a critical review of pandas research in the context of obsessive compulsive disorder

The discovery and elaboration of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is emerging from a polemical status and gaining wide recognition. Current research has proposed a specific neurological pathogenesis for the disorder. This paper connects the dominant neurobiological model of obsessive compulsive disorder (OCD) with the proposed pathogenesis and treatment of PANDAS. PANDAS presentation is described and an important early debate regarding anti-neuronal antibodies in the brain of PANDAS patients is outlined. Recent research on a specific immunological trigger for antibodies that cause a blood brain barrier breakdown will be discussed along with treatment for the disorder. Future avenues of research are discussed including a critique of the seminal studies in PANDAS pathology and treatment from the focal point of the dominant OCD model.