Pediatric early-onset neuropsychiatric obsessive compulsive disorders

Area of Science:

• Neuroscience
• Child Psychiatry
• Infectious Disease

Background:

• Pediatric autoimmune neuropsychiatric disorder associated with Group A beta-hemolytic streptococcus (PANDAS) and pediatric autoimmune neuropsychiatric syndrome (PANS) are increasingly recognized conditions.
• These disorders, along with Tourette syndrome, manifest with obsessive-compulsive disorder (OCD) behaviors and share common central nervous system (CNS) pathways.

Purpose of the Study:

• To review the clinical and neuroimaging features of PANS, PANDAS, and Tourette syndrome.
• To highlight the need for neuroscience collaborations to advance the understanding and management of pediatric neuropsychiatric disorders.

Main Methods:

• Review of clinical vignettes and descriptive clinical and neuroimaging correlations from the author's file.
• Analysis of shared neuroimaging features, including medial temporal lobe and hippocampal hypometabolism on 18F-Fluorodeoxyglucose positron emission tomography fused to magnetic resonance imaging (PET/MRI).

Main Results:

• PANS, PANDAS, and Tourette syndrome exhibit overlapping neuroimaging findings suggestive of CNS pathway involvement.
• Advances in medial temporal area neurobiology and CNS immune responsiveness provide new insights into these disorders.

Conclusions:

• The field of pediatric neuropsychiatric disorders manifesting OCD behaviors is at a critical juncture.
• Collaborative clinical trials are essential for developing evidence-based guidelines for the management of early-onset childhood OCD, particularly PANS.