Serum autoantibodies do not differentiate PANDAS and Tourette syndrome from controls

Abstract

Results do not support the hypothesis that PANDAS and Tourette syndrome are secondary to antineuronal antibodies. Longitudinal studies are required to determine whether autoantibodies correlate with fluctuations in clinical activity.

The Immunobiology of Tourette's Disorder, Pediatric Autoimmune Neuropsychiatric Disorders Associated withStreptococcus, and Related Disorders: A Way Forward

“…One retrospective study examined patients aged 5-17 years who developed tics. In this group, 53% were found to have an abrupt onset of symptoms, and of this subset, 21% were shown to have the onset within 6 weeks of infection (Singer et al 2000). Another study examined strep titers in a group of 150 children at their initial evaluation for tics and showed that 38% with tics had elevated ASO titers compared with 2% in the control group (Cardona and Orefici 2001).…”

“…Antibodies to basal ganglia are found in the sera of most TD, OCD, SC, and PANDAS subjects (Morshed et al 2001;Pavone et al 2004;Singer et al 2004Singer et al , 2005Dale et al 2005;Hoekstra et al 2005;Kansy et al 2006;Martino et al 2007;Gause et al 2009;Morris et al 2009) and may extend beyond the basal ganglia to include the cerebellum and cerebral cortex (Bronze and Dale 1993).…”

“…An initial model in which sera from TD and OCD patients with high levels of antineural antibodies were microinfused into the dorsal lateral striatum initially appeared promising (Hallett et al 2000;Taylor et al 2002). However, a subsequent multisite study failed to demonstrate a significant difference in stereotypic behaviors induced by sera from neuropsychiatric patients containing either elevated or low concentrations of antineural antibodies (Singer et al 2005). The results from this multisite study were similar to a third report that identified no significant differences for rodents infused in either the ventral or ventrolateral striatum with TD and PANDAS sera when compared with controls ).…”

Examining cortisol rhythmicity and responsivity to stress in children with Tourette syndrome

“…An example of an environmental trigger is pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS) that arise after exposure to streptococcal (group A beta-hemolytic streptococcal [GABHS]) infections (Mell et al, 2005;Swedo et al, 1998;Trifiletti & Packard, 1999). However, other research does not support the notion that PANDAS and TS are the result of autoantibody exposure (Harris & Singer, 2006;Kurlan, 1998;Loiselle et al, 2004;Singer et al, 2005).…”

Tourette Syndrome: Gene Expression as a Tool to Discover Drug Targets

“…30 However, this is still controversial in TS. 31 Finally, the observation that tics are exacerbated during increased psychosocial stress has led to the proposal that TS arises, in part, from increased reactivity of the hypothalamic-pituitary-adrenal (HPA) axis. 32 TS is often comorbid with obsessive-compulsive disorder (OCD) and attention deficit hyperactivity disorder (ADHD).…”