Researchers from Yale University have uncovered a potential cause of obsessive-compulsive disorder (OCD) in some children. They found that certain antibodies—proteins the body produces to fight infections—may mistakenly target specific brain cells, leading to OCD symptoms.
This discovery offers new insights into how certain mental health conditions develop and could point to new treatments in the future.
The study, led by Christopher Pittenger and published in the American Journal of Psychiatry, focused on a condition called Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS).
First described in the 1990s, PANDAS refers to a type of OCD thought to be triggered by strep throat or similar infections.
These infections might cause the immune system to go awry, attacking not only bacteria but also certain parts of the brain. While PANDAS has been a controversial diagnosis, many parents and some doctors believe it explains a subset of OCD cases in children.
Children with PANDAS often have symptoms that go beyond typical OCD. While OCD affects 1% to 3% of children by age 17, those with PANDAS may show additional signs, including extreme separation anxiety, difficulty controlling motor skills, frequent urination, and refusal to eat.
However, not all doctors agree that PANDAS is a distinct disorder, and its exact role in OCD cases remains unclear.
In the study, the researchers analyzed blood samples and brain activity in 27 children diagnosed with PANDAS and compared them to 23 children without the condition.
They discovered that many PANDAS children had unusually high levels of antibodies that specifically target interneurons. These are specialized brain cells that help regulate how other brain cells communicate.
The antibodies were most concentrated in a brain region called the striatum, which is linked to movement and compulsive behaviors. When these antibodies attach to interneurons, they seem to weaken the cells’ activity, potentially disrupting brain functions related to OCD.
Interestingly, the findings also connect PANDAS to another neurological condition—Tourette syndrome.
Tourette syndrome, which causes vocal and motor tics, has been linked to a shortage of similar interneurons in the striatum. This overlap suggests that problems with these brain cells might contribute to several disorders.
The Yale team plans to investigate whether similar antibodies are present in other children with OCD and Tourette syndrome.
By studying a broader group, they hope to determine how common these immune-related issues are and whether they can explain more cases of these conditions.
This research opens up possibilities for new approaches to diagnosing and treating OCD, particularly in cases where the immune system may be involved.
While much work remains to be done, the study offers hope for better understanding and addressing the causes of OCD and related disorders in children.
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