Relationship of Movements and Behaviors to Group A Streptococcus Infections in Elementary School Children

Background Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcus (PANDAS) research is based on the hypothesis that infections trigger changes in behavior and movement in children. Methods We enrolled 693 children (ages 3 to 12 years) into a systematic, longitudinal study. Dat...

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Bibliographic Details
Published in:Biological psychiatry (1969) 2007-02, Vol.61 (3), p.279-284
Main Authors: Murphy, Tanya K, Snider, Lisa A, Mutch, P. Jane, Harden, Elaine, Zaytoun, Annette, Edge, Paula J, Storch, Eric A, Yang, Mark C.K, Mann, Giselle, Goodman, Wayne K, Swedo, Susan E
Format: Article
Language:English
Subjects:
ADHD
Adolescent
behavior
Child
Child Behavior Disorders - epidemiology
Child Behavior Disorders - psychology
Child, Preschool
Chorea - epidemiology
Chorea - physiopathology
choreiform
Data Interpretation, Statistical
Female
group A streptococcus
Humans
Longitudinal Studies
Male
Neurologic Examination
PANDAS
Pharynx - microbiology
Prospective Studies
Psychiatry
Seasons
Streptococcal Infections - epidemiology
Streptococcal Infections - physiopathology
Streptococcal Infections - psychology
Streptococcus
Streptococcus pyogenes
Tic Disorders - epidemiology
Tic Disorders - psychology
tics
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Summary:Background Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcus (PANDAS) research is based on the hypothesis that infections trigger changes in behavior and movement in children. Methods We enrolled 693 children (ages 3 to 12 years) into a systematic, longitudinal study. Data were collected monthly for 8 months (October–May) to determine point prevalence of Group A Streptococcal (GAS) infections, tics, behavior, and choreiform movements. Simultaneous throat cultures were obtained, and relational analyses were made between GAS and movement/observation ratings. Results Combined behavior/GAS associations (concurrent with or 3 subsequent months to GAS) revealed a strong relationship, relative risk (RR) of 1.71 ( p < .0001). Detailed analysis revealed that balance/swaying and non-tic grimacing were responsible for a significant proportion of this association (RR = 2.92, p < .0001). A strong seasonal pattern was found, with fall being more significant for GAS infections and observation ratings ( p < .0001) compared with winter/spring. Children with repeated streptococcus ( n = 64) showed higher rates of behavior and distal choreiform observations ( p = .005). Conclusions Motor/behavior changes were noted to occur in relationship to positive GAS culture with support that repeated GAS increases risk.
ISSN:0006-3223
1873-2402
DOI:10.1016/j.biopsych.2006.08.031