Jump to content
ACN Latitudes Forums

article


Recommended Posts

http://www.physorg.com/news190034694.html

 

PANDAS don't like stress

 

April 9, 2010 PANDAS is an abbreviation for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections. This diagnosis was created when clinicians observed that following streptococcal infections, which include strep throat, scarlet fever, and impetigo, children developed tics and symptoms of obsessive-compulsive disorder (OCD).

 

 

In a new longitudinal study appearing in Biological Psychiatry, published by Elsevier, researchers identified new infections in children and adolescents with Tourette syndrome (TS) and/or OCD, and compared them with healthy control subjects. They also measured the participants' levels of emotional stress. Prior research has shown that stress is an important factor in developing depression, and that individuals with TS or OCD tend to be particularly sensitive to stress.

 

They then used this data to examine the power of the infections and measures of psychosocial stress to predict future tic, obsessive-compulsive, and depressive symptom severity.

 

Dr. James Leckman, senior author of this project, explains their findings: "We found that periods of tic and OC symptom worsening were independently associated with antecedent newly diagnosed strep infections as well as higher levels of antecedent psychosocial stress. When we looked at just the PANDAS, we also found similar results."

 

In other words, stress may aggravate the impact of prior streptococcal infection in promoting symptoms of TS and OCD. There was no impact of prior streptococcal infections on depressive symptoms.

 

PANDAS remain a controversial topic for many Tourette's experts. For example, another recently completed intensive longitudinal study that tracked a larger number of PANDAS cases found little evidence to support a link between newly diagnosed strep infections and a marked worsening of tic or obsessive-compulsive symptoms.

 

PANDAS is also frequently diagnosed in the community without the application of all the published diagnostic criteria. This has resulted in unwarranted use of antibiotic treatment for TS or OCD when there is no evidence of a recent strep infection.

 

However, some version of PANDAS likely does exist. The typical PANDAS case appears to have an abrupt sudden onset of separation anxiety and obsessive-compulsive symptoms, a loss of writing skills, and sleep problems. Tics are often present, but they can also confuse the picture, especially if they had been present in some form prior to PANDAS onset.

 

It is important to note that the number of PANDAS cases in this study was too small to allow firm conclusions, but it does indicate how important psychosocial stress is in TS and OCD, as well as depression.

 

 

More information: The article appears in Biological Psychiatry, Volume 67, Issue 7 (April 1, 2010), published by Elsevier.

 

 

Provided by Elsevier

Edited by Vickie
Link to comment
Share on other sites

Are you sh&^%&*( me!!!!

this wasn't an article on pandas...stress makes every condition worse....it was an opportuinity to bash pandas......

It's like lymes you idiots....YOU CANT ALWAYS FIND IT ..think outside the box...

an ointment that works on your rash, may not work on mine or make it worse.....

I AM SO P..... AND IT DOESN'T JUST HAVE TO BE STREP!!!!!!!

WE NEED TO MAKE PITANDS THE BATTLE CRY!!!!

 

http://www.physorg.com/news190034694.html

 

PANDAS don't like stress

 

April 9, 2010 PANDAS is an abbreviation for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections. This diagnosis was created when clinicians observed that following streptococcal infections, which include strep throat, scarlet fever, and impetigo, children developed tics and symptoms of obsessive-compulsive disorder (OCD).

 

 

In a new longitudinal study appearing in Biological Psychiatry, published by Elsevier, researchers identified new infections in children and adolescents with Tourette syndrome (TS) and/or OCD, and compared them with healthy control subjects. They also measured the participants' levels of emotional stress. Prior research has shown that stress is an important factor in developing depression, and that individuals with TS or OCD tend to be particularly sensitive to stress.

 

They then used this data to examine the power of the infections and measures of psychosocial stress to predict future tic, obsessive-compulsive, and depressive symptom severity.

 

Dr. James Leckman, senior author of this project, explains their findings: "We found that periods of tic and OC symptom worsening were independently associated with antecedent newly diagnosed strep infections as well as higher levels of antecedent psychosocial stress. When we looked at just the PANDAS, we also found similar results."

 

In other words, stress may aggravate the impact of prior streptococcal infection in promoting symptoms of TS and OCD. There was no impact of prior streptococcal infections on depressive symptoms.

 

PANDAS remain a controversial topic for many Tourette's experts. For example, another recently completed intensive longitudinal study that tracked a larger number of PANDAS cases found little evidence to support a link between newly diagnosed strep infections and a marked worsening of tic or obsessive-compulsive symptoms.

 

PANDAS is also frequently diagnosed in the community without the application of all the published diagnostic criteria. This has resulted in unwarranted use of antibiotic treatment for TS or OCD when there is no evidence of a recent strep infection.

 

However, some version of PANDAS likely does exist. The typical PANDAS case appears to have an abrupt sudden onset of separation anxiety and obsessive-compulsive symptoms, a loss of writing skills, and sleep problems. Tics are often present, but they can also confuse the picture, especially if they had been present in some form prior to PANDAS onset.

 

It is important to note that the number of PANDAS cases in this study was too small to allow firm conclusions, but it does indicate how important psychosocial stress is in TS and OCD, as well as depression.

 

 

More information: The article appears in Biological Psychiatry, Volume 67, Issue 7 (April 1, 2010), published by Elsevier.

 

 

Provided by Elsevier

Link to comment
Share on other sites

Are you sh&^%&*( me!!!!

this wasn't an article on pandas...stress makes every condition worse....it was an opportuinity to bash pandas......

It's like lymes you idiots....YOU CANT ALWAYS FIND IT ..think outside the box...

an ointment that works on your rash, may not work on mine or make it worse.....

I AM SO P..... AND IT DOESN'T JUST HAVE TO BE STREP!!!!!!!

WE NEED TO MAKE PITANDS THE BATTLE CRY!!!!

 

Well, this is the part that set my hair standing on end:

 

PANDAS is also frequently diagnosed in the community without the application of all the published diagnostic criteria. This has resulted in unwarranted use of antibiotic treatment for TS or OCD when there is no evidence of a recent strep infection.

Yep, let's encourage some more ignorance and nay-saying out there in the medical community, why don't we?!?! There's just not enough going around at the present time. :angry:

Link to comment
Share on other sites

I do wonder how far they go to determine there is no "recent strep infection". It seems a lot of doctors stop at strep throat. Everyone needs to remember that PANDAS is caused by strep, in general...not only strep throat! You then can bring PITAND into this and maybe there was a different infection, such as Mycoplasma P involved.

 

Second, in Swedo's paper on the first 50 cases, she stated that in subsequent episodes an exacerbation can be triggered by even viruses. I don't have the whole quote right now but she does state...

 

"...Thus, the lack of evidence... for a preceding strep infection in a particular episode does not preclude the diagnosis of PANDAS"

 

At least it does state in a brief blurb, "However, some version of PANDAS likely does exist. "

 

Overall, I don't know why, but I can't quite figure out what they are trying to say in here. Are they saying that it is stress causing these symptoms and not PANDAS or are they saying that stress is a trigger in PANDAS?

Edited by Vickie
Link to comment
Share on other sites

I thought, in its best light, they were saying stress can be a trigger for exacerbation.

 

Didn't Leckman's name come up in a questionable way a few week ago w/NY Times article?? I seem to recall several parents defending him as definitely pro-pandas.

 

Perhaps he needs to be more careful in how his work is conveyed by others. This article came across as agenda driven to me.

Link to comment
Share on other sites

The "unwarranted use of antibiotics" is what sticks out for me. If the tics and OCD are diminished w/ antibiotic use, I think its safe to say there is evidence of a bacterial etiology, and that, in itself, warrants the use of abx- whether you can find and identify the causative bacteria or not. Symptom improvement on abx, IMHO, is good evidence that abx is warranted. That's a big "DUH", no?

Link to comment
Share on other sites

Are you sh&^%&*( me!!!!

this wasn't an article on pandas...stress makes every condition worse....it was an opportuinity to bash pandas......

It's like lymes you idiots....YOU CANT ALWAYS FIND IT ..think outside the box...

an ointment that works on your rash, may not work on mine or make it worse.....

I AM SO P..... AND IT DOESN'T JUST HAVE TO BE STREP!!!!!!!

WE NEED TO MAKE PITANDS THE BATTLE CRY!!!!

 

http://www.physorg.com/news190034694.html

 

PANDAS don't like stress

 

April 9, 2010 PANDAS is an abbreviation for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections. This diagnosis was created when clinicians observed that following streptococcal infections, which include strep throat, scarlet fever, and impetigo, children developed tics and symptoms of obsessive-compulsive disorder (OCD).

 

 

In a new longitudinal study appearing in Biological Psychiatry, published by Elsevier, researchers identified new infections in children and adolescents with Tourette syndrome (TS) and/or OCD, and compared them with healthy control subjects. They also measured the participants' levels of emotional stress. Prior research has shown that stress is an important factor in developing depression, and that individuals with TS or OCD tend to be particularly sensitive to stress.

 

They then used this data to examine the power of the infections and measures of psychosocial stress to predict future tic, obsessive-compulsive, and depressive symptom severity.

 

Dr. James Leckman, senior author of this project, explains their findings: "We found that periods of tic and OC symptom worsening were independently associated with antecedent newly diagnosed strep infections as well as higher levels of antecedent psychosocial stress. When we looked at just the PANDAS, we also found similar results."

 

In other words, stress may aggravate the impact of prior streptococcal infection in promoting symptoms of TS and OCD. There was no impact of prior streptococcal infections on depressive symptoms.

 

PANDAS remain a controversial topic for many Tourette's experts. For example, another recently completed intensive longitudinal study that tracked a larger number of PANDAS cases found little evidence to support a link between newly diagnosed strep infections and a marked worsening of tic or obsessive-compulsive symptoms.

 

PANDAS is also frequently diagnosed in the community without the application of all the published diagnostic criteria. This has resulted in unwarranted use of antibiotic treatment for TS or OCD when there is no evidence of a recent strep infection.

 

However, some version of PANDAS likely does exist. The typical PANDAS case appears to have an abrupt sudden onset of separation anxiety and obsessive-compulsive symptoms, a loss of writing skills, and sleep problems. Tics are often present, but they can also confuse the picture, especially if they had been present in some form prior to PANDAS onset.

 

It is important to note that the number of PANDAS cases in this study was too small to allow firm conclusions, but it does indicate how important psychosocial stress is in TS and OCD, as well as depression.

 

 

More information: The article appears in Biological Psychiatry, Volume 67, Issue 7 (April 1, 2010), published by Elsevier.

 

 

Provided by Elsevier

PITANDS absolutely! Our DS4 gets exacerbations with viral infections. Proven viral infections on swab and bloods. Coronavirus and Epstein Barr. When the virus passes his tics almost go away. Strep is the big offender though. Since AB prophylaxis his tics are way less.

Link to comment
Share on other sites

Man - sometimes I really hate the popular press! Buried beneath this nasty title is the hint that there were a small number of kids with PANDAS in the study. Actually, there were 41 typically - developing kids and 46 kids with Tics / OCD - of which 11 had been previously identified with PANDAS. So they did not find statistical significance for much, but with that small of a number it is not surprising. They also did find more GABHS infections in the PANDAS kids compared to controls or Non Pandas Tic/OCD cases... again not significant, but that could have been due to the low numbers.

 

Overall, though - it seems that this group of authors recognize that some kids have infection-triggered responses, but they are questioning the GABHS piece (I know - we have already found out that it does not have to be GABHS -- unfortunately, it will take years to get that in print in 50 different ways to make it a fact)... Overall, I think this group has some interesting work with immune deficiency, though this is certainly not my specialty area. I'd love to hear other people's take on another article that was in the very same issue of Biological Psychology, which also included Leckman - it found the following:

 

Children with Tourette's syndrome may suffer immunoglobulin A dysgammaglobulinemia: preliminary report.

Kawikova I, Grady BP, Tobiasova Z, Zhang Y, Vojdani A, Katsovich L, Richmand BJ, Park TW, Bothwell AL, Leckman JF.

 

Department of Immunobiology, Yale University School of Medicine, New Haven, Connecticut 06520, USA. ivana.kawikova@yale.edu

Abstract

BACKGROUND: Postinfectious autoimmunity has been implicated in Tourette's syndrome and obsessive-compulsive disorder (TS/OCD), whereas increased frequency of upper respiratory tract infections (URTI) in TS/OCD patients suggests immune deficiency. We hypothesized that antineuronal antibodies may be elevated in patients (reflecting autoimmune processes), and levels of total immunoglobulins (Igs) may be decreased (reflecting immune deficiency). METHODS: We analyzed plasma of TS/OCD patients (n = 24) and healthy age- and sex-matched control subjects (n = 22) by enzyme-linked immunosorbent assay (ELISA) for the levels of total and specific IgG, IgM, and IgA against antigens previously identified in multiple sclerosis (myelin basic protein and myelin-associated glycoprotein) and Sydenham's chorea (ganglioside-GM1, lysoganglioside, and tubulin). RESULTS: Total IgA was decreased in TS/OCD patients (median 115 mg/100 mL) compared with control subjects (141 mg/100 mL; p = .02). Specific IgA against all antigens, except tubulin were also decreased in the patients (MPB 0 vs. 13 [ELISA units [EU]; myelin-associated glycoprotein 29 vs. 44 EU, p = .04; ganglioside GM1 21 vs. 35 EU, p = .01; lysoganglioside 44 vs. 56 EU, p = .03; tubulin 44 vs. 44 EU, p = .8). The levels of total IgA and anti-myelin basic protein (MBP) IgA were significantly lower in the subgroup of pediatric autoimmune neuropsychiatric disorder associated with Streptococcus (PANDAS) cases (n = 10) than in non-PANDAS cases (n = 9; total IgA 98 mg/100 mL vs. 133 mg/mL, p = .03; anti-MBP IgA 1 vs. 6 EU, p = .03) or healthy control subjects (total IgA 141 mg/100 mL, p = .02; anti-MBP IgA 13 EU, p = .005). CONCLUSIONS: At least some TS/OCD patients may suffer IgA dysgammaglobulinemia, possibly rendering the children more prone to URTI. Copyright 2010 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

http://www.ncbi.nlm.nih.gov/pubmed/20006327

Link to comment
Share on other sites

EXACTLY....we don't need another stress study!!!!!!ON ANYTHING....if you have condition, syndrome, rash....stress will make it worse...STudy complete, now give me a couple of mill so i can do some real research....G.D....*%^&(%*()($#*&()($#@%&(!!!!!!!!!!!!!!!!!!!!!

I AM SO MAD!!!!!!!!!!!

 

what do we do vickie.....i am overwhelmed here...but i can certainly write my story up and put it somewhere.......

 

 

 

OMG! I have a google alert set up for PANDAS...that's how I find out about these articles. between the day I posted this and today there are so many websites posting this stress story! I feel like we need to go in "damage control" mode.
Link to comment
Share on other sites

Well, I think when I find a little more time (hopefully in a few days while the story is still fresh), I'll just simply go the various places that are posting this article and comment. I always try to write it calmly so they will hopefully take the comment seriously and I include a link to a site such as www.pandasnetwork.org so they can see what these disorders really entails. I'm tired of this disorder looking like a just a bunch words or a game of whose going to win the debate. People need to remember that there are kids, adults, families really and truly affected by this.

 

Again, there's just too much drama and suffering in our own, independent lives to keep playing games with these people.

Link to comment
Share on other sites

Well, I think when I find a little more time (hopefully in a few days while the story is still fresh), I'll just simply go the various places that are posting this article and comment. I always try to write it calmly so they will hopefully take the comment seriously and I include a link to a site such as www.pandasnetwork.org so they can see what these disorders really entails. I'm tired of this disorder looking like a just a bunch words or a game of whose going to win the debate. People need to remember that there are kids, adults, families really and truly affected by this.

 

Again, there's just too much drama and suffering in our own, independent lives to keep playing games with these people.

 

 

Perhaps we need to align forces and try to send the same message to every site we find. Perhaps we could enlist Buster's help to come with a rational, understandable response to this misrepresentation of the article, and we could try to post similar words... you know - kind of like "talking points"...

Link to comment
Share on other sites

If I can publicly post a comment, I do that so even if the writer disagrees with what I say, the public still has a chance to read my view.

 

I agree, that almost something like our own "press release" in response to the article would be nice. But it needs to be polite and to the point. If we start a lot of lecturing they won't read it.

 

Do you want to take a try at writing it?

Edited by Vickie
Link to comment
Share on other sites

If I can publicly post a comment, I do that so even if the writer disagrees with what I say, the public still has a chance to read my view.

 

I agree, that almost something like our own "press release" in response to the article would be nice. But it needs to be polite and to the point. If we start a lot of lecturing they won't read it.

 

Do you want to take a try at writing it?

 

i agaree in that if it sounds lecutrey, angry , we nay not get the response we'd like

one idea for who ever may write this is...take snippets from other artilces...even the things that postulates theories of why things are working even though they shouldn't, because it's already well thought out, ... like the article i just posted and make sure you include a bibliography.....

Link to comment
Share on other sites

If I can publicly post a comment, I do that so even if the writer disagrees with what I say, the public still has a chance to read my view.

 

I agree, that almost something like our own "press release" in response to the article would be nice. But it needs to be polite and to the point. If we start a lot of lecturing they won't read it.

 

Do you want to take a try at writing it?

 

i agaree in that if it sounds lecutrey, angry , we nay not get the response we'd like

one idea for who ever may write this is...take snippets from other artilces...even the things that postulates theories of why things are working even though they shouldn't, because it's already well thought out, ... like the article i just posted and make sure you include a bibliography.....

 

I agree - and I lecture for a living, so I am probably not the best person to do it! If I have time later I'll try to pull out a few points but only if others are willing to honestly tear it apart. If anyone else wants to take a stab at it, I'm happy to put in my 2 cents.

Link to comment
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
 Share

×
×
  • Create New...