Articlebronze2005

Incidence of anti-brain antibodies in children with obsessive–compulsive disorder

Russell Clive Dale · Isobel Heyman · Gavin Giovannoni · Andrew J. Church

122 citations0/0 files storedThe British Journal of Psychiatry

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Obsessive-Compulsive Spectrum Disorders Streptococcal Infections and Treatments Autoimmune Neurological Disorders and Treatments

Abstract

BACKGROUND: Obsessions and compulsions may occur in the post-streptococcal disorders Sydenham's chorea and paediatric autoimmune neuropsychiatric disorders associated with streptococcus (PANDAS). The proposed mediators are anti-basal ganglia antibodies (ABGA). AIMS: We tested the hypothesis that post-streptococcal autoimmunity may have a role in'idiopathic'obsessive-compulsive disorder (OCD). METHOD: We examined 50 children with OCD for ABGA using enzyme-linked immunosorbent assay (ELISA) and western immunoblotting. The findings were compared with paediatric autoimmune (n=50), neurological (n=100) and streptococcal (n=40) controls. RESULTS: The mean ABGA binding on ABGA binding on ELISA was elevated in the patient cohort compared with all control groups (P<0.005 in all comparisons). Western immunoblotting revealed positive antibody binding (as seen in Sydenham's chorea) in 42% of the patient cohort compared with 2-10% of control groups (P<0.001 in all comparisons). CONCLUSIONS: Our findings support the hypothesis that central nervous system autoimmunity may have a role in a significant subgroup of cases of OCD. Further study is required to examine whether the antibodies concerned are pathogenic.

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References

2013Diagnostic and Statistical Manual of Mental Disorders 1997Children's Yale-Brown Obsessive Compulsive Scale: Reliability and Validity 1998Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections: Clinical Description of the First 50 Cases 1995A family study of obsessive-compulsive disorder 1999Therapeutic plasma exchange and intravenous immunoglobulin for obsessive-compulsive disorder and tic disorders in childhood 2002Obsessive-compulsive disorder 2004The Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infection (PANDAS) Subgroup: Separating Fact From Fiction 1997B lymphocyte antigen D8/17: a peripheral marker for childhood-onset obsessive-compulsive disorder and Tourette's syndrome?

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2019Tics and Tourette Syndrome 2014The role of immune mechanisms in Tourette syndrome 2015Plasma cytokine abnormalities in drug-naïve, comorbidity-free obsessive–compulsive disorder 2010Comparison of Clinical Characteristics of Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections and Childhood Obsessive-Compulsive Disorder

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