PANDAS – Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococci

I recently became aware of this condition where a variety of emotional and psychiatric symptoms arise due to an adverse reaction to the strep virus. I hope to raise awareness and note the import of understanding this condition for mental health professionals and consumers.
Years ago, I specialized in child mental health and saw cases of anxiety with no apparent precursor. Despite my psychodynamic training, it became clear to me that family dynamics played little to no role in the etiology of these conditions. However, in some of the cases, I could find no clear explanation. I suspect I was dealing with PANDAS. Some background:

PANDAS, is an abbreviation for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. The term is used to describe a subset of children who have Obsessive Compulsive Disorder (OCD) and/or tic disorders such as Tourette’s Syndrome, and in whom symptoms worsen following streptococcus infections such as “Strep throat” and Scarlet Fever.
The children usually have dramatic, “overnight” onset of symptoms, including motor or vocal tics, obsessions, and/or compulsions. In addition to these symptoms, children may also become moody, irritable or show concerns about separating from parents or loved ones. This abrupt onset is generally preceeded by a Strep throat infection.

How does Strep throat lead to PANDAS?

What is the mechanism behind this phenomenon? At present, it is unknown but researchers at the NIMH are pursuing a theory that the mechanism is similar to that of Rheumatic Fever, an autoimmune disorder triggered by strep. throat infections. In every bacterial infection, the body produces antibodies against the invading bacteria, and the antibodies help eliminate the bacteria from the body. However in Rheumatic Fever, the antibodies mistakenly recognize and “attack” the heart valves, joints, and/or certain parts of the brain. This phenomenon is called “molecular mimicry”, which means that proteins on the cell wall of the strep. bacteria are similar in some way to the proteins of the heart valve, joints, or brain. Because the antibodies set off an immune reaction which damages those tissues, the child with Rheumatic Fever can get heart disease (especially mitral valve regurgitation), arthritis, and/or abnormal movements known as Sydenham’s Chorea or St. Vitus Dance.
In PANDAS, it is believed that something very similar to Sydenham’s Chorea occurs. One part of the brain that is affected in PANDAS is the Basal Ganglia, which is believed to be responsible for movement and behavior. Thus, the antibodies interact with the brain to cause tics and/or OCD, instead of Sydenham Chorea.

In other cases, the child with PANDAS can become fearful, especially surrounding separations from parents. Mood swings have an abrupt onset and are more extreme than prior to the strep infection. There is a clear and dramatic change.
The best treatment seems to be antibiotics to address the strep infectiom. However, even after the infection is ended, the antibodies can remain in the child with negative impact.
I suspect many counselors have seen children with PANDAS without knowing it. The following description seems quite plausible:

Typically, a child with undiagnosed PANDAS may be taken to the Psychologist and/or Paediatrician for treatment of an onset or exacerbation of ADHD symptoms, oppositional behaviours or OCD. Stimulant or anti-depressant medication may be prescribed and/or a behavioural intervention or counselling initiated. As the infection passes and the strep antibodies reduce, the symptoms gradually subside and parents and clinicians believe that the intervention was successful. However then there is another strep infection, the symptoms return and the process is repeated. The problem is that the brain is being continuously damaged by the repeated attacks by streptococcus antibodies; and after each attack the recovery of damaged brain tissues may not be as complete as we would hope. Eventually the child may develop a chronic psychiatric disorder

This condition should cause health professionals to reconsider models of personality and psychopathology development. Counselors advising parents who have a child with PANDAS might be tempted to propose environmental theories for sudden anxiety states. However, such hypotheses would be far off. Counselors should take detailed health histories even with adult clients given how this biological causal factor gradually coould compromise mental health and lead to a psychiatric condition. Rather than hunt for psychic trauma, a bacterial trauma may be implicated.
This disorder came up on another thread regarding causes of same-sex attraction. There is no evidence as yet that a virus/bacteria could create a similar autoimmune reaction which would effect brain development or perhaps glutamate levels in the developing brain. However, it appears that behavior and emotional experience are effected in PANDAS. Is it a stretch to think other experiences (e.g., sexual attraction) might be altered in some similar manner?
Part 2 discusses a paradigm shift in treatment stimulated by PANDAS.

40 thoughts on “PANDAS – Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococci”

  1. Warren,
    OMG, I just read the article you shared with Victoria. Recall that I researched PANDAS right before I found this blog. I was a kid with some compulsions, and I think (but can’t be absolutely sure ) that it all began after an illness. Well, the behaviors you describe in your article fit me to a tee. The checking under the bed for a snake or a monster or something bad hanging out is still vivid in my memory. The checking over and over and over just wore me out. I would guess I was about 8.
    I KNEW that it was absolutely silly, but each time I checked under the bed and found nothing, I became immediately convinced that I hadn’t checked well enough. There was always a reason that compelled me to check again. I would be worn out in the morning.
    I am convinced I had a case of it.

  2. As a mother of a 5 year old w/ PANDAS, it scares me how the medical community is pushing these children aside and not treating them. I cannot even get proph antibiotics for my son even though he had his tonsils out to prevent strep, just to get strep and PANDAS resurface a month later for a 3rd time. It has been 5 months since his last strep infection. He is close to baseline and is still recovering from some residual OCD. I pray to God he doesn’t get sick again. He is entering kindergarten in a week.

  3. I think this is the right thread for this: Yowza!
    I mean I knew about the other infectious causes of schiz, but I had never heard that T. gondii was also a cause. I do know they figure that the wide spectrum of behavior termed schiz (and of course they have physiological proof that the brain has undergone deterioration by looking at scans) is caused by many things including different pathogens that have been identified as suspects, but T gondii?
    I’ve lived with cats all my life!

  4. Patrick said,

    As for Paul Cameron – he is an extremely antigay propagandist who uses BS stats to try to paint gays as diseased and depraved.

    Thanks for the heads-up. I don’t know what causes that kind of belief/behavior from someone who’d say that.
    I am always reminded of John Knowles, who through his narrator Gene in
    A Separate Peace spoke of “something ignorant in the human heart.”

  5. Patrick said,

    If you are talking about non-STD pathogens – then the most likely mode of transmisson is inhalation and/or physical contact (shaking hands – handling contaminated objects etc).

    We really don’t know. What we do know is that germs are like the inimitable cockroach–always changing or ready to change. Yes, many of these non-STDs would gain their mobility through a host’s sneezing, coughing, touching, not through sexual contact. A lot of them don’t transport themselves at all. They are content to live on us–skin, hair, eyelashes even–and in us,–in our mouths, ears, nose and other orifices.
    The thing is, however, when those germs happen to get introduced into a new environment, one that they find unfriendly, they are just like us–they struggle mightily to survive. They are looking to grab onto something that will act like a life raft the same way a non-swimmer is looking for one when he finds himself in a body of water.
    So, if a germ is introduced into the rectum by a finger, a penis, a whatever…. and finds it a hostile place, it may find egress out of there through a tiny life raft–a scratch in the rectal wall (and the rectum is not hard to scratch). Some germs are better at surviving than others.
    The question becomes, can that germ survive in that environment? Can it replicate itself there? If it does, and it causes symptoms, the host goes to the doctor and the doctor treats the infection. This is what happens with most STDs. Thankfully, most of them produce uncomfortable symptoms, uncomfortable enough to get people to seek help before the germ has done lasting damage. However, women infected with syphilis are often asymptomatic for a long time. This is when things are really dangerous–when they don’t produce symptoms, and thus the host doesn’t get treated quickly.
    Sorry— back to the hypothetical “non-STD” germ in the rectum—if it is still alive but finds the other side of the rectal wall just as unfriendly as the rectum itself, can it transport itself to a friendlier environment like the liver, the spleen, the intestines, the wherever? Can it latch onto the outside of the colon’s wall, for instance? Can it hop a ride to another place, a friendlier place, by riding through the blood stream? Can it change itself and manage to survive somewhere in the body by not making itself known for a long while, by seeing to it the host has no symptoms? Then, years and years later, will it have been found to be the cause of a slow-growing tumor, a cancer?
    Or, did the germ just die, finding that it could not survive the environment in which it found itself? Or another possibility…. did it manage to find a safe place where it could reproduce and live happily and peacefully inside us like it appears so many others do.( I’ll add here that we should not be one day surprised to discover that so-called benign germs that live in our stomach or digestive tract, say, have actually done damage we didn’t anticipate.)
    As in so many cases, the load matters. A few germs introduced into a strange new place might die quickly in such an environment, but if a lot of germs are introduced a few at a time through each sexual contact, perhaps a really strong one survives and evolves to prosper and multiply.
    This is where the field of molecular biology is now headed since science has accepted that the germ theory of disease put forth by people like Hamilton, Ewald, and Cochran was not poppycock. It’s taken many years for the theorists to have convinced the people in the labs that they were looking for the causes of cancer in many of the wrong places. Perhaps it was just failure alone that convinced those researchers and their progeny that they had been looking in the wrong places. Compare the number of studies of pathogenic causes of things done 20 years ago to the number today, and it is astounding.
    It’s dawning on them that the brain is just like all our other organs–susceptible to those wily germs. And the most intriguing question of all is, “Are there germs that have hijacked our brains and thus our behavior to their own advantage, like T. gondii, which uses the rodent as an intermediary host to get to its ultimate host, the cat and a few other animals, including man? The rodent infected with T. gondii loses its fear of cat urine and is eaten by the cat. Viola! Mission accomplished. (BTW, there is no suggestion here that SSA is the by-product of such a hijacking.)
    People can die from the brain cysts of T gondii. Pregnant women lose their babies or their babies suffer damage. However, millions of people in the world, particularly people in countries that eat undercooked meat, have T. gondii infections and researchers are studying whether their behaviors have been affected even though they certainly do not appear ill. France is one such country although there are many others. Yes, it’s a great subject of jokes among researchers that the French are loaded with T. gondii. Does that explain the de Gaullian personality of so many? LOL.

    I would think that the celibate gays would be just as likely as the sexually active gays to have these pathogens (as well as everyone else).

    Yes, of course, these same non-STD pathogens are on and in the bodies of both celibate and non-celibate people of all orientations.
    However, because a celibate person, gay or straight, has had nothing introduced into a rectum, colon, or vagina, (unless they placed an object there) those pathogens don’t enter those places where they then might find a passage to another part of the body as I described above. And, I will repeat that it’s much easier to get from the rectum to another part of the body than it is to get from the vagina to another part of the body.

    1. Good find, wow this stuff is happening everywhere!

      The said truth is that if this happened to humans scientists would immediately start looking for the genes responsible. For example up until recently 90% of all Autism research money went towards genetics. (facepalm)

  6. If you are talking about non-STD pathogens – then the most likely mode of transmisson is inhalation and/or physical contact (shaking hands – handling contaminated objects etc). I would think that the celibate gays would be just as likely as the sexually active gays to have these pathogens (as well as everyone else). [Baring instances of HIV-low immunity]. I mean this is why we distinguish between infections caused by sexual contact and other infections.
    As for Paul Cameron – he is an extremely antigay propagandist who uses BS stats to try to paint gays as diseased and depraved.

    1. Patrick
      By the time someone is an adult it seems almost certain that virtually everyone would have come in contact with the “gay germ.” That makes it really tough.

      Maybe scientists could look at young children with gender dysphoria for increased reactivity to something. Realistically speaking sheep are the easiest because scientists can remove them from their normal environment and crank down the variables until they get an answer. If a “gay germ” actually exists and they find it then they can look for it in humans.

  7. Sorry I didn’t proofread that post above very well, Patrick. The sentence following the blocked quote were your words as well. (Plus, I caught other errors. I swear there are gremlins on this site! I thought I had proofed my words carefully, but well…sorry)

  8. Patrick, I am posting this to the first PANDAS thread since Warren wanted any comments relating this on this thread rather than on Part 2:
    In answering my last post on that you said,

    You know anal sex doesn’t create pathogens. If a couple is free of STDs remains monogamous – then they don’t magically create new pathogens.
    Certainly that group of gay men could be looked at if a disease free sample was needed.

    Perhaps I am too sensitive here – but it seemed like you were veering awfully close to the ‘gay men as disease ridden’ point of view (ala Cameron etc).
    Yes, I surely know that anal sex doesn’t “create new pathogens.” However, it provides an avenue of entry into the the body in ways vaginal sex does not or at least it provides a much easier avenue of entry.
    1. “Pathogens, ” as both Drowssap and I have been using the term (I think I can speak for him) include more than the usual suspects that we term “STDs” and which were once called venereal diseases. That is what makes this so difficult.
    We don’t KNOW all the pathogens that may spread through sexual contact and cause something. AFter all, that is why were were having this discussion to begin with. Who would have ever thought the behavior Warren referred to (PANDAS) was caused by a strep infection?
    So, we are thinking here in terms of germs/bugs of all kinds, including ones that we believe have peacefully co-existed with us, living on our skin, in our intestines, stomach, etc. and which, up to this point in time, have appeared to do nothing harmful or out of the ordinary.
    We are thinking not just about STDS, but beyond things that we ordinarily think of as causing “diseases.” AFter all, a common bug on my finger means nothing unless it gets into my blood stream and there attacks a mitral valve that might be a bit “sticky.” Then, it becomes dangerous.
    2. So, the discussion is not limited to STDs but even if it were, it remains true that even a couple who use precautions (hetero and homosexual) in their sexual practices, cannot be intimate in a sterile environment. Nature, of course, knew this and provided for this, , managing to give our bodies mechanisms to shed invaders that could be introduced through sex or through sexual play and intimacy.
    Even a condom put on carefully is loaded with pathogens the minute it is removed from the wrapper. So is a woman’s diaphram. So is the penis. The difference is that a vagina is not as susceptible to infection as is a rectum, anyone’s, straight or gay, and that is because of its biology and structure. So a bug that is quite benign on my hand, introduced into the rectum , through which it can easily pass into the capillaries beyond that thin cell lining, makes anal sex riskier than vaginal sex for two major reasons–thin cell and the reduced capacity to shed the way the vagina.
    So while a mongamous gay couple or a straight couple practicing anal sex believe they have been very careful and while, because they are monogamous, they won’t pass on STDs (the usual suspects) they can and do pass on bugs that are likely to make their way beyond the anal wall and also up into the colon. That’s when we don’t know what bugs are capable of causing trouble and which aren’t.
    Nature provided us an anal sphincter valve that opened outward, a point illustrating and reminding us that evolution hasn’t yet changed our bodies to the point that anal sex has the same defense mechanisms as vaginal sex. This is a point people of all orientations need to be aware of. Not contacting what we normally term STDs like syphilis, gonorhhea, etc. is not proof that there aren’t bugs getting where our bodies never expected them to go and for which defenses have not yet been designed.
    So, that’s what the point was about anal sex. A bug of any kind has tremendously greater chance of getting through an anal wall than the tough muscular wall of the heavily mucoused lining of the vaginal. Even the chemical make-up of the mucous lining of the two are different, if I remember my college physiology.
    3. I have to confess, Patrick, that I don’t know who Cameron is. If he writes about pathogens as a possible trigger to SSA, I haven’t yet read him.

  9. Whoops, two more.

    Cerabral Palsy
    (Urinary tract infections, Herpes Virus)

    (Viral infection especially Herpes)

  10. Is SSA triggered by a childhood infection? Nobody knows but it might be useful to see what other things are triggered by pathogens.

    (Common respritory infections, Flu Virus, Toxoplasma, Tick Born Encephilitus)

    Pandas (OCD Tourettes)
    (Strep Throat)

    (Strong evidence of as of yet unknown Virus)

    (Herpes Virus)

    (Flu Virus association, environment is growing area of interest)

    Pathological Left Handedness
    (Meningitis Infection)

    Multiple Sclerosis
    (Infection with Epstein Barr Virus required)

    Most of this stuff has been figured out in just the last 5 to 10 years. In another decade this list will be many times larger and more definitive. When you are thinking about phenomenon that commonly effect young people you’d have to be crazy to bet against pathogens.

  11. Eminem is prolly throwing a party over the news.
    But, Drowssap, read the fine prints. What the Jewish folks have done was expose a bunch of mice to a pesticide and heroin before birth. They did it deliberately to damage a few specific areas, because new neurons can only be generated in two areas (dentate gyrus and lateral ventricles). Seems they’ve been working on this for a few years (link). Those areas are not part of the core circuitry of the sexual radar. They’re involved in brain protection and memory formation. That’s what they did actually, they restored learning ability:

    In the researchers’ animal model, they were able to reverse learning deficits in the offspring of pregnant mice who were exposed to organophosphate (a pesticide) and heroin. This was done by direct neural stem cell transplantation into the brains of the offspring. The recovery was almost one hundred percent, as proved in behavioral tests in which the treated animals improved to normal behavior and learning scores after the transplantation. On the molecular level, brain chemistry of the treated animals was also restored to normal.

    This might help a few folks with depression and learning problems in the future, but that’s about it. Geeky scientists like to talk big about their work in the news just like any other member of the family. They say “generally speaking, stem cells may develop into any type of cell in the body”, which means that they can develop into any type of cells in some areas.
    On a related note, personality traits are linked with brain wiring like the sexual orientation brain patterns in the last year Swedish study. That’d be homework for the 3D-thinking futuristic minds: fine-tune your personality to match your real-world avatar. Body, that is.

    1. I just did some googling to confirm this but scientists say they can regrow the Neurons that produce Dopamine. This should ultimately (theoretically) cure Parkinsons. I’m not sure where those Neurons are located, maybe they are in one of the 2 locations you mentioned.

    2. I’m no scientist either. Who knows, maybe they will do that. From what I’ve read, it’s not possible right now. But I know that you’re very optimistic and always check out frontier science stuff.
      The Parkinson’s D case – neurons producing dopamine in a certain area degenerate and don’t produce enough of it to maintain direct communication between two brain areas and keep movement orderly. The method to stimulate regrowth that you mentioned did not produce new neurons and neither did it restore communication between those brain areas. What they did was to attach dopamine to a chemical compound to trick degenerated neurons into projecting again. They did not create new neurons (like in the case of neural stem cells), they encouraged the old ones to shoot projections (axons or dendrites) again. This is called neurite growth and it was only done in a lab on a plate of rat culture cells. The biggest task lies ahead: building the bridges between neurons — synapses. If someone has PD’s or knows someone with the disease, this is another reason to hope for a cure in humans one day.
      That magic powder is cracking cool. Could you cut your finger and make it grow bigger? ;):)

      1. Wow, that’s fascinating about the PD research. I know they are working on gene therapy for PD too. Maybe I’m thinking about what you just wrote about. They inject someone with a virus that programs existing neurons to produce Dopamine again. This basic concept is getting a lot of research attention and probably $. I read one scientist who said they expect this (sometimes called recombinant DNA) will cure Scoliosis in 10 to 15 years. Researchers believe the problem isn’t in the spine, but in the brain. For some reason Melatonin isn’t being processed correctly. In a couple of decades a lot of this stuff is going to be in the history books…. I hope.

        That finger powder is definitely cool. I just hope I don’t have to use it someday. 😎

  12. On a positive note gene splicing has given scientists the ability to rapidly (relatively speaking) produce very powerful vaccines.
    Herpes Vaccine Developed at HMS Licensed for Preclinical Trials
    There are so many awesome vaccines in the pipeline. Epstein Barr, Flu virus, Strep Throat, etc. etc. In another decade or two mental illness triggered by common infections might be a thing of the past.
    The other amazing thing are the treatments. I had no idea that stem cells could find and heal damage all on their own. The future is bright.

  13. Speaking of PANDAS and infectious causation..each year the EDGE asks people about the future. For those interested, try this link for Paul Ewald’s thoughts about the promises of and the obstacles awaiting studies of pathogenic causation of disease. Scroll down about half the page, IIRC, for his piece.

    1. Samples from prostate tumors were tested on a micro-array that contained 20,000 DNA snippets from all known viruses. The results documented a significant association with an obscure retrovirus related to one that normally infects mice. If this virus is a cause of prostate cancer, it causes only a small portion that occurs in men with a particular genetic background.

      Pathogens evolve to defeat particular defense types. This is one reason that genes might correlate with illness but rarely cause it.
      Before scientists spent a single dollar on genetics research you could predict that virtually every illness mankind suffers from correlates (perhaps strongly) with particular genes. Unfortunately in most cases it doesn’t mean very much.

  14. Warren,
    I do concur with your assessment of Mike Bailey if only because I know what a sceptic Greg Cochran is, yet in all his comments about research into this subject, GC has been nothing but complimentary toward Bailey. He uses him as a resource on many of the topics surrounding this issue (concordance rates, for example).
    Part of the glt (sorry, I forget the other letter) community was out to destroy his career after his The Man Who Would Be Queen , and the press did a very poor job reporting the details of that story and those who perpetrated it. He was forced to resign as dept. chair although I think the school denied that’s what happened.
    The guy has to be given credit for continuing to pursue his research as it’s clear that some groups have it out for him. This is the kind of thing that in the past dissuaded others from becoming heavily involved in the etiology of homosexuality. Cochran once called it career suicide. That was years ago, however; maybe things have slowly changed. We’ll see.

  15. Say what you will about Bailey, I believe he will follow the evidence wherever it leads. He is very willing to brain scan ex-gays if we can get funding for it. If they have shifted, he will acknowledge it.

  16. Evan,
    I thought that might be what you had in mind.
    As Ewald points out, this tendency exists in all fields. Hamer, for sure, was hoping for a certain result. Levay? I don’t know. Maybe he was more balanced in his analysis of his research than Hamer was about his. Hamer has been pretty much discredited as an objective researcher, I think.
    It makes a great deal of sense that gay people would be interested in such research. We surely can’t fault gay scientists for their interest in such research; it’s perfectly understandable, but yes, we hope there will be no confirmation bias.
    What I object to is that anytime a subject makes politicians too uncomfortable, you can be sure public funding in this country becomes hard to get.
    Sicence will find what science will find, however; only the time frame is what is in question.
    BTW, Sanders is a psychiatrist while his research partner for this particular study, Bailey, is a psychologist. I’m not suggesting that is bad, but I do know that neither is a geneticist; furthermore, the success of geneticists and their genome projects has , in so many ways, been underwhelming. It appears too many thought we’d find a gene for schiz, for bi-polar, for MS, for this, for that.
    It has been suggested that the amount of financial resources devoted to the human genome project be devoted to researching the infectious causation of disease. More and more, those in the research fields believe we would have gotten more bang for our bucks.
    What bothers me most of all is the lack of good reporting about research. If you go by most of the headlines of the last ten years and not read the articles, you’d be 100% convinced that there indeed is a gene for this and a gene for that! At least, in the USA that’s how it is. Journalism has become entertainment and journalists have rooting interests. Nothing illustrated that more than our last Presidential election. There wasn’t even an attempt to cover up any bias. Democracy is in danger when the 4th estate fumbles the ball.

    1. the success of geneticists and their genome projects has , in so many ways, been underwhelming.

      The fact that tens of thousands of scientists spent years looking for common genes that caused common disorders comes down to one thing, $MUCHO DINERO$!
      These guys understood the theory of natural selection. Heck, most of them taught it at universities. But genes were the new thing so it was easy to get funding. There was so much easy money involved that they couldn’t resist. The general public is not aware that despite billions being spent gene hunters have found very little and even less that is actionable.

  17. carole,
    Most scientists working in the field of sexual orientation study are gay; the few ones who are not are hell-bent on proving the inborn (biological) nature of attractions. Some of them practically built their careers on this assumption. They don’t want to deal with the kind of cases I mentioned, because they want to avoid any intimation that there might be social or developmental causes or anything that might not be inborn. Why would that be? Because that could fuel political and social attitudes against gays, putting pressure on them to change or admit it that they’ve chosen their path (or that they have suffered some traumas in their past).
    I have read a few stories about people who were born OSA, grew up to be exclusively attracted to the opposite sex and then started to have mixed feelings at the end of their adolescence. Obviously this goes against the prevailing dogma that sexual orientation is inborn or that it’s the result of very early post-natal factors. I think these people are the best candidates for this sort of study (of environmental influence on attractions).

    Wouldn’t it be interesting to manage to recruit enough subjects who claim to have had a switch and question their parents and them about illnesses?

    Of course. Who would provide the money and clearance for this study to take place, given the status quo?

    I’ve not read their saying anything about the likelihood of infection in a stage of life as late as adolescence or young adulthood, I wonder if they’d say, “Possible” only because we know that bacteria/viruses can infect the CNS of adults and viruses are, it seems, better invaders than bacteria.

    The human brain gets into full adult form in the early twenties. If someone has gotten a strep infection during their puberty, it might take some time until it hits the areas that manage gender sense and attractions.
    But, as I said, scientists are bent on studying sexual orientation, not sexual disorientation.

  18. Wait a minute, I’ve got an idea. Perhaps children who develop OCD have mothers who posess a gene that makes them super attracted to men. These hyper-attracted moms have more children and this makes up for the occasional OCD child.
    I suspect I’ll be receiving a telegram from the Nobel Prize committee in Stockholm very soon.
    (dodging rotten tomatoes)

  19. Evan, you said,

    There’s one type of cases that these scientists don’t want to talk about. The people who were born OSA, grew up OSA and then, after the end of puberty went through changes in attractions. These people are candidates for this sort of thing. Especially if they did go through sinus infections, headaches produced by those problems and were found to have a strep problem later on. I mean, clearly these guys were not born SSA.

    Question: Why would this “type of case” be one “these scientists don’t want to talk about? Also, I am unclear about who “these scientists” are? Do you mean those searching only for a genetic link?
    I know next to nothing about the kind of case you have mentioned, but I have noticed that you and a few others on this blog have mentioned such cases. If this is the case, very interesting.
    I do recall reading that neurosurgeons have offered anecdotal evidence about people who have sustained brain trauma injuries; they exhibit a switching of attractions until such time as their brain heals or reduces in swelling. It was unclear to me whether there is also anecdotal evidence from these same physicians that such a switch remains for an extended length of time or even permanently in any of those patients.
    Those who have hypothesized the pathogen explanation feel that the infectious agent need not strike prenatally. The brain, they say, is especially susceptible to pathogens throughout the first several years (3-4yrs.) of life just as the whole body is (thus, all the childhood diseases), and while I’ve not read their saying anything about the likelihood of infection in a stage of life as late as adolescence or young adulthood, I wonder if they’d say, “Possible” only because we know that bacteria/viruses can infect the CNS of adults and viruses are, it seems, better invaders than bacteria.
    Wouldn’t it be interesting to manage to recruit enough subjects who claim to have had a switch and question their parents and them about illnesses? The problem is that so many pathogens are not those which leave behind signs nor those whose effects are debilitating enough to be remembered. For example, just think about how many times in our lives most of us have had strep infections. We considered them part of life–a sore throat. If the sore throat was bad enough, we were fed antibiotics. In my case and in my generation, the tonsils were yanked out.

  20. Warren,
    This article posits the very basic position of the one of the most, if not the most, respected evolutionary biologists in the field, Paul Ewald. It’s not about PANDAS per se, but about how researchers tend to look in the wrong places. His arguments about pathogens as the cause of many illnesses/behaviors that were once thought to be psychological in nature is one reason research into such things as PANDAS and many other diseases has advanced as it has over the last few years.
    He and others in his field are often frustrated that researchers, even geneticists, have only a layman’s weak understanding of evolution, something that, of course, causes research dollars to be lost in a dark hole. Googling all things Ewald is a very helpful thing in understanding diseases and in understanding new ways of approaching public health policies.
    These two paragraphs in this article put forth his position on some of the problems of research.

    That’s one of the realities of medicine – researchers tend to deny associations. Denial plays a major role as scientists love to hold on to the current dogmatic explanation. This suggests that in order for pathogens to be fully tied to chronic disease we will have to wait until the current powerful people pass away and a sufficient number of young people entering the arena without these vested interests mature into positions of influence, to tip the balance of expert opinion. This is something that Charles Darwin, Max Planck, and Thomas Kuhn all agreed with.
    That’s because powerful people tend to hang on to the opinions that made them powerful even if there is no longer sufficient evidence to support their views. It’s a social problem that relates to the weakness of the mind. Human beings didn’t evolve to be scientists. Instead they evolved to be competitive – to grab and hold onto what is theirs. Hence the name calling often observed among the medical community and the resistance among scientists to fund or support ideas other than their own, ideas that question the validity of current dogma.

    1. powerful people tend to hang on to the opinions that made them powerful even if there is no longer sufficient evidence to support their views. It’s a social problem that relates to the weakness of the mind. Human beings didn’t evolve to be scientists. Instead they evolved to be competitive – to grab and hold onto what is theirs. Hence the name calling often observed among the medical community and the resistance among scientists to fund or support ideas other than their own, ideas that question the validity of current dogma.

      HOLY FREAKIN’ SMOKES is that Narth or what? To be fair the gay gene side isn’t any better.

      1. I think these days the gay gene people are figments of NARTH’s imagination. The biological people exist and are looking at hormones and the geneS that may influence them. I thought about NARTH when she quoted that as well…

  21. There’s one type of cases that these scientists don’t want to talk about. The people who were born OSA, grew up OSA and then, after the end of puberty went through changes in attractions. These people are candidates for this sort of thing. Especially if they did go through sinus infections, headaches produced by those problems and were found to have a strep problem later on. I mean, clearly these guys were not born SSA.

    1. Men who change from OSA to SSA during adulthood might be experiencing a completely different but no less valid phenomenon. This one might have less to do with pathogens and more to do with life experience… but I dunno, it could be anything.

  22. Is it theoretically possible that SSA could be triggered by exposure to a germ or virus? If it turns out to be true it would join a long line of other things that scientists already know are triggered by common, childhood/prenatal infections.
    Another point is that the neurons that create sexual attraction or gender awareness are not invincible like the Death Star. They can be altered or even flipped off just like any other cell in our bodies.

  23. About a year ago I read another PANDAS thread on a mental health blog. One teen who had just heard of this felt relieved that they were finally working in the right direction. He mentioned that the worst anxiety he had ever felt coincided with a severe, sore throat. He said that finally makes some sense.
    A good PANDAS article.
    Peeking into a Child’s Brain

    Trifiletti comments that in some cases, aggressive treatment with antibiotics, such as penicillin, can turn things around for a child with OCD and/or Tourette’s: “You give a short course of intensive therapy and then follow up with prophylactic treatment for a year.”
    He says that 80 to 90 percent of those with OCD and Tourette’s are strep carriers. “They may not get a sore throat but they can shed the bacterium,” he explains. “Something is different about their immune system.”

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