Researchers Discover Subtle Brain Abnormalities in Children with PANS
Researchers from Stanford University have uncovered subtle structural differences in the brains of children with a rare condition that seemingly causes their personalities to change overnight.
Children with Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) experience a rapid onset of symptoms, including new obsessions, compulsions, dramatic mood swings, and tantrums.
Little is known about the condition, and many pediatricians are unaware of its existence, according to U.S. News & World Report. Some experts suggest that PANS is triggered by an infection, such as streptococcus, which leads to the immune system attacking the brain. However, some pediatricians view the symptoms as purely psychological.
The Stanford researchers documented microstructural differences in the brains of children with PANS, a development that could potentially facilitate the diagnosis of the condition. These abnormalities are not visible with standard magnetic resonance imaging (MRI). The hope is that brain scans could eventually be used as a diagnostic tool for PANS, the researchers said.
Still, these observations do not prove that the structural differences cause PANS symptoms, according to Dr. Jennifer Frankovich, the lead author of the study. However, they indicate that certain brain structures are affected in these children.
And if an autoimmune response is indeed the culprit, then inflammation may be driving the changes.
“We are operating under the hypothesis that [PANS] is an inflammatory process,” said Dr. Kyle Williams, director of pediatric neuropsychiatry and immunology at Massachusetts General Hospital in Boston, to U.S. News & World Report.
Williams, who was not directly involved in the study, added that anti-inflammatory medications, such as corticosteroids, could be used to treat PANS if further research confirms the study’s findings.
The symptoms of PANS were first observed in the late 1980s when researchers noticed that some children were displaying sudden obsessive-compulsive behaviors. The onset of psychiatric and neurological symptoms following a streptococcal infection is called PANDAS. PANS is the term used when other types of infections are suspected.
The Stanford researchers used special software to analyze diffusion magnetic resonance brain scans from 34 children with PANS and 64 healthy controls. They found increased water molecule movement in certain brain regions, especially the basal ganglia and amygdala.
The basal ganglia plays a role in learning, movement, and emotional expression. The amygdala is also involved in emotional processes, particularly fear.
Further research is needed to determine the significance of these differences and whether they are permanent, said Frankovich. The study was published in JAMA Network Open.