANS 2. Diagnosis of PANS: abrupt onset of OCD or food restriction, and at least two of the following associated symptoms: frequent urination, worsening handwriting/cognition, inattention, anorexia, separation anxiety, oppositionality, irritability/rage outbursts, and emotional lability. 3. Patients must live within 90 miles of Stanford University and have a new onset of PANS illness 4. Patients must have an established pediatrician within 90 miles of Stanford University for 3 years. * Healthy Controls 1. Age 4-18 2. No psychiatric diagnosis
Exclusion criteria
* Any neuropsychiatric illness that may obscure the clear diagnosis of PANS
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cerebral blood flow | Through study completion, up to 12 years | The investigators will report results of altered cerebral blood flow from patients with PANS. |
| EEG patterns | Through study completion, up to 12 years | The investigators will report results of abnormal EEG patterns from patients with PANS. All data will be obtained through the review of medical records, which are created during the routine clinical care of patients. |
| Rapid Eye Movement (REM) motor disinhibition | Through study completion, up to 12 years | The investigators will report results of REM motor disinhibition from polysomnography studies. All data will be obtained through the review of medical records, which are created during the routine clinical care of patients. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Caregiver Burden Inventory | Every 2-4 weeks for up to 12 years | All data will be obtained through the review of medical records, which are created during the routine clinical care of patients. |
| Global Impairment Scores | Every 2-4 weeks for up to 12 years | All data will be obtained through the review of medical records, which are created during the routine clinical care of patients. |
| Neurological findings | Every 2-4 weeks for up to 12 years | The investigators will report data from neurological exam findings, including milk maid grip, chorea, choreiform movements of arms and legs, apraxia, overflow dystonia, truncal instability, piano-playing fingers, glabellar sign, etc. All data will be obtained through the review of medical records, which are created during the routine clinical care of patients. These results will be aggregated to report the number of participants with abnormal neurological findings. |
| Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) | Every 2-4 weeks for up to 12 years | All data will be obtained through the review of medical records, which are created during the routine clinical care of patients. |
| Columbia Impairment Scale | Every 2-4 weeks for up to 12 years | All data will be obtained through the review of medical records, which are created during the routine clinical care of patients. |
Countries
United States
Contacts
Primary ContactJoanne Cheung
Backup ContactEllen Spartz
Outcome results
None listed