title: Incidence of anti-brain antibodies in children with obsessive-compulsive disorder.
abstract: BACKGROUND
  Obsessions and compulsions may occur in the post-streptococcal disorders Sydenham's chorea and paediatric autoimmune neuropsychiatric disorders associated with streptococcus (PANDAS). The proposed mediators are anti-basal ganglia antibodies (ABGA).
  
  
  OBJECTIVE
  We tested the hypothesis that post-streptococcal autoimmunity may have a role in'idiopathic'obsessive-compulsive disorder (OCD).
  
  
  METHODS
  We examined 50 children with OCD for ABGA using enzyme-linked immunosorbent assay (ELISA) and western immunoblotting. The findings were compared with paediatric autoimmune (n=50), neurological (n=100) and streptococcal (n=40) controls.
  
  
  RESULTS
  The mean ABGA binding on ABGA binding on ELISA was elevated in the patient cohort compared with all control groups (P<0.005 in all comparisons). Western immunoblotting revealed positive antibody binding (as seen in Sydenham's chorea) in 42% of the patient cohort compared with 2-10% of control groups (P<0.001 in all comparisons).
  
  
  CONCLUSIONS
  Our findings support the hypothesis that central nervous system autoimmunity may have a role in a significant subgroup of cases of OCD. Further study is required to examine whether the antibodies concerned are pathogenic.
authors.affiliation: Department of Child and Adolescent Psychiatry, PO Box 085, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK.
authors.forename: Russell C
authors.initials: RC
authors.lastname: Dale
authors.forename: Isobel
authors.initials: I
authors.lastname: Heyman
authors.forename: Gavin
authors.initials: G
authors.lastname: Giovannoni
authors.forename: Andre W J
authors.initials: AW
authors.lastname: Church
mesh_terms: D000293:Adolescent; D000906:Antibodies / Q000097:blood / Q000276:immunology*; D000937:Antigen-Antibody Reactions / Q000276:immunology; D001324:Autoantigens / Q000276:immunology; D015551:Autoimmunity / Q000276:immunology; D001479:Basal Ganglia / Q000276:immunology; D015153:Blotting, Western / Q000379:methods; D001921:Brain / Q000276:immunology*; D002648:Child; D015331:Cohort Studies; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000276:immunology*; D013290:Streptococcal Infections / Q000276:immunology
chemical_list: D000906:Antibodies; D001324:Autoantigens