Researchers from Yale University have discovered a potential cause of obsessive-compulsive disorder (OCD) in some children, involving antibodies that attack specific brain cells known as interneurons.
These findings provide fresh insight into the biology of mental illness and could lead to new ways of understanding and treating OCD.
The study focuses on a condition known as pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, or PANDAS, first proposed in the 1990s.
Children with PANDAS develop OCD and other symptoms after a strep infection, but the biological mechanisms behind this condition have remained unclear.
OCD, a disorder that affects about 1% to 3% of children by the age of 17, can severely impact daily life. While the proportion of OCD cases linked to PANDAS is not known, it is a controversial topic in the medical community.
Some doctors believe PANDAS is simply a subset of OCD with no distinct biological basis, while others—including many parents—argue it accounts for a significant number of childhood OCD cases.
Children with PANDAS often show not only OCD symptoms but also severe separation anxiety, frequent urination, subtle motor difficulties, and, in some cases, refusal to eat. These unique symptoms set them apart from children with more typical forms of OCD.
To investigate further, the researchers studied 27 children who met strict criteria for a PANDAS diagnosis and compared them with 23 children without the condition. They found that many of the PANDAS-diagnosed children had high levels of an antibody that specifically targets interneurons in the brain.
Interneurons are specialized cells that help regulate the activity of nearby neurons. The study showed that these antibodies were concentrated in the striatum, a region of the brain involved in motor control and linked to OCD.
When the antibodies attach to these interneurons, they reduce the cells’ activity, potentially disrupting brain function and triggering OCD symptoms.
Interestingly, the study also highlights a connection to Tourette syndrome, a condition characterized by vocal and motor tics.
Adults with Tourette syndrome lack certain interneurons in the striatum, suggesting that problems with these brain cells may contribute to a range of related disorders.
The researchers hope to extend their work by studying other children with OCD and Tourette syndrome to determine how common these interneuron-binding antibodies are across these conditions. This could pave the way for new treatments targeting the underlying biology of these disorders.
The study, led by Christopher Pittenger and published in the American Journal of Psychiatry, sheds light on the complex relationship between the immune system and mental health, offering hope for better understanding and treatment of OCD and related conditions.
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