Pediatric Autoimmune Neuropsychiatric Syndrome

Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS) are sudden-onset severe psychiatric syndromes that present in prepubertal children. Children present with abrupt-onset obsessive compulsive disorder and/or eating restriction in conjunction with new or abrupt worsening of other neuropsychiatric issues (anxiety, behavior changes, tics, sensory dysregulation, urinary changes, sleep disturbance). Epidemiological and animal data point towards this disorder as being a post-infectious neuroinflammatory disorder involving the basal ganglia. Most children have neurotypical development before onset of the condition and this striking change often causes extreme levels of mental anguish and tremendous caregiver burden.

There are researchers across the globe working on multiple aspects of PANS/PANDAS. Researchers are investigating many aspects of this disease including: the microbiome, immunogenetics, adaptive and innate immune differences, polysomnography, imaging, etc. Several animal models exist as researchers investigate the underlying infectious and immunological etiology of these conditions. Clinical research is focused on the natural course of the condition as well as treatments.

The goal of this Research Topic focused on PANS/PANDAS is to bring together both broad picture review of the topic as well as very specific reports on subtopics related to PANS/PANDAS. The Research Topic may focus both on diagnosis and treatment of the condition.

Clinical treatments are focused both on anti-inflammatory approaches (non-steroidal anti-inflammatory medications, antibiotics and steroids) as well as behavioral and psychiatric interventions to treat obsessive-compulsive disorder and the associated symptoms. Most studies to date are observational trials with only two randomized trials which have conflicting results. However, there is a new international trial examining the use of intravenous immune globulin as part of the treatment coarse of this condition.

We propose a focus on PANS/PANDAS with articles focused on the basic science (animal models) and clinical research related to conditions. We will consider manuscripts such as original research articles (both basic science and clinical research), review articles, perspectives, and short communications.