Incidence of anti-brain antibodies in children with obsessive-compulsive disorder.
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.
Dale
Russell C
RC
Department of Child and Adolescent Psychiatry, PO Box 085, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK.
Heyman
Isobel
I
Giovannoni
Gavin
G
Church
Andre W J
AW
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
D000906:Antibodies; D001324:Autoantigens