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Medscape
3 days ago
- Health
- Medscape
PANS and PANDAS: Diagnosis and Treatment
While anxiety symptoms are common in prepubertal children, they occasionally present suddenly and with a high degree of severity. In these circumstances, parents may turn to you, the pediatrician, to address the possibility that these syndromes are autoimmune, under the diagnostic umbrellas of pediatric acute-onset neuropsychiatric syndrome (PANS) and pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS). While the clinical community continues to debate many aspects of these diagnoses, families may seek treatment based on their own online research. Your understanding of what is known about the prevalence and assessment of immune-related neuropsychiatric disorders will help you to provide these patients and their families with meaningful support and responsible guidance for the management of these syndromes. Prevalence and Controversy Susan D. Swick, MD In 1989, researchers studying Sydenham chorea noted a high prevalence of obsessive thoughts and compulsive behaviors in children with rheumatic fever without chorea. Susan Swedo, MD, and colleagues at the National Institutes of Health eventually characterized this syndrome as PANDAS, occurring in 50 children who developed acute-onset obsessive compulsive disorder (OCD), anxiety, or tics with a preceding or concurrent group A streptococcal (GAS) infection. In 2012, PANS or childhood acute-onset neuropsychiatric syndrome was proposed to broaden the criteria to include similar abrupt-onset psychiatric symptoms (OCD and restricted eating) with inciting events other than GAS infection, including mycoplasma, influenza, Lyme disease, or even psychosocial stressors. Reliable prevalence estimates remain elusive, largely because of small numbers, diagnostic uncertainty, and lack of consensus criteria to be applied across studies. In the original studies, the mean age of onset was 6.3 years for tics and 7.4 years for OCD symptoms. The ratio of males to females was 4.7 to 1 under the age of 8 years. In one prospective study, only 10 cases were identified among 30,000 participants with throat cultures that were positive for GAS. The broader category of PANS has proven even more difficult to quantify, given its heterogeneous triggers. The high rate of GAS exposure and anxiety disorders in prepubertal children make the establishment of a causal link very difficult. Michael S. Jellinek, MD This has led to significant controversy over the diagnosis and treatment of PANDAS and PANS. While there is research interest in the role of the immune system in some psychiatric illnesses, neither diagnosis is listed in the DSM-V or the ICD-10. Nonetheless, there are parents who will come to you with questions about PANS and some small number of children each year who will develop it. Helpfully, the American Academy of Pediatrics (AAP) published a clinical report on PANS (encompassing PANDAS) in March 2025 to provide guidance. Our aim is to review the current guidance and help you use your best clinical judgment to treat all children thoughtfully and responsibly. Clinical Presentation and Assessment The hallmark symptom of PANDAS and PANS is the sudden, dramatic onset of symptoms of OCD, severely restricted food intake, or tic disorder, often appearing literally overnight in a prepubertal child. There are typically multiple severe symptoms starting abruptly together, like an 'explosion.' PANS diagnosis requires concurrent abrupt onset of additional severe neuropsychiatric symptoms in at least two of the following areas: anxiety, emotional lability or depression, irritability or aggression, developmental regression, deterioration in school performance, sensory or motor abnormalities, or somatic signs (sleep disturbances, enuresis, or urinary frequency). When any syndrome is sudden and severe, it is normal for parents to be very concerned and distressed. Express understanding and validation as you begin your assessment, which should include: Clinical History: Timing of symptom onset (Was it abrupt and severe? Did it reach a crescendo in 24-48 hours?) Assessment for signs of Sydenham chorea, Tourette, encephalitis, and anorexia nervosa History of developmental or psychiatric disorders Any recent illnesses, particularly GAS pharyngitis (documented via throat culture) Physical and Neurological Exam: To rule out signs of infection, systemic illness, or neurologic disease Motor examination, with attention to choreiform movements Laboratory Workup: Throat culture or rapid strep with symptomatic pharyngitis (although a negative rapid test may be inaccurate) Routine screening for GAS, antistreptolysin O, and anti-DNase B titers are not recommended by the AAP When the neurological examination is suggestive, lumbar puncture or MRI may be warranted to assess CNS inflammation If there is no evidence of GAS infection, PANDAS is unlikely. In general, the onset of OCD (and other anxiety disorders) is usually gradual and persistent, although children may internalize and hide symptoms until they no longer can. Tic disorders usually begin with isolated, intermittent motor or vocal tics, not an 'explosion.' The presence of cognitive decline, psychosis, catatonia, new seizures, or movement disorders other than tics should lead to an expanded and thorough neurological workup, including for autoimmune encephalitis. The AAP specifies that further laboratory testing and imaging have no evidence to support their use in the workup for PANS. Management Strategies If your assessment suggests PANS, how do you begin treatment? Explain to the family that treatment will address any confirmed infection, psychiatric symptoms, and inflammation. While some children may improve with antibiotics alone (symptoms may resolve fully within several weeks), most children will require treatment of persistent psychiatric symptoms even when all signs of GAS infection have resolved. Treatment typically involves three concurrent pathways: 1. Medical Management of Infection and Inflammation: Start with treatment of the GAS infection, if there is one. Antibiotics: The AAP recommends a standard (10-day) course with appropriate antibiotics for a positive culture in a symptomatic child. The AAP does not recommend prophylactic or long-term use of antibiotics, or treatment of asymptomatic positive culture (colonization). Some children's neuropsychiatric symptoms respond to antibiotics; others do not. The AAP recommends a standard (10-day) course with appropriate antibiotics for a positive culture in a symptomatic child. The AAP does not recommend prophylactic or long-term use of antibiotics, or treatment of asymptomatic positive culture (colonization). Some children's neuropsychiatric symptoms respond to antibiotics; others do not. Anti-inflammatory Treatment: The AAP does not recommend NSAIDS or more aggressive anti-inflammatories, given the absence of evidence and considerable side effects. The AAP does not recommend NSAIDS or more aggressive anti-inflammatories, given the absence of evidence and considerable side effects. Immune Modulation: Invasive therapies like intravenous immunoglobulin or plasmapheresis have no evidence to support their use in PANS. Patients with severe, persistent neuropsychiatric symptoms should have an expanded neurological and rheumatologic assessment before any consideration of these treatments. 2. Psychiatric Symptom Management: An infection may have caused the psychiatric symptoms or simply exacerbated or unmasked an underlying illness that will require independent treatment. OCD: Cognitive behavioral therapy (CBT) — specifically, exposure and response prevention (ERP) — is the gold standard for managing OCD symptoms, regardless of etiology. Selective serotonin reuptake inhibitors (SSRIs) are similarly effective and the combination of the two has demonstrated superior efficacy to either treatment alone. Each treatment may take 12 weeks or more to be effective. ERP may be difficult to access. SSRIs should be started at low doses and titrated gradually as they may cause temporary activation if started at too high a dose. They are not contraindicated in OCD, anxiety disorders, or PANS, and parents should be offered education to prevent any concern about these effective treatments. Cognitive behavioral therapy (CBT) — specifically, exposure and response prevention (ERP) — is the gold standard for managing OCD symptoms, regardless of etiology. Selective serotonin reuptake inhibitors (SSRIs) are similarly effective and the combination of the two has demonstrated superior efficacy to either treatment alone. Each treatment may take 12 weeks or more to be effective. ERP may be difficult to access. SSRIs should be started at low doses and titrated gradually as they may cause temporary activation if started at too high a dose. They are not contraindicated in OCD, anxiety disorders, or PANS, and parents should be offered education to prevent any concern about these effective treatments. Tics: Tics are only treated when they interfere with a child's function or lead to significant embarrassment or bullying. A behavioral psychotherapy (comprehensive behavioral intervention for tics, CBIT) has demonstrated efficacy. Medications (alpha-2 agonists) have modest efficacy and can be used in more severe cases. Tics are only treated when they interfere with a child's function or lead to significant embarrassment or bullying. A behavioral psychotherapy (comprehensive behavioral intervention for tics, CBIT) has demonstrated efficacy. Medications (alpha-2 agonists) have modest efficacy and can be used in more severe cases. Food Restriction ( Avoidant/Restrictive Food Intake Disorder, ARFID): Almost all children with ARFID and PANS also have underlying OCD. Treatment starts with a medical assessment of nutritional and hydration status and weight restoration and correction of electrolyte abnormalities, if needed. Then CBT (ERP again) is the effective treatment for the avoidant behaviors around food. This is a specialized treatment that requires a clinician who has training in CBT and experience working with ARFID specifically. Avoidant/Restrictive Food Intake Disorder, Almost all children with ARFID and PANS also have underlying OCD. Treatment starts with a medical assessment of nutritional and hydration status and weight restoration and correction of electrolyte abnormalities, if needed. Then CBT (ERP again) is the effective treatment for the avoidant behaviors around food. This is a specialized treatment that requires a clinician who has training in CBT and experience working with ARFID specifically. Additional Symptoms: Sleep disturbances and separation anxiety both can be addressed with CBT, with an additional component of parental skill building to complement and support the child's work. 3. Family Support: The sudden, severe onset of disruptive behavioral symptoms is bound to be very distressing for your patient and particularly for their parents, whatever the cause. Families of children with severe, sudden psychiatric symptoms experience significant stress and distress. If they suspect it might be caused by a current or recent infection, it is important that their pediatrician is genuinely curious about their observations and concerns. Some families may think they have been treated dismissively when they are told that there is 'no evidence' to support their observations. Remember, they are the experts on their children. When they have experienced your genuine curiosity and respect, it will be easier for them to trust your judgment should you conclude that their child may need treatment beyond antibiotics. Support, reassurance, and education are vital. Build a team with a psychiatrist and psychotherapist and engage the school to provide accommodations during treatment (eg, reduced workload and support for attention deficits or anxiety). The Pediatrician is Critical Pediatricians are the first point of contact when children present with symptoms that suggest PANS. Your responsiveness, targeted workup, and collaborative management are critical. Your ability to provide the family with meaningful support will create a strong foundation of trust that will improve the course of their child's care. Given the complex and uncertain nature of these diagnoses, your partnership with the parents is the critical first step. Acknowledge that inflammation is emerging as an important factor in many medical and psychiatric conditions, but that it may not always guide treatment. It should not be a matter of medical illness or psychiatric illness. Help families to understand that even if a strep infection triggered the psychiatric symptoms, they will both need treatment. Treatment may be slow, but with your guidance and partnership the child will recover. A parent's trust in you is the essential foundation for this process. Conclusion PANS and PANDAS are emerging clinical entities residing at the intersection of psychiatry, pediatrics, and immunology. While more research is needed to understand their pathophysiology and optimal treatment strategies, the reality is that affected children may be presenting to your offices today — suffering and in need of thoughtful, coordinated care. Maintain a curious, compassionate posture, acknowledge uncertainty where it exists, and provide clarity about our ability to offer reasonable and effective treatments guided by evidence and good judgment even when there is uncertainty.
Daily Record
30-06-2025
- Health
- Daily Record
Teenage girl left 'unrecognisable' after suffering sudden personality change
"It is like someone has flipped a switch and you don't recognise that person in front of you." A teenager was left unrecognisable to her friends and family after she suffered a sudden personality change. Beth Shepherd was diagnosed with a mysterious condition known as PANS in 2022 when her whole personality instantly transformed. The 16-year-old's behaviour suddenly became violent and she would fly into fits of rage, often subjecting her mum, Toni, to beatings. She struggled to recognise her family members and feared she would be kidnapped. Other times the teen hid under tables believing she was going to be murdered. Mum Toni had to give up work for five weeks after Beth's first symptom. Speaking of her daughter's condition, she told the Mirror: 'Absolutely terrifying. You cannot imagine. You have a baby, they hand you the baby on your chest and say, 'Here is your healthy baby girl. And that will never leave me, because the comparison to now… I don't recognise her. On a good day I do. "But when we are rolling around for two hours and I put myself between her and a wall so she can't injure herself... It is like someone has flipped a switch and you don't recognise that person in front of you.' Toni, who had been a childminder before it became too dangerous to have other kids in the house with Beth, hopes to raise awareness of her daughter's condition and get her child the help she desperately needs. Symptoms Toni, from Matlock, Derbyshire, said her daughter's first symptom was an unusual one. She said: 'She started making strange noises. But I didn't really address it. I left it because I know with Tourettes that sometimes the more you talk about it the worse it gets.' Asked to describe the sound, she said: 'Kapow! Kapow! She would be sitting on the sofa watching telly and she would randomly go 'kapow'. It was just odd. We didn't try to make a thing of it.' However, things escalated quickly, and Beth rang her mother from school one day with the ominous statement: 'Mum, something is happening to me.' She thought she might be having a seizure and Toni said she was 'jerking all over the place' when she arrived. The family rang an ambulance. At the hospital, they were told it could be motor tics. They went home and were told to return in a year, where they might then get a diagnosis of Tourettes. Verbal tics came four days later but soon her personality and behaviour transformed. Describing the change, Toni said: 'Really really rapidly, she became really anxious, she was paranoid, she was having hallucinations, she didn't recognise her family, she thought we were going to kidnap her. 'She was screaming for me, I'm right in front of her, but she is screaming for me because she didn't recognise me. And she thought I was a stranger. She thought the whole world was falling to pieces. Then the rages started, she would literally erupt, and excuse my language, but she would physically attack me. It was scary, it was really really scary.' More symptoms arrived in the form of seizures, up to 80 a day, and despite lasting just a few seconds, they resulted in Beth falling to the floor. She then started having paralysis for up to four days at a time because her body simply forgot how to work. After countless visits to A&E, Toni, completely desperate for answers, staged a sit-in, and begged someone from CAMHS (Child and Adolescent Mental Health Services) to see them. Diagnosis Beth also started having restrictive eating where she would refuse certain foods because they 'came from a farm and farms were dirty'. Along with irrational thoughts, she regularly smashed her head against the wall. They proved to be particularly devastating moments for the family that includes Beth's younger sister, 11, who has been hugely impacted by her sibling's decline. However, eventually a diagnosis was found, and Toni remembered: 'It was my mum. We had spent hours trawling the internet trying to find what the hell is happening. It was actually my mum who found PANS (Paediatric Acute-Onset Neuropsychiatric Syndrome) and she rang one day and said I've got it.' I was a bit sceptical because so many symptoms overlap with different things but it was just spot on.' She said there were 20 symptoms on a PANS criteria and at the time Beth had 19, before eventually developing the one she did not have. It is a neuropsychiatric condition caused by a misdirected immune response to an unknown trigger causing inflammation in the brain and leads to both physical and psychiatric symptoms. These include rages, anxiety, tics, hallucinations, chronic fatigue and pain, sleep difficulties and being unable to walk. It is a syndrome that develops incredibly suddenly and impacts the physical and mental health of children and young adults. It can develop after common infection, and in Beth's case, it may have appeared after she had Covid-19 in July 2021. Despite being recognised by the World Health Organisation, there are no treatment guidelines for it in England, making Beth's situation particularly turbulent. Treatment / Fundraiser Toni spent up to £8,000 finally getting Beth diagnosed privately and was prescribed antibiotics and steroids. The latter caused her to become manic, resulting in her climbing walls and thinking her skin was covered in spiders. As of today, Beth now has invaluable chiropractic care every week that regulates her nervous system. If she does not attend, her mum notices symptoms immediately, and her daughter will become more agitated, fiery and in pain. She also has counselling once a week, and all of these things are funded privately, with Toni stressing she has not been able to get any support. Toni has spent countless hours contacting every local statutory body in the hopes someone will take responsibility to provide what Beth needs to function – but said it has been a year of hitting brick walls. However, after starting a GoFundMe in recent weeks to fund private care, more than £3,000 has been raised, meaning her daughter has started hyperbaric oxygen therapy. And writing on the fundraiser, Beth, who is falling behind in her education because of the lack of support, said: 'I haven't given up on life; I'm still here and I am still fighting this debilitating illness. With your help, I hope to be able to strengthen my body and mind and become more like the person I was.' Join the Daily Record WhatsApp community! Get the latest news sent straight to your messages by joining our WhatsApp community today. You'll receive daily updates on breaking news as well as the top headlines across Scotland. No one will be able to see who is signed up and no one can send messages except the Daily Record team. All you have to do is click here if you're on mobile, select 'Join Community' and you're in! If you're on a desktop, simply scan the QR code above with your phone and click 'Join Community'. We also treat our community members to special offers, promotions, and adverts from us and our partners. If you don't like our community, you can check out any time you like. To leave our community click on the name at the top of your screen and choose 'exit group'. If you're curious, you can read our Privacy Notice. The therapy, which involves breathing pure oxygen in a pressurized chamber, will hopefully reduce Beth's inflammation and infection. That may lead to an increase in energy and sleep (currently she only gets three hours per night). Giving an insight into her daughter's life now, Toni said: 'She spends probably two to four days a week in a wheelchair. Another couple on her specialised crutches. She usually gets one day a week where she is mobile, but she has to have rested all the way up to that and needs to rest three days after. 'She lives for one day a week and that is the only light she has left.' Toni hopes the alternative therapy will help with that and any proceeds from the fundraiser will go towards a possible purchase of a hyperbaric oxygen machine, adaptations to the house so Beth can live downstairs in her own space and eventually a therapy dog for support.
Daily Mirror
30-06-2025
- Health
- Daily Mirror
Teen called mum saying 'something's wrong' – days later she didn't recognise her
Beth was diagnosed with a mysterious condition known as PANS in 2022 when her whole personality instantly transformed – she now lives for just one day a week where she is strong enough to walk unaided A teenage girl suffered a complete personality change as her world 'fell apart in a matter of weeks' – making her instantly unrecognisable to friends and family. Toni Shepherd, speaking about what her daughter, Beth, 16, was like before her shock diagnosis of a mysterious and little known condition, said: 'She was really academic, in the top sets in school. She was mature. She was independent. She already had a job. She was doing fantastic – and then things just went wrong…' Beth's behaviour suddenly became disturbing and she would fly into fits of rage where her mum would often be beaten. The petrified and confused teenager struggled to recognise her family members and feared she would be kidnapped. Other times she hid under tables believing she was going to be murdered. Her mum, who had to give up work five weeks after her daughter's first symptom, said: 'Absolutely terrifying. You cannot imagine. You have a baby, they hand you the baby on your chest and say, 'Here is your healthy baby girl.' 'And that will never leave me, because the comparison to now… I don't recognise her. On a good day I do. But when we are rolling around for two hours and I put myself between her and a wall so she can't injure herself... It is like someone has flipped a switch and you don't recognise that person in front of you.' Toni, who had been a childminder before it became too dangerous to have other kids in the house with Beth, has now bravely spoken about her daughter's complex condition for the first time, in the hope of raising awareness and getting her child the help she desperately needs. Symptoms The first symptom was an unusual one, and Toni, who is from Matlock, Derbyshire, said: 'She started making strange noises. But I didn't really address it. I left it because I know with Tourettes that sometimes the more you talk about it the worse it gets.' Asked to describe the sound, she said: 'Kapow! Kapow! She would be sat on the sofa watching telly and she would randomly go 'kapow'. It was just odd. We didn't try to make a thing of it.' However, things escalated quickly, and Beth rang her mother from school one day with the ominous statement: 'Mum, something is happening to me.' She thought she might be having a seizure and Toni said she was 'jerking all over the place' when she arrived. They rang an ambulance and at the hospital they were advised that it might be motor tics, despite the pain being "horrendous" for Beth because of how hard she was jerking. They were told to go home, return in a year, where they then might get a diagnosis of Tourettes. Verbal tics came four days later but soon her personality and behaviour transformed. Describing the change, Toni said: 'Really really rapidly, she became really anxious, she was paranoid, she was having hallucinations, she didn't recognise her family, she thought we were going to kidnap her. 'She was screaming for me, I'm right in front of her, but she is screaming for me because she didn't recognise me. And she thought I was a stranger. She thought the whole world was falling to pieces. Then the rages started, she would literally erupt, and excuse my language, but she would physically attack me. It was scary, it was really really scary.' More symptoms arrived in the form of seizures, up to 80 a day, and despite lasting just a few seconds, they resulted in Beth falling to the floor. She then started having paralysis for up to four days at a time because her body simply forgot how to work. After countless visits to A&E, Toni, completely desperate for answers, staged a sit-in, and begged someone from CAMHS (Child and Adolescent Mental Health Services) to see them. Diagnosis Beth also started having restrictive eating where she would refuse certain foods because they 'came from a farm and farms were dirty'. Along with irrational thoughts, she regularly smashed her head against the wall. They proved to be particularly devastating moments for the family that includes Beth's younger sister, 11, who has been hugely impacted by her sibling's decline. However, eventually a diagnosis was found, and Toni remembered: 'It was my mum. We had spent hours trawling the internet trying to find what the hell is happening. 'It was actually my mum who found PANS (Paediatric Acute-Onset Neuropsychiatric Syndrome) and she rang one day and said I've got it.' I was a bit sceptical because so many symptoms overlap with different things but it was just spot on.' She said there were 20 symptoms on a PANS criteria and at the time Beth had 19, before eventually developing the one she did not have. It is a neuropsychiatric condition caused by a misdirected immune response to an unknown trigger causing inflammation in the brain and leads to both physical and psychiatric symptoms. These include rages, anxiety, tics, hallucinations, chronic fatique and pain, sleep difficulties and being unable to walk. It is a syndrome that develops incredibly suddenly and impacts the physical and mental health of children and young adults. It can develop after common infection, and in Beth's case, it may have appeared after she had Covid-19 in July 2021. Despite being recognised by the World Health Organisation, there are no treatment guidelines for it in England, making Beth's situation particularly turbulent. Treatment / Fundraiser Toni spent up to £8,000 finally getting Beth diagnosed privately and was prescribed antibiotics and steroids. The latter caused her to become manic, resulting in her climbing walls and thinking her skin was covered in spiders. As of today, Beth now has invaluable chiropractic care every week that regulates her nervous system. If she does not attend, her mum notices symptoms immediately, and her daughter will become more agitated, fiery and in pain. She also has counselling once a week, and all of these things are funded privately, with Toni stressing she has not been able to get any support. Toni has spent countless hours contacting every local statutory body in the hopes someone will take responsibility to provide what Beth needs to function – but said it has been a year of hitting brick walls. However, after starting a GoFundMe in recent weeks to fund private care, more than £3,000 has been raised, meaning her daughter has started hyperbaric oxygen therapy. And writing on the fundraiser, Beth, who is falling behind in her education because of the lack of support, said: 'I haven't given up on life; I'm still here and I am still fighting this debilitating illness. With your help, I hope to be able to strengthen my body and mind and become more like the person I was.' The therapy, which involves breathing pure oxygen in a pressurized chamber, will hopefully reduce Beth's inflammation and infection. That may lead to increase in energy and sleep (currently she only gets three hours per night). Giving an insight into her daughter's life now, Toni said: 'She spends probably two to four days a week in a wheelchair. Another couple on her specialised crutches. She usually gets one day a week where she is mobile, but she has to have rested all the way up to that and needs to rest three days after. 'She lives for one day a week and that is the only light she has left.' Toni hopes the alternative therapy will help with that and any proceeds from the fundraiser will go towards a possible purchase of a hyperbaric oxygen machine, adaptations to the house so Beth can live downstairs in her own space and eventually a therapy dog for support. After sharing her own struggles as a mum, Toni spoke about the impact it has had on Beth herself, concluding: 'Because it changes them so much it terrifies them. 'They are terrified and they don't know what the hell is happening. You can't sit back and watch your kids smash their head until it bleeds. There is no control. You don't know what is going to happen in the next 10 seconds. People plan days ahead, weeks ahead, months ahead. We literally couldn't and still can't do that.'
Associated Press
03-04-2025
- Health
- Associated Press
PANDAS Physicians Network Awards Funding to the Agalliu Lab for Immune Mediated OCD, PANDAS/PANS Research
This research will provide important insights into how the immune system and inflammation affect brain function, particularly in children with PANDAS/PANS. MOORESVILLE, NC, UNITED STATES, April 3, 2025 / / -- The PANDAS Physicians Network is pleased to award funding to the Agalliu Lab in the Department of Neurology at Columbia University Irving Medical Center. This award will enhance our understanding of how the adaptive and innate immune systems contribute to post-infectious sequelae in the brain. Through whole exome sequencing of children with PANDAS, researchers in the lab of Dr. Dritan Agalliu identified RXRA as a potential genetic risk factor for the disease. This award will support an ongoing study conducted by Dr. Uğur Akcan which will provide insight into the mechanisms by which the RXRA genetic risk factor identified in children with PANDAS affects the immune responses that triggers immune-mediated neuropsychological changes, including obsessive-compulsive behaviors. According to Dr. Akcan, 'Our research will provide important insights into how the immune system and inflammation affect brain function, particularly in children with PANDAS/PANS. It underscores the importance of studying the neuroimmune axis, which connects the immune system and the brain, as a vital area of biomedical research. The findings challenge the traditional focus on neurons alone in psychiatric disorders. Instead, they emphasize the role of other central nervous system (CNS) cells, particularly those governing immune functions, in the development of neuropsychiatric symptoms after infections. Moreover, the study highlights that microglia, the brain's immune protectors, are crucial players in the development of behavioral abnormalities seen in post-infectious obsessive-compulsive disorders. This research also points to genetic risk factors like RXRA mutations as potential contributors to psychiatric disorders, including obsessive-compulsive disorders.' We celebrate the continued excellence from the Agalliu Lab and congratulate Dr. Agalliu and Dr. Akcan on their accomplishments. CLICK HERE to learn more about this work and contribute to the Agalliu Lab. PANDAS Physicians Network (PPN) is a non-profit organization that provides PANS/PANDAS resources to clinicians while supporting research. Our vision is that PANS/PANDAS will become easily diagnosed and treated with accessible therapies that dramatically reduce suffering and lead to a cure. Learn more at X Instagram YouTube Legal Disclaimer:
