PANS/Immune Behavioral Health Publications

Evaluation and Treatment Recommendations

Tran, P, Frankovich J, Van Mater H, Dale R, Or-Geva N, McHugh A, Thienemann M. “Pediatric Inflammatory Brain Disease" Complex Disorders in Pediatric Psychiatry. A Clinician's Guide1st Edition Editors: David I Driver & Shari Thomas. December 2017.
Cellucci T, Van Mater H, Graus F, Muscal E, Gallentine W, Klein-Gitelman MS, Benseler SM, Frankovich J, Gorman MP, Van Haren K, Dalmau J, Dale RC. Clinical approach to the diagnosis of autoimmune encephalitis in the pediatric patient. Neurol Neuroimmunol Neuroinflamm. 2020 Jan 17;7(2). pii: e663. doi: 10.1212/NXI.0000000000000663. Print 2020 Mar. PMID:31953309
Chang K*, Frankovich J*, Cooperstock M, Cunningham M, Latimer E, Murphy T, Pasternack M, Thienemann M, Williams K, Walter J, Swedo S. Clinical Evaluation of Youth with Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS): Recommendations from the 2013 PANS Consensus Conference. Journal of Child and Adolescent Psychopharmacology, Vol. 25, No. 1, February 2015: 3-13. PMID: 25325534
Swedo S, Frankovich J, Murphy T. Overview of Treatment of Pediatric Acute-Onset Neuropsychiatric Syndrome . J of Child and Adolescent Psychopharmacology. Vol. 27, No.7, September 2017. doi:10.1089/cap/2017.0042
Thienemann M, Murphy T, Leckman J, Shaw R, Williams K, Kapphahn C, Frankovich J, Geller D, Bernstein G, Chang K, Elia J, Swedo S. Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome: Part I-Psychiatric and Behavioral Interventions. J of Child and Adolescent Psychopharmacology. Vol. 27, No.7, 566-573. September 2017. doi:10.1089/cap.2016.0145
Frankovich J, Swedo S, Murphy T, Dale R C, Agalliu D, Williams K, Daines M, Hornig M, Chugani H, Sanger T, Muscal E, Pasternack M, Cooperstock, et al. Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome: Part II—Use of Immunomodulatory Therapies . Journal of Child and Adolescent Psychopharmacology, Vol. 27, No. 7, 574-593. September 2017. doi: 10.1089/cap.2016.0148
Cooperstock M, Swedo SE, Pasternack M, Murphy T, and for the PANS/PANDAS Consortium. Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome:Part III—Treatment and Prevention of Infections. Journal of Child and Adolescent Psychopharmacology.Sep 2017.594-606.http://doi.org/10.1089/cap.2016.0151
Pfeiffer HCV, Wickstrom R, Skov L, Sørensen CB, Sandvig I, Gjone IH, Ygberg S, de Visscher C, Idring Nordstrom S, Herner LB, Hesselmark E, Hedderly T, Lim M, Debes NM. Clinical guidance for diagnosis and management of suspected Pediatric Acute-onset Neuropsychiatric Syndrome in the Nordic countries. Acta Paediatr. 2021 Dec;110(12):3153-3160. doi: 10.1111/apa.15875. Epub 2021 May 6. PMID: 33848371.
Johnson M, Ehlers S, Fernell E, Hajjari P, Wartenberg C, Wallerstedt SM. Anti-inflammatory, antibacterial and immunomodulatory treatment in children with symptoms corresponding to the research condition PANS (Pediatric Acute-onset Neuropsychiatric Syndrome): A systematic review. PLoS One. 2021 Jul 1;16(7):e0253844. doi: 10.1371/journal.pone.0253844. PMID: 34197525; PMCID: PMC8248649.
Pollak TA, Lennox BR, Müller S, Benros ME, Prüss H, Tebartz van Elst L, Klein H, Steiner J, Frodl T, Bogerts B, Tian L, Groc L, Hasan A, Baune BT, Endres D, Haroon E, Yolken R, Benedetti F, Halaris A, Meyer JH, Stassen H, Leboyer M, Fuchs D, Otto M, Brown DA, Vincent A, Najjar S, Bechter K. Autoimmune psychosis: an international consensus on an approach to the diagnosis and management of psychosis of suspected autoimmune origin. Lancet Psychiatry. 2020 Jan;7(1):93-108. doi: 10.1016/S2215-0366(19)30290-1. Epub 2019 Oct 24. Erratum in: Lancet Psychiatry. 2019 Dec;6(12):e31. PMID: 31669058.
Mahmud FH, Lteif AN, Renaud DL, Reed AM, Brands CK. Steroid-responsive encephalopathy associated with Hashimoto's thyroiditis in an adolescent with chronic hallucinations and depression: case report and review. Pediatrics. 2003 Sep;112(3 Pt 1):686-90. doi: 10.1542/peds.112.3.686. PMID: 12949305.

Stanford Clinical Research

Masterson EE, Miles K, Schlenk N, Manko C, Ma M, Farhadian B, Chang K, Silverman M, Thienemann M, Frankovich J. Defining Clinical Course of Patients Evaluated for Pediatric Acute-Onset Neuropsychiatric Syndrome: Phenotypic Classification Based on 10 Years of Clinical Data. Dev Neurosci. 2025 Apr 4:1-17. doi: 10.1159/000545598. Epub ahead of print. PMID: 40188825.
Saini T, Ma M, Sandberg J, Farhadian B, Manko C, Xie Y, Madan J, Bauer K, Tran P, Frankovich J. New-onset OCD and juvenile enthesitis related arthritis after COVID-19 (Three Cases). Dev Neurosci. 2025 Apr 2:1-29. doi: 10.1159/000545137. Epub ahead of print. PMID: 40174578.
Kapphahn C, Peet B, Gao J, Chan A, Farhadian B, Ma M, Silverman M, Tran P, Schlenk N, Thienemann M, Frankovich J. Sudden Onset Disordered Eating Behaviors and Appetite Issues in a Local Clinical Cohort of Children With Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS). Int J Eat Disord. 2025 Mar 31. doi: 10.1002/eat.24388. Epub ahead of print. PMID: 40165330.
Frankovich J, Calaprice D, Ma M, Knight O, Miles K, Manko C, Hernandez JD, Sandberg J, Farhadian B, Xie Y, Silverman M, Madan J, Strand V, Chang K, Thienemann M. Obsessive Compulsive Disorder associated with Autoimmunity in Youth: Clinical Course before and after Rituximab+/- Adjunctive Immunomodulation. Dev Neurosci. 2025 Mar 10:1-26. doi: 10.1159/000544993. Epub ahead of print. PMID: 40064151.
Zebrack JE, Gao J, Verhey B, Tian L, Stave C, Farhadian B, Ma M, Silverman M, Xie Y, Tran P, Thienemann M, Wilson JL, Frankovich J. Neurological Soft Signs at Presentation in Patients With Pediatric Acute-Onset Neuropsychiatric Syndrome. JAMA Netw Open. 2025 Mar 3;8(3):e250314. doi: 10.1001/jamanetworkopen.2025.0314. PMID: 40053347; PMCID: PMC11889471.
Tang AW, Prieto Jimenez PM, Miller IKT, Madan JC, Nguyen J, Ma M, Silverman M, Farhadian B, Wilson J, Goyal A, Manko C, Davies Y, Rabizadeh S, Frankovich J. Eight cases of Pediatric Acute Onset Neuropsychiatric Syndrome (PANS) with Inflammatory Bowel Disease (IBD): Immunologic Intersections. Dev Neurosci. 2025 Feb 10:1-23. doi: 10.1159/000543969. Epub ahead of print. PMID: 39929162.
Melamed I, Rahman S, Pein H, Heffron M, Frankovich J, Kreuwel H and Mellins ED. IVIG response in pediatric acute-onset neuropsychiatric syndrome correlates with reduction in pro-inflammatory monocytes and neuropsychiatric measures. Front. Immunol. 15:1383973. 02 October 2024 doi: 10.3389/fimmu.2024.1383973
Pooni R, Zheng W, Ma M, Silverman M, Xie Y, Farhadian B, Thienemann M, Mellins E, Frankovich J. Cerebrospinal fluid characteristics of patients presenting for evaluation of pediatric acute-neuropsychiatric syndrome. Front Behav Neurosci. 2024 Aug 19;18:1342486. doi: 10.3389/fnbeh.2024.1342486. PMID: 39224487; PMCID: PMC11367679.
Xu J, Frankovich J, Liu RJ, Thienemann M, Silverman M, Farhadian B, Willet T, Manko C, Columbo L, Leibold C, Vaccarino FM, Che A, Pittenger C. Elevated antibody binding to striatal cholinergic interneurons in patients with pediatric acute-onset neuropsychiatric syndrome. Brain Behav Immun. 2024 Jul 29:S0889-1591(24)00515-4. doi: 10.1016/j.bbi.2024.07.044. Epub ahead of print. PMID: 39084540.
Ma M, Masterson EE, Gao J, Karpel H, Chan A, Pooni R, Sandberg J, Rubesova E, Farhadian B, Willet T, Xie Y, Tran P, Silverman M, Thienemann M, Mellins E, Frankovich J. Development of Autoimmune Diseases Among Children With Pediatric Acute-Onset Neuropsychiatric Syndrome. JAMA Netw Open. 2024 Jul 1;7(7):e2421688. doi: 10.1001/jamanetworkopen.2024.21688. PMID: 39078633; PMCID: PMC11289697.
Bernstein GA, Khan MH, Freese RL, Manko C, Silverman M, Ahmed S, Farhadian B, Ma M, Thienemann M, Murphy TK, Frankovich J. Psychometric Properties of the PANS 31-Item Symptom Rating Scale. J Child Adolesc Psychopharmacol. 2024 Mar 27. doi: 10.1089/cap.2023.0088. Epub ahead of print. PMID: 38536004.
Vreeland A, Calaprice D, Or-Geva N, Frye RE, Agalliu D, Lachman HM, Pittenger C, Pallanti S, Williams K, Ma M, Thienemann M, Gagliano A, Mellins E, Frankovich J. Post-infectious inflammation, autoimmunity, and OCD: Sydenham Chorea, Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infection (PANDAS), and Pediatric Acute-onset Neuropsychiatric Disorder (PANS). Dev Neurosci. 2023 Sep 22. doi: 10.1159/000534261. Epub ahead of print. PMID: 37742615.
Kalinowski A, Tian L, Pattni R, Ollila H, Khan M, Manko C, Silverman M, Ma M, Columbo L, Farhadian B, Swedo S, Murphy T, Johnson M, Fernell E, Gillberg C, Thienemann M, Mellins ED, Levinson DF, Urban AE, Frankovich J. Evaluation of C4 gene copy number in Pediatric Acute Neuropsychiatric Syndrome. Dev Neurosci. 2023 Jun 28. doi: 10.1159/000531707. Epub ahead of print. PMID: 37379808.
Ma M, Sandberg J, Farhadian B, Silverman M, Xie Y, Thienemann M, Frankovich J. Arthritis in children with psychiatric deteriorations: a case series. Dev Neurosci. 2023 May 12:1. doi: 10.1159/000530854. Epub ahead of print. PMID: 37231875.
Vreeland A, Thienemann M, Cunningham M, Muscal E, Pittenger C, Frankovich J. Neuroinflammation in Obsessive-Compulsive Disorder: Sydenham Chorea, Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, and Pediatric Acute Onset Neuropsychiatric Syndrome. Psychiatr Clin North Am. 2023 Mar;46(1):69-88. doi: 10.1016/j.psc.2022.11.004. PMID: 36740356.
Ellerkamp H, Thienemann M, Tinero J, Shaw R, Dowtin LL, Frankovich J, Borkovi TC. Group Psychotherapy for Parents of Youth with Pediatric Acute-Onset Neuropsychiatric Syndrome. J Clin Psychol Med Settings. 2022 Dec 8. doi: 10.1007/s10880-022-09926-0. Epub ahead of print. PMID: 36480109.
Gao J, Chan A, Willett T, Farhadian B, Silverman M, Tran P, Ahmed S, Thienemann M, Frankovich J. Sex and Aggression Characteristics in a Cohort of Patients with Pediatric Acute-Onset Neuropsychiatric Syndrome. J Child Adolesc Psychopharmacol. 2022 Aug 23. doi: 10.1089/cap.2021.0084. Epub ahead of print. PMID: 35998241.
Chan A, Gao J, Houston M, Willett T, Farhadian B, Silverman M, Tran P, Jaradeh S, Thienemann M, Frankovich J. Children With PANS May Manifest POTS. Front Neurol. 2022 Apr 26;13:819636. doi: 10.3389/fneur.2022.819636. PMID: 35557616; PMCID: PMC9086964.
McHugh A, Chan A, Herrera C, Park JM, Balboni I, Gerstbacher D, Hsu JJ, Lee T, Thienemann M, Frankovich J. Profiling Behavioral and Psychological Symptoms in Children undergoing treatment for Spondyloarthritis and Polyarthritis. J Rheumatol. 2022 Feb 1:jrheum.210489. doi: 10.3899/jrheum.210489. Epub ahead of print. PMID: 35105715.
Thienemann M, Park M, Chan A, Frankovich J. Patients with abrupt early-onset OCD due to PANS tolerate lower doses of antidepressants and antipsychotics. Journal of Psychiatric Research. 2021 Jan;135:270-278. doi:10.1016/j.jpsychires.2021.01.022 doi:10.1016/j.jpsychires.2021.01.022
Lopez Pineda A, Pourshafeie A, Ioannidis A, Leibold CM, Chan AL, Bustamante CD, Frankovich J, Wojcik GL. Discovering prescription patterns in pediatric acute-onset neuropsychiatric syndrome patients. J Biomed Inform. 2021 Jan;113:103664. doi: 10.1016/j.jbi.2020.103664. Epub 2020 Dec 28. PMID: 33359113.
Chan A, Karpel H, Spartz E, Willett T, Farhadian B, Jeng M, Thienemann M, Frankovich J. Hypoferritinemia and iron deficiency in youth with pediatric acute-onset neuropsychiatric syndrome. Pediatr Res. 2020 Aug 3. doi: 10.1038/s41390-020-1103-3. Epub ahead of print. PMID: 32746449.
Zheng J*, Frankovich J*, McKenna E, Rowe N, MacEachern S, Ng N, Tam L, Moon P, Gao J, Thienemann M, Forkert N, Yeom K. Association of Pediatric Acute-Onset Neuropsychiatric Syndrome With Microstructural Differences in Brain Regions Detected via Diffusion-Weighted Magnetic Resonance Imaging. Journal of the American Medical Association (JAMA) Network Open. 2020 May 4. doi:10.1001/jamanetworkopen.2020.4063
Chan A, Phu T, Farhadian B, Willet T, Thienemann M, Frankovich J. Familial Clustering of Immune-Mediated Diseases in Children with Abrupt-Onset Obsessive Compulsive Disorder. J Child Adolesc Psychopharmacol. 2020 Apr 20. Doi: 10.1089/cap.2019.0167 PMID 32311283
Bey AL, Gorman MP, Gallentine W, Kohlenberg TM, Frankovich J, Jiang YH, Van Haren K. Subacute Neuropsychiatric Syndrome in Girls With SHANK3 Mutations Responds to Immunomodulation. Pediatrics. 2020 Feb;145(2). pii: e20191490. doi: 10.1542/peds.2019-1490.
Chan A, Frankovich J. Infections, Antibiotics, and Mental Health Deteriorations . J Child Adolesc Psychopharmacol. 2019 Oct doi: 10.1089/cap.2019.0100. [Epub ahead of print]
Silverman, M., Frankovich, J., Nguyen, E., Leibold, C., Yoon, J., Mark Freeman, G. J., Karpel, H., Thienemann, M. Psychotic symptoms in youth with Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) may reflect syndrome severity and heterogeneity . Journal of Psychiatric Research. March 2019, online ahead of print. doi: 10.1016/j.jpsychires.2018.11.013
Frankovich J, Leibold CM, Farmer C, Sainani K, Kamalani G, Farhadian B, Willett T, Park JM, Sidell D, Ahmed S, Thienemann M. The Burden of Caring for a Child or Adolescent With Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS): An Observational Longitudinal Study. J Clin Psychiatry. 2018 Dec 11;80(1) PMID: 30549499 doi: 10.4088/JCP.17m12091
Leibold C, Thienemann M, Farhasian B, Willett T, Frankovich J. Psychometric Properties of the Pediatric Acute-Onset Neuropsychiatric Syndrome Global Impairment Score in Children and Adolescents with Pediatric Acute-Onset Neuropsychiatric Syndrome. Journal of Child and Adolescent Psychopharmacology. Published online ahead of print Epub 2018 Nov 13. doi: 10.1089/cap.2018.0029
Thienemann, M., Frankovich, J. Action in the face of uncertainty? The Journal of Pediatrics, October 2018, online ahead of print. PMID:30318368 doi:10.1016/j.jpeds.2018.08.014
Rosa J, Hernandez J, Sherr J, Smith B, Brown K, Farhadian B, Mahony T, McGhee S, Lewis D B, Thienemann M, Frankovich J. Allergic Diseases and Immune-Mediated Food Disorders in Pediatric Acute-Onset Neuropsychiatric Syndrome . Pediatric Allergy, Immunology, and Pulmonology, Vol 31, No.3. Sept 2018. doi: 10.1089/ped.2018.0888
Santoro JD, Frankovich J, Bhargava S. Continued Presence of Period Limb Movements During REM Sleep in Patients With Chronic Static Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS). Journal of Clinical Sleep Medicine, Vol. 14, Np. 7 1187-1192. July 2018. doi:10.5664/jcsm.7222
Farmer C, Thienemann M, Leibold C, Kamalani G, Sauls B, Frankovich J. Psychometric Evaluation of the Caregiver Burden Inventory in Children and Adolescents With PANS. J Pediatr Psychol. March 2018. doi:10.1093/jpepsy/jsy014.
Tran, P, Frankovich J, Van Mater H, Dale R, Or-Geva N, McHugh A, Thienemann M. “Pediatric Inflammatory Brain Disease" Complex Disorders in Pediaric Psychiatry. A Clinician's Guide1st Edition Editors: David I Driver & Shari Thomas. December 2017.
Swedo S, Frankovich J, Murphy T. Overview of Treatment of Pediatric Acute-Onset Neuropsychiatric Syndrome. J of Child and Adolescent Psychopharmacology. Vol. 27, No.7, September 2017. doi:10.1089/cap/2017.0042.
Brown K, Farmer C, Farhadian B, Hernandez J, Thienemann M, Frankovich J. Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) – Response to Oral Corticosteroid Bursts: An Observational Study of Patients in an Academic Community-Based PANS Clinic. Journal of Child and Adolescent Psychopharmacology, Vol. 27, No.7, July 2017, online ahead of print. PMID: 28714753. DOI: 10.1089/cap.2016.0139
Brown K, Farmer C, Freeman GM, Spartz E, Farhadian B, Thienemann M, Frankovich J. Effect of Early and Prophylactic Nonsteroidal Anti-Inflammatory Drugs (NSAIDS) on Flare Duration in Pediatric Acute-onset Neuropsychiatric Syndrome (PANS): An Observational Studyof Patients Followed by an Academic Community-Based Pediatric Acute-onset Neuropsychiatric Syndrome Clinic. Journal of Child and Adolescent Psychopharmacology. Vol. 27, No. 7, July 2017, online ahead of print. PMID: 28696786. DOI: 10.1089/cap.2016.0193
Spartz E, Freeman GM, Brown K, Farhadian B, Thienemann M, Frankovich J. Course of Neuropsychiatric Symptoms after Introduction or Removal of Non-Steroidal Anti-Inflammatory Drugs: A Pediatric Observational Study. Journal of Child and Adolescent Psychopharmacology, Vol. 27, No. 7, July 2017, online ahead of print. PMID: 28696783. DOI: 10.1089/cap.2016.0179
Thienemann M, Murphy TK. "Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections" in The SAGE Encyclopedia of Abnormal and Clinical Psychology (2017).
Thienemann M, Murphy TK, Pediatric Acute-onset Neuropsychiatric Syndrome. Handbook of Obsessive-Compulsive Disorder Across the Lifespan. Eds. Storch E and Abramowitz J, Wiley. 19 June 2017 doi:10.1002/9781118890233.ch41
Mahony T, Sidell D, Gans H, Brown K, Farhadian B, Gustafson M, Sherr J, Thienemann M, Frankovich J. Improvement of Psychiatric Symptoms in Youth Following Resolution of Sinusitis. International Journal of Pediatric Otorhinolaryngology, Vol. 92, January 2017: 38-44. DOI: 10.1016/j.ijporl.2016.10.034
Mahony T, Sidell D, Gans, H, Cooperstock M, Brown K, Cheung J, Farhadian B, Gustafson M, Thienemann M, Frankovich J. Palatal Petechiae in the Absence of Group A Streptococcus in Pediatric Patients with Acute-onset Neuropsychiatric Deterioration: A Cohort Study. Journal of Child and Adolescent Psychopharmacology, Vol. 27, No. 7, April 2017, online ahead of print. DOI: 10.1089/cap.2016.0153
Thienemann M, Frankovich J. Sudden Onset of Tics, Tantrums, Hyperactivity, and Emotional Lability: Update on PANS and PANDAS . Psychiatric Times, Vol. 34, April 2017.
Thienemann M. Seeing Your First Child with PANDAS/PANS. The PANDAS Physicians Network Diagnostics and Therapeutics Committee. 2016.
Thienemann M. "PANDAS and PANS in School Settings: A Handbook for Educators." in PANDAS and PANS in School Settings, Jessica Kingsley, Philadelphia. August 2016.
Frankovich J, Thienemann M, Pearlstein J, Crable A, Brown K, Chang K. Multidisciplinary Clinic Dedicated to Treating Youth with Pediatric Acute-Onset of Neuropsychiatric Syndrome: Presenting Characteristics of the First 47 Consecutive Patients. Journal of Child and Adolescent Psychopharmacology, Vol. 25, No. 1, February 2015: 38-47. PMID: 25695943
Frankovich J, Thienemann M, Rana S, Chang K. Five Youth with Pediatric Acute-Onset Neuropsychiatric Syndrome of Different Etiologies. Journal of Child and Adolescent Psychopharmacology, Vol. 25, No. 1, February 2015: 31-37. PMID: 25695942
Chang K*, Frankovich J*, Cooperstock M, Cunningham M, Latimer E, Murphy T, Pasternack M, Thienemann M, Williams K, Walter J, Swedo S. Clinical Evaluation of Youth with Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS): Recommendations from the 2013 PANS Consensus Conference. Journal of Child and Adolescent Psychopharmacology, Vol. 25, No. 1, February 2015: 3-13. PMID: 25325534
Chang K, Koplewicz HS, Steingard R: Special issue on pediatric acute-onset neuropsychiatric syndrome. J Child Adolesc Psychopharmacol 25: 1-2, 2015.
Cox CJ, Zuccolo AJ, Edwards EV, Mascaro-Blanco A, Alvarez K, Stoner J, Chang K, Cunningham MW:Antineuronal antibodies in a heterogeneous group of youth and young adults with tics and obsessive-compulsive disorder. J Child Adolesc Psychopharmacol 25: 76-85, 2015.

Stanford Overview Articles

Vreeland A, Thienemann M, Cunningham M, Muscal E, Pittenger C, Frankovich J. Neuroinflammation in Obsessive-Compulsive Disorder: Sydenham Chorea, Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, and Pediatric Acute Onset Neuropsychiatric Syndrome. Psychiatr Clin North Am. 2023 Mar;46(1):69-88. doi: 10.1016/j.psc.2022.11.004. PMID: 36740356.
Thienemann M, Frankovich J. Sudden Onset of Tics, Tantrums, Hyperactivity, and Emotional Lability: Update on PANS and PANDAS . Psychiatric Times, Vol. 34, April 2017.
Thienemann M. Seeing Your First Child with PANDAS/PANS. The PANDAS Physicians Network Diagnostics and Therapeutics Committee. 2016.

Stanford Poster Presentations

Overview Articles

Gagliano A, Carta A, Tanca MG, Sotgiu S. Pediatric Acute-Onset Neuropsychiatric Syndrome: Current Perspectives. Neuropsychiatr Dis Treat. 2023 May 24;19:1221-1250. doi: 10.2147/NDT.S362202. PMID: 37251418; PMCID: PMC10225150.
Leonardi L, Perna C, Bernabei I, Fiore M, Ma M, Frankovich J, Tarani L, Spalice A. Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS): Immunological Features Underpinning Controversial Entities. Children (Basel). 2024 Aug 27;11(9):1043. doi: 10.3390/children11091043. PMID: 39334578; PMCID: PMC11430956.
Vreeland A, Thienemann M, Cunningham M, Muscal E, Pittenger C, Frankovich J. Neuroinflammation in Obsessive-Compulsive Disorder: Sydenham Chorea, Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, and Pediatric Acute Onset Neuropsychiatric Syndrome. Psychiatr Clin North Am. 2023 Mar;46(1):69-88. doi: 10.1016/j.psc.2022.11.004. PMID: 36740356.
Swedo SE, Leckman JF, Rose NR (2012) From Research Subgroup to Clinical Syndrome: Modifying the PANDAS Criteria to Describe PANS (Pediatric Acute-onset Neuropsychiatric Syndrome). Pediatr Therapeut 2:113. doi:10.4172/2161-0665.1000113
Swedo SE, Frankovich J, Murphy TM. Overview of Treatment of Pediatric Acute-Onset Neuropsychiatric Syndrome Journal of Child and Adolescent Psychopharmacology.Sep 2017.562-565.http://doi.org/10.1089/cap.2017.0042
Murphy TK, Gerardi DM, Leckman JF. Pediatric acute-onset neuropsychiatric syndrome. Psychiatr Clin North Am. 2014 Sep;37(3):353-74. doi: 10.1016/j.psc.2014.06.001. PMID: 25150567.
Williams KA, Swedo SE. Post-infectious autoimmune disorders: Sydenham's chorea, PANDAS and beyond. Brain Res. 2015 Aug 18;1617:144-54. doi: 10.1016/j.brainres.2014.09.071. Epub 2014 Oct 7. PMID: 25301689.

Imaging in PANS/PANDAS

Zheng J*, Frankovich J*, McKenna E, Rowe N, MacEachern S, Ng N, Tam L, Moon P, Gao J, Thienemann M, Forkert N, Yeom K. Association of Pediatric Acute-Onset Neuropsychiatric Syndrome With Microstructural Differences in Brain Regions Detected via Diffusion-Weighted Magnetic Resonance Imaging. Journal of the American Medical Association (JAMA) Network Open. 2020 May 4. doi:10.1001/jamanetworkopen.2020.4063
Cabrera B, Romero-Rebollar C, Jiménez-Ángeles L, Genis-Mendoza AD, Flores J, Lanzagorta N, Arroyo M, de la Fuente-Sandoval C, Santana D, Medina-Bañuelos V, Sacristán E, Nicolini H. Neuroanatomical features and its usefulness in classification of patients with PANDAS. CNS Spectr. 2019 Oct;24(5):533-543. doi: 10.1017/S1092852918001268. PMID: 30428956.
Kumar A, Williams MT, Chugani HT: Evaluation of Basal Ganglia and Thalamic Inflammation in Children With Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infection and Tourette Syndrome: A Positron Emission Tomographic (PET) Study Using 11C-[R]-PK11195. J Child Neurol 30: 749-756, 2015.
Giedd JN, Rapoport JL, Garvey MA, Perlmutter S, Swedo SE. MRI assessment of children with obsessive-compulsive disorder or tics associated with streptococcal infection. Am J Psychiatry. 2000 Feb;157(2):281-3. doi: 10.1176/appi.ajp.157.2.281. PMID: 10671403.

REM Sleep Motor Disinhibition

Congiu P, Gagliano A, Carucci S, Lanza G, Ferri R, Puligheddu M. REM sleep atonia in patients with pediatric acute-onset neuropsychiatric syndrome (PANS): implications for pathophysiology. J Clin Sleep Med. 2024 Dec 30. doi: 10.5664/jcsm.11544. Epub ahead of print. PMID: 39745443.
Santoro JD, Frankovich J, Bhargava S. Continued Presence of Period Limb Movements During REM Sleep in Patients With Chronic Static Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS). Journal of Clinical Sleep Medicine, Vol. 14, Np. 7 1187-1192. July 2018. doi:10.5664/jcsm.7222
Gaughan T, Buckley A, Hommer R, Grant P, Williams K, Leckman JF, Swedo SE. Rapid Eye Movement Sleep Abnormalities in Children with Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS). J Clin Sleep Med. 2016 Jul 15;12(7):1027-32. doi: 10.5664/jcsm.5942. PMID: 27166296; PMCID: PMC4918985.
Gagliano A, Puligheddu M, Ronzano N, Congiu P, Tanca MG, Cursio I, Carucci S, Sotgiu S, Grossi E, Zuddas A. Artificial Neural Networks Analysis of polysomnographic and clinical features in Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS): from sleep alteration to "Brain Fog". Nat Sci Sleep. 2021 Jul 23;13:1209-1224. doi: 10.2147/NSS.S300818. PMID: 34326674; PMCID: PMC8315772.
Jan JE, Reiter RJ, Wasdell MB, Bax M. The role of the thalamus in sleep, pineal melatonin production, and circadian rhythm sleep disorders. J Pineal Res. 2009 Jan;46(1):1-7. doi: 10.1111/j.1600-079X.2008.00628.x. Epub 2008 Aug 28. PMID: 18761566.

Autoantibodies in PANS/PANDAS

Xu J, Frankovich J, Liu RJ, Thienemann M, Silverman M, Farhadian B, Willett T, Manko C, Columbo L, Leibold C, Vaccarino FM, Che A, Pittenger C. Elevated antibody binding to striatal cholinergic interneurons in patients with pediatric acute-onset neuropsychiatric syndrome. Brain Behav Immun. 2024 Nov;122:241-255. doi: 10.1016/j.bbi.2024.07.044. Epub 2024 Jul 30. PMID: 39084540; PMCID: PMC11569416.
Xu J, Liu RJ, Fahey S, et al. Antibodies From Children With PANDAS Bind Specifically to Striatal Cholinergic Interneurons and Alter Their Activity [published online ahead of print, 2020 Jun 16]. Am J Psychiatry. 2020;appiajp202019070698. doi:10.1176/appi.ajp.2020.19070698
Frick, L. R., Rapanelli, M., Jindachomthong, K., Grant, P., Leckman, J. F., Swedo, S., Williams, K., & Pittenger, C. (2018). Differential binding of antibodies in PANDAS patients to cholinergic interneurons in the striatum. Brain, behavior, and immunity, 69, 304–311. https://doi.org/10.1016/j.bbi.2017.12.004
Chain JL, Alvarez K, Mascaro-Blanco A, et al. Autoantibody Biomarkers for Basal Ganglia Encephalitis in Sydenham Chorea and Pediatric Autoimmune Neuropsychiatric Disorder Associated With Streptococcal Infections. Front Psychiatry. 2020;11:564. Published 2020 Jun 24. doi:10.3389/fpsyt.2020.00564
Brimberg L, Benhar I, Mascaro-Blanco A, Alvarez K, Lotan D, Winter C, Klein J, Moses AE, Somnier FE, Leckman JF, Swedo SE, Cunningham MW, Joel D. Behavioral, pharmacological, and immunological abnormalities after streptococcal exposure: a novel rat model of Sydenham chorea and related neuropsychiatric disorders. Neuropsychopharmacology. 2012 Aug;37(9):2076-87. doi: 10.1038/npp.2012.56. Epub 2012 Apr 25. PMID: 22534626; PMCID: PMC3398718.
Yaddanapudi K, Hornig M, Serge R, De Miranda J, Baghban A, Villar G, Lipkin WI. Passive transfer of streptococcus-induced antibodies reproduces behavioral disturbances in a mouse model of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection. Mol Psychiatry. 2010 Jul;15(7):712-26. doi: 10.1038/mp.2009.77. Epub 2009 Aug 11. PMID: 19668249.
Kirvan CA, Swedo SE, Heuser JS, Cunningham MW. Mimicry and autoantibody-mediated neuronal cell signaling in Sydenham chorea. Nat Med. 2003 Jul;9(7):914-20. doi: 10.1038/nm892. PMID: 12819778.
Kirvan CA, Cox CJ, Swedo SE, Cunningham MW: Tubulin is a neuronal target of autoantibodies in Sydenham's chorea. J Immunol 178: 7412-7421, 2007.
Kirvan CA, Swedo SE, Kurahara D, Cunningham MW: Streptococcal mimicry and antibody-mediated cell signaling in the pathogenesis of Sydenham's chorea. Autoimmunity 39: 21-29, 2006
Kirvan CA, Swedo SE, Snider LA, Cunningham MW. Antibody-mediated neuronal cell signaling in behavior and movement disorders. J Neuroimmunol. 2006 Oct;179(1-2):173-9. doi: 10.1016/j.jneuroim.2006.06.017. Epub 2006 Jul 27. PMID: 16875742.
Cox CJ, Zuccolo AJ, Edwards EV, Mascaro-Blanco A, Alvarez K, Stoner J, Chang K, Cunningham MW:Antineuronal antibodies in a heterogeneous group of youth and young adults with tics and obsessive-compulsive disorder. J Child Adolesc Psychopharmacol 25: 76-85, 2015.
Shimasaki C, Frye RE, Trifiletti R, Cooperstock M, et al. Evaluation of the Cunningham Panel™ in pediatric autoimmune neuropsychiatric disorder associated with streptococcal infection (PANDAS) and pediatric acute-onset neuropsychiatric syndrome (PANS): Changes in antineuronal antibody titers parallel changes in patient symptoms. J Neuroimmunol. 2020 Feb 15;339:577138. doi: 10.1016/j.jneuroim.2019.577138. Epub 2019 Dec 15. PMID: 31884258.
Frye RE, Shimasaki C. Reliability of the Cunningham Panel. Transl Psychiatry. 2019 Apr 8;9(1):129. doi: 10.1038/s41398-019-0462-1. PMID: 30962420; PMCID: PMC6453973.
Morris CM, Pardo-Villamizar C, Gause CD, Singer HS. Serum autoantibodies measured by immunofluorescence confirm a failure to differentiate PANDAS and Tourette syndrome from controls. J Neurol Sci. 2009 Jan 15;276(1-2):45-8. doi: 10.1016/j.jns.2008.08.032. Epub 2008 Sep 27. PMID: 18823914.
Hesselmark E, Bejerot S. Biomarkers for diagnosis of Pediatric Acute Neuropsychiatric Syndrome (PANS) - Sensitivity and specificity of the Cunningham Panel. J Neuroimmunol. 2017 Nov 15;312:31-37. doi: 10.1016/j.jneuroim.2017.09.002. Epub 2017 Sep 9. Erratum in: J Neuroimmunol. 2017 Dec 15;313:116-117. PMID: 28919236.

Psychiatric and Behavioral Interventions

Gerland, G. Self-Harm and Suicidality in Pediatric Acute-Onset Neuropsychiatric Syndrome (Pans) And Immunopsychiatric Disorders. SANE Sweden. 2023 1:2023
Thienemann M, Park M, Chan A, Frankovich J. Patients with abrupt early-onset OCD due to PANS tolerate lower doses of antidepressants and antipsychotics. Journal of Psychiatric Research. 2021 Jan;135:270-278. doi:10.1016/j.jpsychires.2021.01.022 doi:10.1016/j.jpsychires.2021.01.022
Thienemann M, Murphy T, Leckman J, Shaw R, Williams K, Kapphahn C, Frankovich J, Geller D, Bernstein G, Chang K, Elia J, Swedo S. Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome: Part I-Psychiatric and Behavioral Interventions. J of Child and Adolescent Psychopharmacology. Vol. 27, No.7, 566-573. September 2017. doi:10.1089/cap.2016.0145
Nadeau JM, Jordan C, Selles RR, et al. A pilot trial of cognitive-behavioral therapy augmentation of antibiotic treatment in youth with pediatric acute-onset neuropsychiatric syndrome-related obsessive-compulsive disorder. J Child Adolesc Psychopharmacol. 2015;25(4):337-343. doi:10.1089/cap.2014.0149
Storch EA, Murphy TK, Geffken GR, Mann G, Adkins J, Merlo LJ, Duke D, Munson M, Swaine Z, Goodman WK. Cognitive-behavioral therapy for PANDAS-related obsessive-compulsive disorder: findings from a preliminary waitlist controlled open trial. J Am Acad Child Adolesc Psychiatry. 2006 Oct;45(10):1171-8. doi: 10.1097/01.chi.0000231973.43966.a0. PMID: 17003662.

Immunomodulation

Melamed I, Rahman S, Pein H, Heffron M, Frankovich J, Kreuwel H and Mellins ED. IVIG response in pediatric acute-onset neuropsychiatric syndrome correlates with reduction in pro-inflammatory monocytes and neuropsychiatric measures. Front. Immunol. 15:1383973. 02 October 2024 doi: 10.3389/fimmu.2024.1383973
Frankovich J, Swedo S, Murphy T, Dale R C, Agalliu D, Williams K, Daines M, Hornig M, Chugani H, Sanger T, Muscal E, Pasternack M, Cooperstock, et al. Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome: Part II—Use of Immunomodulatory Therapies. Journal of Child and Adolescent Psychopharmacology, Vol. 27, No. 7, 574-593. September 2017. doi: 10.1089/cap.2016.0148
Perlmutter SJ, Leitman SF, Garvey MA, Hamburger S, Feldman E, Leonard HL, Swedo SE. Therapeutic plasma exchange and intravenous immunoglobulin for obsessive-compulsive disorder and tic disorders in childhood. Lancet. 1999 Oct 2;354(9185):1153-8. doi: 10.1016/S0140-6736(98)12297-3. PMID: 10513708.
Williams KA, Swedo SE, Farmer CA, et al. Randomized, Controlled Trial of Intravenous Immunoglobulin for Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections. J Am Acad Child Adolesc Psychiatry. 2016;55(10):860-867.e2. doi:10.1016/j.jaac.2016.06.017
Brown K, Farmer C, Freeman GM, Spartz E, Farhadian B, Thienemann M, Frankovich J. Effect of Early and Prophylactic Nonsteroidal Anti-Inflammatory Drugs (NSAIDS) on Flare Duration in Pediatric Acute-onset Neuropsychiatric Syndrome (PANS): An Observational Study of Patients Followed by an Academic Community-Based Pediatric Acute-onset Neuropsychiatric Syndrome Clinic. Journal of Child and Adolescent Psychopharmacology. Vol. 27, No. 7, July 2017, online ahead of print. PMID: 28696786. DOI: 10.1089/cap.2016.0193
Spartz E, Freeman GM, Brown K, Farhadian B, Thienemann M, Frankovich J. Course of Neuropsychiatric Symptoms after Introduction or Removal of Non-Steroidal Anti-Inflammatory Drugs: A Pediatric Observational Study. Journal of Child and Adolescent Psychopharmacology, Vol. 27, No. 7, July 2017, online ahead of print. PMID: 28696783. DOI: 10.1089/cap.2016.0179
Brown K, Farmer C, Farhadian B, Hernandez J, Thienemann M, Frankovich J. Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) – Response to Oral Corticosteroid Bursts: An Observational Study of Patients in an Academic Community-Based PANS Clinic. Journal of Child and Adolescent Psychopharmacology, Vol. 27, No.7, July 2017, online ahead of print. PMID: 28714753. DOI: 10.1089/cap.2016.0139
Latimer ME, L'Etoile N, Seidlitz J, Swedo SE. Therapeutic plasma apheresis as a treatment for 35 severely ill children and adolescents with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections . J Child Adolesc Psychopharmacol. 2015;25(1):70-75. doi:10.1089/cap.2014.0080
Pavone P, Falsaperia R, Nicita F, Zecchini A, et al Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infection (PANDAS): Clinical Manifestations, IVIG Treatment Outcomes, Results from a Cohort of Italian Patients. Neuropsych 2018; 8 (3)
Pavone P, Falsaperla R, Cacciaguerra G, et al PANS/PANDAS: Clinical Experience in IVIG Treatment and State of the Art in Rehabilitation Approaches. NeuroSci 2020, 1, 75-84; doi:10.3390/neurosci1020007
Kovacevic M, Grant P, Swedo SE. Use of intravenous immunoglobulin in the treatment of twelve youths with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections. J Child Adolesc Psychopharmacol. 2015;25(1):65-69. doi:10.1089/cap.2014.0067

Genetics

Cunningham JL, Frankovich J, Dubin RA, Pedrosa E, Baykara RN, Schlenk NC, Maqbool SB, Dolstra H, Marino J, Edinger J, Shea J, Laje G, Swagemakers SMA, Sinnadurai S, Zhang ZD, Lin JR, van der Spek P, Lachman HM. Ultrarare Variants in DNA Damage Repair Genes in Pediatric Acute-Onset Neuropsychiatric Syndrome or Acute Behavioral Regression in Neurodevelopmental Disorders. Dev Neurosci. 2024 Oct 11:1-33. doi: 10.1159/000541908. Epub ahead of print. PMID: 39396515.
Leonardi L, Lorenzetti G, Carsetti R, Piano Mortari E, Guido C, Zicari A, Förster-Waldl E, Loffredo L, Duse M, and Spalice A. Immunological Characterization of an Italian PANDAS Cohort. Frontiers Pediatrics. 2023 Nov 16. doi: 10.3389//fped.2023.1216282
Chan A, Phu T, Farhadian B, Willet T, Thienemann M, Frankovich J. Familial Clustering of Immune-Mediated Diseases in Children with Abrupt-Onset Obsessive Compulsive Disorder. J Child Adolesc Psychopharmacol. 2020 Apr 20. Doi: 10.1089/cap.2019.0167 PMID 32311283
Bey AL, Gorman MP, Gallentine W, Kohlenberg TM, Frankovich J, Jiang YH, Van Haren K. Subacute Neuropsychiatric Syndrome in Girls With SHANK3 Mutations Responds to Immunomodulation. Pediatrics. 2020 Feb;145(2). pii: e20191490. doi: 10.1542/peds.2019-1490.
Lewin AB, Storch EA, Murphy TK: Pediatric autoimmune neuropsychiatric disorders associated with Streptococcus in identical siblings. J Child Adolesc Psychopharmacol 21: 177-182, 2011.
Mataix-Cols D, Frans E, Pérez-Vigil A, et al. A total-population multigenerational family clustering study of autoimmune diseases in obsessive-compulsive disorder and Tourette's/chronic tic disorders. Mol Psychiatry. 2018;23(7):1652-1658. doi:10.1038/mp.2017.215

Caregiver Burden

Frankovich J, Leibold CM, Farmer C, Sainani K, Kamalani G, Farhadian B, Willett T, Park JM, Sidell D, Ahmed S, Thienemann M. The Burden of Caring for a Child or Adolescent With Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS): An Observational Longitudinal Study. J Clin Psychiatry. 2018 Dec 11;80(1) PMID: 30549499 doi: 10.4088/JCP.17m12091
Farmer C, Thienemann M, Leibold C, Kamalani G, Sauls B, Frankovich J. Psychometric Evaluation of the Caregiver Burden Inventory in Children and Adolescents With PANS. J Pediatr Psychol. March 2018. doi:10.1093/jpepsy/jsy014.

Infections and Antibiotics in PANS/PANDAS

Saini T, Ma M, Sandberg J, Farhadian B, Manko C, Xie Y, Madan J, Bauer K, Tran P, Frankovich J. New-onset OCD and juvenile enthesitis related arthritis after COVID-19 (Three Cases). Dev Neurosci. 2025 Apr 2:1-29. doi: 10.1159/000545137. Epub ahead of print. PMID: 40174578.
Jasser MT, Ferland T, Bocian T, Goff M, Gauch A, Heinz MV, Joffrey E, Morse R, Albert D, Frankovich J, Madan JC. Acute onset neuropsychiatric conditions in children and adolescents following SARS-CoV-2 infection: a case series. Dev Neurosci. 2025 Mar 24:1-22. doi: 10.1159/000545349. Epub ahead of print. PMID: 40127628.
Murphy TK, Brennan EM, Johnco C, Parker-Athill EC, Miladinovic B, Storch EA, Lewin AB. A Double-Blind Randomized Placebo-Controlled Pilot Study of Azithromycin in Youth with Acute-Onset Obsessive-Compulsive Disorder. J Child Adolesc Psychopharmacol. 2017 Sep;27(7):640-651. doi: 10.1089/cap.2016.0190. Epub 2017 Mar 30. PMID: 28358599.
Murphy TK, Snider LA, Mutch PJ, Harden E, Zaytoun A, Edge PJ, Storch EA, Yang MC, Mann G, Goodman WK, Swedo SE. Relationship of movements and behaviors to Group A Streptococcus infections in elementary school children. Biol Psychiatry. 2007 Feb 1;61(3):279-84. doi: 10.1016/j.biopsych.2006.08.031. Epub 2006 Nov 27. PMID: 17126304.
Orlovska S, Vestergaard CH, Bech BH, Nordentoft M, Vestergaard M, Benros ME. Association of Streptococcal Throat Infection With Mental Disorders: Testing Key Aspects of the PANDAS Hypothesis in a Nationwide Study. JAMA Psychiatry. 2017 Jul 1;74(7):740-746. doi: 10.1001/jamapsychiatry.2017.0995. PMID: 28538981; PMCID: PMC5710247.
Chan A, Frankovich J. Infections, Antibiotics, and Mental Health Deteriorations . J Child Adolesc Psychopharmacol. 2019 Jul 29. doi: 10.1089/cap.2019.0100. [Epub ahead of print]
Mahony T, Sidell D, Gans H, Brown K, Farhadian B, Gustafson M, Sherr J, Thienemann M, Frankovich J. Improvement of Psychiatric Symptoms in Youth Following Resolution of Sinusitis. International Journal of Pediatric Otorhinolaryngology, Vol. 92, January 2017: 38-44. DOI: 10.1016/j.ijporl.2016.10.034
Murphy TK, Parker-Athill EC, Lewin AB, Storch EA, Mutch PJ. Cefdinir for recent-onset pediatric neuropsychiatric disorders: a pilot randomized trial. J Child Adolesc Psychopharmacol. 2015 Feb;25(1):57-64. doi: 10.1089/cap.2014.0010. Epub 2014 Oct 9. PMID: 25299463; PMCID: PMC4340343.

Animal Models of PANS/PANDAS and Strep

Dileepan T, Smith ED, Knowland D, Hsu M, Platt M, Bittner-Eddy P, Cohen B, Southern P, Latimer E, Harley E, Agalliu D, Cleary PP. Group A Streptococcus intranasal infection promotes CNS infiltration by streptococcal-specific Th17 cells. J Clin Invest. 2016 Jan;126(1):303-17. doi: 10.1172/JCI80792. Epub 2015 Dec 14. PMID: 26657857; PMCID: PMC4701547.
Cutforth T, DeMille MM, Agalliu I, Agalliu D. CNS autoimmune disease after Streptococcus pyogenes infections: animal models, cellular mechanisms and genetic factors. Future Neurol. 2016;11(1):63-76. doi:10.2217/fnl.16.4
Xu J, Liu RJ, Fahey S, Frick L, Leckman J, Vaccarino F, Duman RS, Williams K, Swedo S, Pittenger C. Antibodies From Children With PANDAS Bind Specifically to Striatal Cholinergic Interneurons and Alter Their Activity. Am J Psychiatry. 2020 Jun 16:appiajp202019070698. doi: 10.1176/appi.ajp.2020.19070698. Epub ahead of print. PMID: 32539528.
Hoffman KL, Hornig M, Yaddanapudi K, Jabado O, Lipkin WI. A murine model for neuropsychiatric disorders associated with group A beta-hemolytic streptococcal infection. The Journal of Neuroscience : the Official Journal of the Society for Neuroscience. 2004 Feb;24(7):1780-1791. DOI: 10.1523/jneurosci.0887-03.2004.
Brimberg L, Benhar I, Mascaro-Blanco A, Alvarez K, Lotan D, Winter C, Klein J, Moses AE, Somnier FE, Leckman JF, Swedo SE, Cunningham MW, Joel D. Behavioral, pharmacological, and immunological abnormalities after streptococcal exposure: a novel rat model of Sydenham chorea and related neuropsychiatric disorders. Neuropsychopharmacology. 2012 Aug;37(9):2076-87. doi: 10.1038/npp.2012.56. Epub 2012 Apr 25. PMID: 22534626; PMCID: PMC3398718.
Hornig, M., Lipkin, W.I., Immune-mediated animal models of Tourette syndrome. Neurosci. Biobehav. Rev. (2013), http://dx.doi.org/10.1016/j.neubiorev.2013.01.007
Hallett JJ, Harling-Berg CJ, Knopf PM, Stopa EG, Kiessling LS. Anti-striatal antibodies in Tourette syndrome cause neuronal dysfunction. Journal of Neuroimmunology. 2000 Nov;111(1-2):195-202. DOI: 10.1016/s0165-5728(00)00320-9.
Taylor JR, Morshed SA, Parveen S, et al. An animal model of Tourette's syndrome. The American Journal of Psychiatry. 2002 Apr;159(4):657-660. DOI: 10.1176/appi.ajp.159.4.657.
Lotan D, Cunningham M, Joel D. Antibiotic treatment attenuates behavioral and neurochemical changes induced by exposure of rats to group a streptococcal antigen. PLoS One. 2014 Jun 30;9(6):e101257. doi: 10.1371/journal.pone.0101257. PMID: 24979049; PMCID: PMC4076315.
Lotan D, Benhar I, Alvarez K, Mascaro-Blanco A, Brimberg L, Frenkel D, Cunningham MW, Joel D. Behavioral and neural effects of intra-striatal infusion of anti-streptococcal antibodies in rats. Brain Behav Immun. 2014 May;38:249-62. doi: 10.1016/j.bbi.2014.02.009. Epub 2014 Feb 20. PMID: 24561489; PMCID: PMC4000697.

Observational studies, case studies, and case control studies with relevance to PANS/PANDAS

Swedo SE, Leonard HL, Garvey M, Mittleman B, Allen AJ, Perlmutter S, Lougee L, Dow S, Zamkoff J, Dubbert BK. Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections: clinical description of the first 50 cases. Am J Psychiatry. 1998 Feb;155(2):264-71. doi: 10.1176/ajp.155.2.264. Erratum in: Am J Psychiatry 1998 Apr;155(4):578. PMID: 9464208.
Murphy TK, Patel PD, McGuire JF, et al. Characterization of the pediatric acute-onset neuropsychiatric syndrome phenotype. J Child Adolesc Psychopharmacol. 2015;25(1):14-25. doi:10.1089/cap.2014.0062
Frankovich J, Thienemann M, Pearlstein J, Crable A, Brown K, Chang K. Multidisciplinary clinic dedicated to treating youth with pediatric acute-onset neuropsychiatric syndrome: presenting characteristics of the first 47 consecutive patients. J Child Adolesc Psychopharmacol. 2015 Feb;25(1):38-47. doi: 10.1089/cap.2014.0081. PMID: 25695943; PMCID: PMC4340335.
Frankovich J, Thienemann M, Rana S, Chang K. Five Youth with Pediatric Acute-Onset Neuropsychiatric Syndrome of Different Etiologies. Journal of Child and Adolescent Psychopharmacology, Vol. 25, No. 1, February 2015: 31-37. PMID: 25695942
Gromark C, Harris RA, Wickström R, et al. Establishing a Pediatric Acute-Onset Neuropsychiatric Syndrome Clinic: Baseline Clinical Features of the Pediatric Acute-Onset Neuropsychiatric Syndrome Cohort at Karolinska Institutet. J Child Adolesc Psychopharmacol. 2019;29(8):625-633. doi:10.1089/cap.2018.0127
Gromark C, Hesselmark E, Djupedal IG, et al. A Two-to-Five Year Follow-Up of a Pediatric Acute-Onset Neuropsychiatric Syndrome Cohort [published online ahead of print, 2021 Feb 9]. Child Psychiatry Hum Dev. 2021;1-11. doi:10.1007/s10578-021-01135-4
Mahony T, Sidell D, Gans, H, Cooperstock M, Brown K, Cheung J, Farhadian B, Gustafson M, Thienemann M, Frankovich J. Palatal Petechiae in the Absence of Group A Streptococcus in Pediatric Patients with Acute-onset Neuropsychiatric Deterioration: A Cohort Study. Journal of Child and Adolescent Psychopharmacology, Vol. 27, No. 7, April 2017, online ahead of print. DOI: 10.1089/cap.2016.0153
Gagliano A, Galati C, Ingrassia M, Ciuffo M, Alquino MA, Tanca MG, Carucci S, Zuddas A, Grossi E. Pediatric Acute-Onset Neuropsychiatric Syndrome: A Data Mining Approach to a Very Specific Constellation of Clinical Variables. J Child Adolesc Psychopharmacol. 2020 Oct;30(8):495-511. doi: 10.1089/cap.2019.0165. Epub 2020 May 28. PMID: 32460516.
Swedo SE, Seidlitz J, Kovacevic M, et al. Clinical presentation of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections in research and community settings. J Child Adolesc Psychopharmacol. 2015;25(1):26-30. doi:10.1089/cap.2014.0073
Lepri G, Rigante D, Bellando Randone S, Meini A, Ferrari A, Tarantino G, Cunningham MW, Falcini F. Clinical-Serological Characterization and Treatment Outcome of a Large Cohort of Italian Children with Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infection and Pediatric Acute Neuropsychiatric Syndrome. J Child Adolesc Psychopharmacol. 2019 Oct;29(8):608-614. doi: 10.1089/cap.2018.0151. Epub 2019 May 29. PMID: 31140830.
Murgia F, Gagliano A, Tanca MG, Or-Geva N, Hendren A, Carucci S, Pintor M, Cera F, Cossu F, Sotgiu S, Atzori L, Zuddas A. Metabolomic Characterization of Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS). Front Neurosci. 2021 May 28;15:645267. doi: 10.3389/fnins.2021.645267. PMID: 34121984; PMCID: PMC8194687.
Johnson M, Fernell E, Preda I, et al. Paediatric acute-onset neuropsychiatric syndrome in children and adolescents: an observational cohort study. The Lancet Child & Adolescent Health. 2019;3(3):175-180. doi:10.1016/s2352-4642(18)30404-8
Tucker DM, Leckman JF, Scahill L, Wilf GE, LaCamera R, Cardona L, Cohen P, Heidmann S, Goldstein J, Judge J, Snyder E, Bult A, Peterson BS, King R, Lombroso P: A putative poststreptococcal case of OCD with chronic tic disorder, not otherwise specified. J Am Acad Child Adolesc Psychiatry 35: 1684-1691, 1996. DOI: 10.1097/00004583-199612000-00022
Waldrep DA: Two cases of ADHD following GABHS infection: a PANDAS subgroup? J Am Acad Child Adolesc Psychiatry 41: 1273-1274, 2002.

Long-term Outcomes in PANS/PANDAS

Leon, J., Hommer, R., Grant, P. et al. Longitudinal outcomes of children with pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS). Eur Child Adolesc Psychiatry 27, 637–643 (2018). https://doi.org/10.1007/s00787-017-1077-9
Gromark C, Hesselmark E, Djupedal IG, et al. A Two-to-Five Year Follow-Up of a Pediatric Acute-Onset Neuropsychiatric Syndrome Cohort [published online ahead of print, 2021 Feb 9]. Child Psychiatry Hum Dev. 2021;1-11. doi:10.1007/s10578-021-01135-4

Differential Diagnoses

Yu CH, Lee MB, Tseng MM, Liao SC: Obsessive-compulsive symptoms as a manifestation of neuropsychiatric systemic lupus erythematosus. J Formos Med Assoc 107: 68-72, 2008.
Mercadante MT, Diniz JB, Hounie AG, Ferrao Y, Alvarenga P, Brotto S, Miguel EC: Obsessive-compulsive spectrum disorders in rheumatic fever patients. J Neuropsychiatry Clin Neurosci 17: 544-547, 2005.
Mahmud FH, Lteif AN, Renaud DL, Reed AM, Brands CK: Steroid-responsive encephalopathy associated with Hashimoto's thyroiditis in an adolescent with chronic hallucinations and depression: case report and review. Pediatrics 112: 686-690, 2003.
Muller N, Riedel M, Forderreuther S, Blendinger C, Abele-Horn M: Tourette's syndrome and mycoplasma pneumoniae infection. Am J Psychiatry 157: 481-482, 2000.
Peatfield RC: Basal ganglia damage and subcortical dementia after possible insidious Coxsackie virus encephalitis. Acta Neurol Scand 76: 340-345, 1987.
Beleza P, Soares-Fernandes J, Jordao MJ, Almeida F: From juvenile parkinsonism to encephalitis lethargica, a new phenotype of post-streptococcal disorders: case report. Eur J Paediatr Neurol 12: 505-507, 2008.
Casanova MF, Crapanzano KA, Mannheim G, Kruesi M: Sydenham's chorea and schizophrenia: a case report. Schizophr Res 16: 73-76, 1995.
Mink J, Kurlan R: Acute postinfectious movement and psychiatric disorders in children and adolescents. J Child Neurol 26: 214-217, 2011.

Microbiome in PANS/PANDAS

Quagliariello A, Del Chierico F, Russo A, et al. Gut Microbiota Profiling and Gut-Brain Crosstalk in Children Affected by Pediatric Acute-Onset Neuropsychiatric Syndrome and Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections. Front Microbiol. 2018;9:675. Published 2018 Apr 6. doi:10.3389/fmicb.2018.00675

Education in PANS

Allergic Disorders and Immune-mediated Food Disorders in PANS

Kapphahn C, Peet B, Gao J, Chan A, Farhadian B, Ma M, Silverman M, Tran P, Schlenk N, Thienemann M, Frankovich J. Sudden Onset Disordered Eating Behaviors and Appetite Issues in a Local Clinical Cohort of Children With Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS). Int J Eat Disord. 2025 Mar 31. doi: 10.1002/eat.24388. Epub ahead of print. PMID: 40165330.
Rosa J, Hernandez J, Sherr J, Smith B, Brown K, Farhadian B, Mahony T, McGhee S, Lewis D B, Thienemann M, Frankovich J. Allergic Diseases and Immune-Mediated Food Disorders in Pediatric Acute-Onset Neuropsychiatric Syndrome. Pediatric Allergy, Immunology, and Pulmonology, Vol 31, No.3. Sept 2018. doi: 10.1089/ped.2018.0888
Toufexis MD, Hommer R, Gerardi DM, et al. Disordered eating and food restrictions in children with PANDAS/PANS. J Child Adolesc Psychopharmacol. 2015;25(1):48-56. doi:10.1089/cap.2014.0063

PANS in Adults

Low Ferritin and Anemia in PANS

OCD and Tourettes

Endres D, Pollak TA, Bechter K, Denzel D, Pitsch K, Nickel K, Runge K, Pankratz B, Klatzmann D, Tamouza R, Mallet L, Leboyer M, Prüss H, Voderholzer U, Cunningham JL; ECNP Network Immuno-NeuroPsychiatry, Domschke K, Tebartz van Elst L, Schiele MA. Immunological causes of obsessive-compulsive disorder: is it time for the concept of an "autoimmune OCD" subtype? Transl Psychiatry. 2022 Jan 10;12(1):5. doi: 10.1038/s41398-021-01700-4. PMID: 35013105; PMCID: PMC8744027.
Meyer J. Inflammation, Obsessive-Compulsive Disorder, and Related Disorders. Curr Top Behav Neurosci. 2021 Feb 24. doi: 10.1007/7854_2020_210. Epub ahead of print. PMID: 33624254.
Mataix-Cols D, Frans E, Pérez-Vigil A, et al. A total-population multigenerational family clustering study of autoimmune diseases in obsessive-compulsive disorder and Tourette's/chronic tic disorders. Mol Psychiatry. 2018;23(7):1652-1658. doi:10.1038/mp.2017.215
Thienemann M, Murphy TK, Pediatric Acute-onset Neuropsychiatric Syndrome. Handbook of Obsessive-Compulsive Disorder Across the Lifespan. Eds. Storch E and Abramowitz J, Wiley June 2017 https://doi.org/10.1002/9781118890233.ch41
Hoekstra PJ, Kallenberg CG, Korf J, Minderaa RB. Is Tourette's syndrome an autoimmune disease? Mol Psychiatry. 2002;7(5):437-45. doi: 10.1038/sj.mp.4000972. PMID: 12082557.
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Tucker DM, Leckman JF, Scahill L, Wilf GE, LaCamera R, Cardona L, Cohen P, Heidmann S, Goldstein J, Judge J, Snyder E, Bult A, Peterson BS, King R, Lombroso P: A putative poststreptococcal case of OCD with chronic tic disorder, not otherwise specified. J Am Acad Child Adolesc Psychiatry 35: 1684-1691, 1996. DOI: 10.1097/00004583-199612000-00022
Attwells S, Setiawan E, Wilson AA, et al. Inflammation in the Neurocircuitry of Obsessive-Compulsive Disorder. JAMA Psychiatry. 2017;74(8):833-840. doi:10.1001/jamapsychiatry.2017.1567
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Allen AJ, Leonard HL, Swedo SE. Case study: a new infection-triggered, autoimmune subtype of pediatric OCD and Tourette's syndrome. J Am Acad Child Adolesc Psychiatry. 1995 Mar;34(3):307-11. doi: 10.1097/00004583-199503000-00015. PMID: 7896671.
Morshed SA, Parveen S, Leckman JF, Mercadante MT, Bittencourt Kiss MH, Miguel EC, Arman A, Yazgan Y, Fujii T, Paul S, Peterson BS, Zhang H, King RA, Scahill L, Lombroso PJ. Antibodies against neural, nuclear, cytoskeletal, and streptococcal epitopes in children and adults with Tourette's syndrome, Sydenham's chorea, and autoimmune disorders. Biol Psychiatry. 2001 Oct 15;50(8):566-77. doi: 10.1016/s0006-3223(01)01096-4. Erratum in: Biol Psychiatry 2001 Dec 15;50(12):following 1009. PMID: 11690591.
Martino D, Dale RC, Gilbert DL, Giovannoni G, Leckman JF. Immunopathogenic mechanisms in tourette syndrome: A critical review. Mov Disord. 2009 Jul 15;24(9):1267-79. doi: 10.1002/mds.22504. PMID: 19353683; PMCID: PMC3972005.
Baumgaertel C, Skripuletz T, Kronenberg J, Stangel M, Schwenkenbecher P, Sinke C, Müller-Vahl KR, Sühs KW. Immunity in Gilles de la Tourette-Syndrome: Results From a Cerebrospinal Fluid Study. Front Neurol. 2019 Jul 4;10:732. doi: 10.3389/fneur.2019.00732. PMID: 31333575; PMCID: PMC6621640.

OCD, Emotional lability, and other psychiatric symptoms in Sydenham's Chorea

Ebaugh FG. Neuropsychiatric aspects of chorea in children. JAMA. 1926;87: 1083-1088
Ridel KR, Lipps TD, Gilbert DL. The prevalence of neuropsychiatric disorders in Sydenham's chorea. Pediatr Neurol 2010; 42:243.
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Swedo SE, Leonard HL, Schapiro MB, et al. Sydenham's chorea: physical and psychological symptoms of St Vitus dance. Pediatrics 1993; 91:706.
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Sydenham Chorea

Mercadante MT, Diniz JB, Hounie AG, Ferrao Y, Alvarenga P, Brotto S, Miguel EC: Obsessive-compulsive spectrum disorders in rheumatic fever patients. J Neuropsychiatry Clin Neurosci 17: 544-547, 2005.
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Kirvan CA, Swedo SE, Kurahara D, Cunningham MW: Streptococcal mimicry and antibody-mediated cell signaling in the pathogenesis of Sydenham's chorea. Autoimmunity 39: 21-29, 2006
Korn-Lubetzki I, Brand A: Sydenham's chorea in Jerusalem: still present. Isr Med Assoc J 6: 460-462, 2004
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Kirvan CA, Swedo SE, Heuser JS, Cunningham MW: Mimicry and autoantibody-mediated neuronal cell signaling in Sydenham chorea. Nat Med 9: 914-920, 2003.
Taranta A, Stollerman GH: The relationship of Sydenham's chorea to infection with group A streptococci. Am J Med 20: 170-175, 1956.
Kummer A, Maia DP, Cardoso F, Teixeira AL: Trichotillomania in acute Sydenham's chorea. Aust N Z J Psychiatry 41: 1013-1014, 2007.
Teixeira AL, Athayde GR, Sacramento DR, Maia DP, Cardoso F: Depressive and anxiety symptoms in Sydenham's chorea. Mov Disord 22: 905-906, 2007.
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Asbahr FR, Ramos RT, Negrao AB, Gentil V: Case series: increased vulnerability to obsessive-compulsive symptoms with repeated episodes of Sydenham chorea. J Am Acad Child Adolesc Psychiatry 38: 1522-1525, 1999.
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Casanova MF, Crapanzano KA, Mannheim G, Kruesi M: Sydenham's chorea and schizophrenia: a case report. Schizophr Res 16: 73-76, 1995.
Castelnovo G, Renard D: Magnetic resonance imaging in Sydenham chorea. Acta Neurol Belg 112: 397-398, 2012.
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Gumus H, Gumus G, Per H, Yikilmaz A, Canpolat M, Poyrazoglu G, Narin N: Diffusion-weighted imaging in Sydenham's chorea. Childs Nerv Syst 29: 125-130, 2013.
Ho L: Hypermetabolism in bilateral basal ganglia in Sydenham chorea on F-18 FDG PET-CT. Clin Nucl Med 34: 114-116, 2009.
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Paghera B, Caobelli F, Giubbini R, Premi E, Padovani A: Reversible striatal hypermetabolism in a case of rare adult-onset Sydenham chorea on two sequential 18F-FDG PET studies. J Neuroradiol 38: 325-326, 2011.
Citak EC, Gucuyener K, Karabacak NI, Serdaroglu A, Okuyaz C, Aydin K: Functional brain imaging in Sydenham's chorea and streptococcal tic disorders. J Child Neurol 19: 387-390, 2004.
Tumas V, Caldas CT, Santos AC, Nobre A, Fernandes RM: Sydenham's chorea: clinical observations from a Brazilian movement disorder clinic. Parkinsonism Relat Disord 13: 276-283, 2007.
Kabakus N, Balci TA, Kurt A, Kurt AN: Cerebral blood flow abnormalities in children with Sydenham's chorea: a SPECT study. Indian Pediatr 43: 241-246, 2006.
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Aron AM: Sydenham's chorea: positron emission tomographic (PET) scan studies. J Child Neurol 20: 832-833, 2005.
Moreau C, Devos D, Delmaire C, Gervais C, Defebvre L, Destee A: Progressive MRI abnormalities in late recurrence of Sydenham's chorea. J Neurol 252: 1341-1344, 2005.
Weindl A, Kuwert T, Leenders KL, Poremba M, Grafin von Einsiedel H, Antonini A, Herzog H, Scholz D, Feinendegen LE, Conrad B: Increased striatal glucose consumption in Sydenham's chorea. Mov Disord 8: 437-444,1993.
Demiroren K, Tastekin G, Oran B: Diagnostic role of 99mTc hexamethyl-propyleneamine oxime brain single photon emission computed tomography in Sydenham's chorea. Pediatr Int 46: 450-455, 2004.
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Faustino PC, Terreri MT, da Rocha AJ, Zappitelli MC, Lederman HM, Hilario MO: Clinical, laboratory, psychiatric and magnetic resonance findings in patients with Sydenham chorea. Neuroradiology 45: 456-462, 2003.
Barsottini OG, Ferraz HB, Seviliano MM, Barbieri A: Brain SPECT imaging in Sydenham's chorea. Braz J Med Biol Res 35: 431-436, 2002.
Robertson WC, Jr., Smith CD: Sydenham's chorea in the age of MRI: a case report and review. Pediatr Neurol 27: 65-67, 2002.
Castillo M, Kwock L, Arbelaez A: Sydenham's chorea: MRI and proton spectroscopy. Neuroradiology 41: 943-945, 1999.
Dilenge ME, Shevell MI, Dinh L: Restricted unilateral Sydenham's chorea: reversible contralateral striatal hypermetabolism demonstrated on single photon emission computed tomographic scanning. J Child Neurol 14: 509-513, 1999.
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Ryan MM, Antony JH: Cerebral vasculitis in a case of Sydenham's chorea. J Child Neurol 14: 815-818, 1999.
Verrips A, Fiselier T, Thijssen H, Gabreëls F: Disappearance of Sydenham's chorea and a caudate nucleus lesion after treatment with methylprednisolone. European Journal of Paediatric Neurology 3: A20, 1999.
Ikuta N, Hirata M, Sasabe F, Negoro K, Morimatsu M: High-signal basal ganglia on T1-weighted images in a patient with Sydenham's chorea. Neuroradiology 40: 659-661, 1998.
Emery ES, Vieco PT: Sydenham Chorea: magnetic resonance imaging reveals permanent basal ganglia injury. Neurology 48: 531-533, 1997.
Van der Merwe PL, Kalis NN: Sydenham's chorea--analysis of 27 patients and a review of the literature. S Afr Med J 87 Suppl 3: C157-160, 1997.
Giedd JN, Rapoport JL, Kruesi MJ, Parker C, Schapiro MB, Allen AJ, Leonard HL, Kaysen D, Dickstein DP, Marsh WL, et al.: Sydenham's chorea: magnetic resonance imaging of the basal ganglia. Neurology 45: 2199-2202, 1995.

Neuropsychiatric aspects of Sydenham Chorea

EBAUGH, FRANKLIN G. “Neuropsychiatric Aspects of Chorea in Children.” JAMA: Journal of the American Medical Association, vol. 87, no. 14, Oct. 1926, pp. 1083–88., https://doi.org/10.1001/jama.1926.02680140001001.
Ridel KR, Lipps TD, Gilbert DL. The prevalence of neuropsychiatric disorders in Sydenham's chorea. Pediatr Neurol. 2010 Apr;42(4):243-8. doi: 10.1016/j.pediatrneurol.2009.12.004. PMID: 20304326.
Maia DP, Teixeira AL Jr, Quintão Cunningham MC, Cardoso F. Obsessive compulsive behavior, hyperactivity, and attention deficit disorder in Sydenham chorea. Neurology. 2005 May 24;64(10):1799-801. doi: 10.1212/01.WNL.0000161840.62090.0E. PMID: 15911817.
Swedo SE, Rapoport JL, Cheslow DL, Leonard HL, Ayoub EM, Hosier DM, Wald ER. High prevalence of obsessive-compulsive symptoms in patients with Sydenham's chorea. Am J Psychiatry. 1989 Feb;146(2):246-9. doi: 10.1176/ajp.146.2.246. PMID: 2912267.
Asbahr FR, Negrão AB, Gentil V, Zanetta DM, da Paz JA, Marques-Dias MJ, Kiss MH. Obsessive-compulsive and related symptoms in children and adolescents with rheumatic fever with and without chorea: a prospective 6-month study. Am J Psychiatry. 1998 Aug;155(8):1122-4. doi: 10.1176/ajp.155.8.1122. PMID: 9699708.
Swedo SE, Leonard HL, Schapiro MB, Casey BJ, Mannheim GB, Lenane MC, Rettew DC. Sydenham's chorea: physical and psychological symptoms of St Vitus dance. Pediatrics. 1993 Apr;91(4):706-13. PMID: 8464654.
FREEMAN JM, ARON AM, COLLARD JE, MACKAY MC. THE EMOTIONAL CORRELATES OF SYDENHAM'S CHOREA. Pediatrics. 1965 Jan;35:42-9. PMID: 14223224.
WERTHEIMER NM. A psychiatric follow-up of children with rheumatic fever and other chronic diseases. J Chronic Dis. 1963 Mar;16:223-37. doi: 10.1016/0021-9681(63)90028-6. PMID: 14000045.
DIEFENDORF AR. . MENTAL SYMPTOMS OF ACUTE CHOREA. The Journal of Nervous and Mental Disease. 1912; 39 (3): 161-172.

Autoimmune Enchephalitis

Cellucci T, Van Mater H, Graus F, Muscal E, Gallentine W, Klein-Gitelman MS, Benseler SM, Frankovich J, Gorman MP, Van Haren K, Dalmau J, Dale RC. Clinical approach to the diagnosis of autoimmune encephalitis in the pediatric patient. Neurol Neuroimmunol Neuroinflamm. 2020 Jan 17;7(2). pii: e663. doi: 10.1212/NXI.0000000000000663. Print 2020 Mar. PMID:31953309
Gibson, L.L., McKeever, A., Coutinho, E. et al. Cognitive impact of neuronal antibodies: encephalitis and beyond. Transl Psychiatry 10, 304 (2020). https://doi.org/10.1038/s41398-020-00989-x
Arai H, Goto T, Kimura N, Miyama S: Acute encephalitis presenting with symmetrical involvement of the bilateral basal ganglia. No To Hattatsu 45: 457-460, 2013.
Dale RC, Brilot F. Autoimmune Basal Ganglia Disorders. Journal of Child Neurology. 2012;27(11):1470-1481. doi:10.1177/0883073812451327

Microglia Activation in PANS, PANDAS, OCD, and Tourette Syndrome

Frick L, Pittenger C. Microglial Dysregulation in OCD, Tourette Syndrome, and PANDAS. J Immunol Res. 2016;2016:8606057. doi:10.1155/2016/8606057
Kumar A, Williams MT, Chugani HT: Evaluation of Basal Ganglia and Thalamic Inflammation in Children With Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infection and Tourette Syndrome: A Positron Emission Tomographic (PET) Study Using 11C-[R]-PK11195. J Child Neurol 30: 749-756, 2015.
Attwells S, Setiawan E, Wilson AA, et al. Inflammation in the Neurocircuitry of Obsessive-Compulsive Disorder. JAMA Psychiatry. 2017;74(8):833-840. doi:10.1001/jamapsychiatry.2017.1567

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