New published article by Kurlan in New England Journal Medicine Dec. 9

[Phasmid]

Just an FYI for those who have access (I don't, but I used to go to my son's doc's office and read his!) to NEJM

 

There is an article by Kurlan on Tourette's with mention of PANDAS. From what I can read, sounds like same old...

[kimballot]

Thanks Phasmid - I was able to read the article. Really just the same stuff we saw before. The article is by kurlan only and the PANDAS section just highlights his perspective study. It says:

 

The observation that Tourette's syndrome resolves or becomes less severe in a substantial number of patients as they grow into adulthood suggests that the underlying mechanisms involve processes that may correct themselves as the brain matures. On the basis of clinical similarities between Sydenham's chorea and Tourette's syndrome with OCD, the PANDAS syndrome (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections) was hypothesized as an autoimmune response to streptococcal infection that might precipitate or exacerbate tics. A recent intensive, prospective, blinded, clinical and laboratory cohort study, however, did not identify any temporal link between streptococcal infection and clinical exacerbations in patients who met the criteria for PANDAS.49 The reference for this quote is:

 

Kurlan R, Johnson D, Kaplan EL, Tourette Syndrome Study Group. Streptococcal infection and exacerbations of childhood tics and obsessive-compulsive symptoms: a prospective blinded cohort study. Pediatrics 2008;121:1188-1197

CrossRef | Web of Science | Medline

 

Yes.. it was definitely double blinded. Actually... the study was TRIPLE blinded since no one knows how many of the kids with PANDAS got antibiotics during the course of the study and no one knows if they would have actually had exacerbations linked to strep if they did not have antibiotics and /or if they were not taking psychotropic drugs to reduce their tics and OCD symptoms. Funny... Kurlan does not mention these limitations when he discusses the 2008 study....

... and I was hoping Kurlan was coming around after publishing with Murphy and Leckman! Maybe this article was submitted a long time ago - before the NIMH meeting in July 2010

Edited December 18, 2010 by kimballot

[Buster]

Probably the most important item in Kurlan's 2008 study is that over a 2 year period, none of the children in his study had more than a 1.6 point variance in OCD symptoms (as measured by CYBOCS). This means these children had no OCD exacerbations with or without streptococcal infection. Pretty unheard of for most PANDAS kids. Kurlan tries to assert that these kids met the PANDAS criteria, but they sure weren't like any of the kids talked about on this forum or in Swedo's studies.

 

Buster

 

 

Thanks Phasmid - I was able to read the article. Really just the same stuff we saw before. The article is by kurlan only and the PANDAS section just highlights his prospective study. It says:

 

The observation that Tourette's syndrome resolves or becomes less severe in a substantial number of patients as they grow into adulthood suggests that the underlying mechanisms involve processes that may correct themselves as the brain matures. On the basis of clinical similarities between Sydenham's chorea and Tourette's syndrome with OCD, the PANDAS syndrome (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections) was hypothesized as an autoimmune response to streptococcal infection that might precipitate or exacerbate tics. A recent intensive, prospective, blinded, clinical and laboratory cohort study, however, did not identify any temporal link between streptococcal infection and clinical exacerbations in patients who met the criteria for PANDAS.49 The reference for this quote is:

 

Kurlan R, Johnson D, Kaplan EL, Tourette Syndrome Study Group. Streptococcal infection and exacerbations of childhood tics and obsessive-compulsive symptoms: a prospective blinded cohort study. Pediatrics 2008;121:1188-1197

CrossRef | Web of Science | Medline

 

Yes.. it was definitely double blinded. Actually... the study was TRIPLE blinded since no one knows how many of the kids with PANDAS got antibiotics during the course of the study and no one knows if they would have actually had exacerbations linked to strep if they did not have antibiotics and /or if they were not taking psychotropic drugs to reduce their tics and OCD symptoms. Funny... Kurlan does not mention these limitations when he discusses the 2008 study....

... and I was hoping Kurlan was coming around after publishing with Murphy and Leckman! Maybe this article was submitted a long time ago - before the NIMH meeting in July 2010