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Everything posted by bobh

  1. Sorry I didn't notice your response until now. Well, we are wanting to replicate for good measure, but as a first approach, we are trying to partner with folks that have existing data sets. They don't know the SNP, and I don't see their data in advance, so I feel that blindness protects us from a certain kind of p-hacking criticism for already-collected data. If working with others falls down, I might consider doing the replication with data collected as we did in this first round. I would be happy to let you know if you wanted to contribute. As to your 2nd question, the simple bonferroni correction was applied for our finding. So, the target p for significance was 0.05/10,340/2 = 0.0000024 (the /2 was because we were checking both tails), and because we were well under that simple correction, we didn't do anything more sophisticated. But this target also left some possibilitiies that might be significant as undiscovered. I have understood bonferroni to be pretty close to the reality - do you know differently?
  2. After checking 10,417 SNPs in the PANS genetics data sets that were donated for the above study (from this and other groups), we finally found one that does have a "statistically significant difference" in incidence between 68 PANS kids (who are mostly of European ethnicity), and a representative general population. This is not at all like Huntington's, where if you have the mutation, you've got the disease, and if you don't, you are clear, 100%. Rather, it is like what we know so far of many immune disorders, where there are many gene mutations (even hundreds of them) that are associated with higher incidence of a disease/disorder (i.e. slightly greater chance of having it with a mutation, but nothing guaranteed either way). For our SNP, almost half of PANS kids don't actually have the risk allele. But a much smaller fraction doesn't have it in the general population; that is the reason it was caught as statistically significant. So, the interesting thing about this mutation (a SNP allele) is that it has been linked to MS in another formal, published study. When we couldn't finding anything significant with all the "popular" SNPs that people were paying attention to (like MTHFR and FUT2), we eventually branched out to checking ones associated with diseases, particularly autoimmune diseases. We aren't going to announce the specific SNP just yet, because we are interested in corroborating it with a second set of data. We don't absolutely need that corroboration (because the result is clearly statistically signficant, p=0.00000015 for those that are familiar with p-values), but a replication would make the find so much stronger.
  3. I committed to feed results back as they trickle in, so here is one such result: For MTHFR A1298C (rs1801131), there were 70 sets of data: - 5 were homo for the risk allele (i.e., +/+) - 23 were heterzygous (+/-) - 42 of them did not have the risk allele at all (-/-) For MTHFR C677T (rs1801133), there were 71 sets of data: - 5 were homo for the risk allele (i.e., +/+) - 26 were heterzygous (+/-) - 40 of them did not have the risk allele at all (-/-) The first result above is a lower count of risk allele than the general population, and the 2nd is a little higher - but neither statistically significantly so, according to how we setup this analysis. Particularly together, the two of them are pretty much like the general population in terms of number of the risk alleles. I hope this result is not upsetting for any that feel these MTHFR SNPs are a significant player in PANS. Because it doesn't correlate wtih PANS doesn't mean that it isn't something of significance for your particular child. So far, we have only tabulated results like the above (how individual SNPs for these PANS kids fare against the general population). We are still wanting to look at other patterns of many SNPs together among the participants, which might show something statistically significant even if an individual SNP doesn't. It can also be the case that for a given individual, a certain combination of SNPs, including these MTHFR ones, work in a way together to affect the disorder. It is really hard to do either of those kinds of analysis with our genetic data though, so we'll see how our investigations of that works out.
  4. Note: This has been approved for posting by Forum administration. For any that contributed to this genetic study that we posted here (and elsewhere) - thank you so much! The cutoff was last night, and we had a great result - 71 sets of data. I will post some tidbits of "aggregate" results here (and in the other groups this was put in). I am wary of posting full results on facebook, because then facebook could claim some ownership. Instead, full analysis results (data in aggregate form only) will eventually be posted here: https://osf.io/pf7q2/?view_only=ba9efeabb38e4a22adced3b5ba4dc5a5 That link above is live to the public now, and you can see (in the last revision of a registration plan), what are the 78 SNPs that we have looked at. We are going to look at many more SNPs, though, and do lots more analysis than what is listed there. The plan was just to lay out in advance what we could declare as significant in this pilot study.
  5. If anyone is still interested in participating, there is only one more week until the cutoff for this pilot study. I am not sure if anyone from this group has uploaded data (it would be some work for me to check where non-anonymous donors are from, and of course I won't know for anonymous donors), but there are 40 participants so far from other groups. It is exciting work for which there has not been (to the best of my knowledge) anything published to date. We intend to publish publicly only at Open Science Foundation, not (at least at this time) formally in any peer-reviewed journal.
  6. Ibuprofen (aka advil, motrin) is for some (not all) a "resuce med" in a flare (you can't keep giving it indefinitely). It is definitely the case that some abx work and others not, and it varies from kid to kid and (likely?) by particular sickness for a child.. Haven't had the vomiting experience, but have had our fair share of mystery stomach aches. I have no experience with Colorado docs - am far away.
  7. Sorry to hear about you and your grandaughter's struggles. For several years, it was impossible for our child to get to school, because of his severe OCD. We chose to homeschool (mostly using online resources) - it was that or nothing. Different parents, and situations, have made for different coping mechanisms (e.g. type schooling in the search box at top right, once you are in this forum). If the issue is just October, you might approach the school for some kind of leniency/temporary school at home option. Many parents have had discussions with schools, with varying success with accomodations. It is quite a chore to educate schools on PANS/PANDAS - it depends on their previous experiences. By the way, probiotics consistently made our child worse. I have found this to be the case for a suprising number of PANS kids, but by no means all. Many kids aren't really checked for this (by on and off several times) - the assumption is often just "probiotics are helpful". Of course, that doesn't explain October, but our kid had lots of flares at different times and for different reasons, but regardless, his symptoms were less when he was off probiotics, whatever his current state.
  8. I've gotten a comment in another place where this is posted, that some might balk at the dropbox technology of the link in the post, and prefer to email data instead. By all means! My email address is also in the post. I am not expert in security, but for what it's worth, I believe that email is less secure than dropbox (i.e. it is easier for someone else to grab your data). To pretty much eliminate that problem, you could send it anonymously, which by email would mean creating or using an email address that can't be traced to you.
  9. You can see a list of 5 for Colorado here: http://pandasnetwork.org/us-providers/#COLORADO No guarantee that any of these will work out well - you might want to check for references or ratings some other way.
  10. Abdominal pain is so common among PANS kids. I recall seeing a video of Dr. K. (he's in Chicago) describing how they went down the esophagus on dozens (maybe over 100?) of PANS kids with a scope, trying to find something that might explain it - but they didn't find anything. Our kid had frequent stomach aches - but not continuous as you describe for your daughter. I have heard speculation (from one doctor that treats PANDAS/PANS) that a "reboot of the gut" by using antibiotics may be a good thing. And I have heard lots of talk on these kinds of pages (and facebook groups) about how bad abx is for the gut microbiome. If you are using a probiotic in between the abx doses, beware: some kids (mine, but others too) get worse on probiotics.
  11. You are invited to participate in a research study titled “Genetic Patterns Among PANS/PANDAS patients”. This study is being conducted by Bob Horvath, Mark Moeglein, Michaela Holden and Sam Keating. We are "citizen scientists” with some qualifications in statistics and data manipulation, and direct experience (ourselves or family members) with various autoimmune or immunological conditions and/or autism, all of which we suspect are related. The purpose of this study is to find out whether certain variations in DNA occur more commonly among PANS patients than the general population. If we find some, we will let you and many others see the (aggregate) results, and hope that a finding will spur further research into the biological processes, and ultimately, in the long term, possibilities for remedies for the disorder. Participation in this is entirely voluntary. You can choose not to participate at all, or to participate anonymously, or with your name attached to the data. Either way, there will be no effect on your relationship with the researchers, or any other negative consequences with not participating. You are being asked to take part in this study because you are a parent of a PANS/PANDAS child, or you are an adult that has suffered with PANS/PANDAS symptoms as a child, or as an adult. If you agree to participate, you will be asked to click on a link below and upload 23andMe or similar genetic data for one person (at this time, please don't upload multiple family members, just the one). You may also email your data (see below). The data will be collected regularly from the upload site, with a January 19th, 9pm EST cutoff time for data used in the study. Data uploaded after the cutoff time will be safely stored (with no direct identification of participants) on two computers only, for possible later confirmation of any result with the initial data. Even if you give your name, the data will not contain that name, but be coded before being processed. After the initial upload and the coding step, no other person, website or online service will have access to your data with your identification attached to it. Your data will be uploaded to GEDmatch (without your identification) in order to obtain ancestry, and to confirm no close relationships (>3%) to other participants. No genetic disease information will be extracted from participant data. For those that contribute anonymously, the only link between us and you will be a fake name and email address that you give at the upload site. You are free to withdraw from this study at any time. However, once you submit your data, the only way to withdraw your anonymous data is if you contact myself (Bob Horvath) and reveal your fake name, so that I know which data to remove. This step could reveal your identity, but your data will be removed from the study. Study data will be stored without names in digital format. One copy will be on a computer in Ontario Canada, and another will be kept on a computer in Oregon, U.S.A. Only Bob Horvath and Mark Moeglein will have access to this full data. Aggregate results for the analysis of the data will later be made known publicly. There are no known risks associated with this study, beyond any risk there may be associated with the data existing (e.g. on the originating site, such as 23andMe). While you will not experience any immediate direct benefits from participation, information collected in this study may benefit you and others in the future by helping to determine genetic factors associated with PANS/PANDAS. If you have any questions regarding the survey or this research project in general, please contact the principal investigator, Bob Horvath, at bobhorvath@alumni.uwaterloo.ca By clicking on the link below to the upload site, or sending data to the email address above, you are indicating your consent to participate in this study. If you want to contribute anonymously, submit only a fake name and email address at the link. If you use a fake name, make it unique (unidentifiable by others) and make a record of it, in case there is any need to try to contact you (via a comment to this poll in the online groups it is listed in). https://www.dropbox.com/request/zrejlPbUjAnvN0OuK4Ny
  12. Oh, a loose or lost tooth is a very common flare source. That would be my bet.
  13. Our case is not the same as yours, but we were long term on probiotics (2+ years) before we discovered/proved that they were making our son's condition worse. So, you might try cutting those out, especially if it is not a recent add. We showed that well-known brands (not the kinds with strep) made him worse.
  14. Most defininately, probiotics make some PANS kids worse. I suspect that phenomenon is under reported, mostly because people don't want to believe it, and tend to suspect something else first. We proved it with our kid, and no, the ones we tried did not have strep in them, they were well-known brands, quoted here on these pages, and recommended by many.
  15. I'm sad that you had no response immediately after your post. You have probably discovered by now, what is known as the herx reaction. It is actually a good thing, showing that the abx is working. How are things now?
  16. mlee, there is a rumor among MD's that some abx's might be anti-inflammatory as well as fight infection. That helps them explain why they work so well sometimes. But I don't think that this aspect of some abx's has been well understood - I see it as speculative (not to say it isn't true).
  17. We have not gone through similar, so can't comment too directly, only on your statement "...apparently in true PANDAS cases it [OCD] accelerates anxiety and vice-versa?" Well, I would say that OCD, if it starts more slowly in a PANS/PANDAS child, is somewhat calming at first, when it is not otherwise debilitating or noticed by others too much, because there is some satisfaction derived from "repeating it right" when they finally get there. But when it grows much more significant later (or for any person with severe OCD) the sufferer fairly quickly becomes exasperated with how debilitating it is, and sometimes satisfaction is eluded, and so of course that creates plenty of anxiety. So I think your statement is fully true for those with very quick onset of PANS/PANDAS, and eventually true for all. If you can get and afford the ivig, the potential benefits probably outweigh the risks (in my mind).
  18. Once in this forum, type "California" in the search bar (near top right), and you'll get at least one thread asking the same question.
  19. We had great difficulty with some blood draws. That advil experience is a clue towards an inflammatory issue. It's not good to give Advil over the long haul, which is why it is known as a "resuce med" - used in the short term for the worst "flares" (does your child get worse at times, or pretty steady in symptoms?). On abx - many have struggled getting it - all I can suggest is to try other PANS/PANDAS-aware doctors.
  20. We have not had this experience with our PANS child, so can't really give advice from that point of view. Just a wild thought - have you considered lowering doses, rather than upping? I know that Zoloft dose you mention (8mg) is very low, but we were actually lower, and the first time we used it (at 2.5mg, in suspension), it had dramatic effect. If he is sensitive as you say, going in the lower direction might have a positive effect? Whatever the change, slow and one at a time is what I would want to try.
  21. I would tend to believe not co-incidence. Nystatin is another anti-yeast drug. I find it easier, safer and much easier to just try it (it doesn't absorb into the bloodstream appreciably, that is why it is safe) than to draw blood (which in our case, was a significant hardship) to have a test done.
  22. I don't know Mepron, but it is my own thought (only) that the anti-yeast drugs (nystatin and diflucan) might be a bit better taken some time after any abx. My thinking there is that when the abx clears out gut bacteria, that is when yeast has an opportunity to jump into the cleared out spots. So taking the anti-yeast some relatively short time after the abx should be better than taking it some relatively time before. But it is probably not a big difference from taking all at once. I don't have any thoughts on am vs. pm for any of these (and, I don't know Mepron).
  23. Our child had severe symptoms for about 4-1/2 years (not including a 1-1/2 year period of time where he was almost normal), and he has been about 90% for the last year. It would be key to root out any chronic infection, as might exist for example in tonsils. That could be a lot of things - at one point (for our child), it was a mild case of gingevitus that really ramped up his symptoms. I didn't believe that the Cunningham panel was worth the $, but I never had a health care provider or system (I am in Canada) that cared to look at it.
  24. At http://www.pandasnetwork.org/research-resources/us-providers/ , there is a naturopath listed in Seattle. I myself can't make any recommendation, except that I myself would want a health care practitioner that can prescribe antibiotics and nystatin.
  25. We had seizure-like symptoms with our PANS child, but they weren't the kind associated with epilepsy (because he was aware, could look right at us, just couldn't respond). Some also have what they call "absence seizures".
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