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Strep throat and OCD are linked, Israeli researchers find


Researchers at Tel Aviv University discover that the childhood exposure to the bacteria streptococcus A, which causes strep throat, can also damage brain function, leading to obsessive-compulsive disorder later on.


By Dan Even | Jan.08, 2013 | 11:41 AM













A common microbe that leads to childhood strep throat, long seen as an irritating but easily treatable virus, can have menacing long-term effects on brain function, Israeli researchers have discovered.


The same germ that causes the sore-throat and fever-inducing sickness in childhood, the researchers found, can manifest in obsessive-compulsive disorder (OCD), an anxiety disorder marked by repeated and intrusive thoughts that can trigger hording, obsessions and intensely repetitive behavior.


The results of the study, which was conducted on young rats, will pave the way for the development of new OCD treatments.


Scientists have been examining the connection between OCD and childhood diseases, including throat infections, for more than 20 years. This most current study, however, led by Prof. Daphna Joel, head of the psychobiological department in the Laboratory of Behavioral Neuroscience in the Department of Psychology at Tel Aviv University, pinpointed the route that caused an outbreak of the disorder in rats. After exposure to streptococcus A, the microbe that causes strep throat, the rats displayed OCD behavior.


In the study, which was conducted as part of the doctoral thesis of Lior Brimberg of the Department of Psychology, and in cooperation with Prof. Madeleine Cunningham of the University of Oklahoma, the rats were injected with streptococcus A microbes. They developed antibodies to the microbe, and were later injected with a substance that would simulate the transfer of antibodies to the brain. The researchers found that after penetrating the brain, the antibodies attached themselves to three regions in the brain, and were also connected to changes in the level of neurotransmitters in the brain.


Compared to a control group of rats that had not been exposed to the microbe, the researchers noticed changes in the behavior of the rats in the research group. Among other things, they diagnosed disturbances in the rats' balance and coordination, which were reflected in difficulties in moving toward the cage on a board and in using their forelegs to pick up food served to them.


They also observed standard obsessive behaviors among the rats in the research group: When you sprinkle water on rats' stomachs, they tend to groom themselves, but the rats in the research group engaged in self grooming for a prolonged period of time, in an obsessive manner.


The findings were recently published in the journal Neuropsychopharmacology.

The research was groundbreaking in its ability to highlight the link between a childhood illness and an adult disorder, Joel said.


“It’s almost impossible to show how strep can lead to OCD in humans ― almost all of us, even very young children, have been exposed to the bacterium at one time or another," she said. "Therefore the description of the model in rats is of great significance."


In a later experiment, the researchers noticed that the streptococcus antibodies became bound to dopamine D1 and D2 receptors in the brain, a finding that will likely aid in development of treatments for OCD.


"We have yet to examine whether the antibodies cause the activation or the blocking of the receptors, but their effect on the receptors will help in the development of new medications for OCD, which is liable to be caused by the route described," Joel said.


In the 1980s, the scientific community first realized that most sufferers of obsessive disorders, which are marked by prolonged hand washing and overly meticulous attention to cleanliness, had previously suffered from strep throat. They also found that the same group carried a high concentration of antibodies to the streptococcus A microbe in their blood. The phenomenon was later named PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus), which appears several weeks to three months after the strep throat. The phenomenon includes another disorder attributed to the infection, the appearance of tics.


The research findings emphasize the importance of proper treatment of strep throat in children, with use of antibiotics in the case of a streptococcus A infection. Even more crucially, the researchers call on parents to be alert to the development of OCD in children after an acute sore throat.


Joel implores parents to give their children a low dosage of antibiotics in addition to psychiatric medications if they suspect a disorder has developed as a result of strep throat.


Researchers remain undecided on whether or not the OCD caused by strep throat will disappear with time or turn into a chronic condition, and as such have not yet ruled on whether or not antibiotic treatments should be for a limited time period or for a lifetime.

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