Executive and attention functioning among children in the PANDAS subgroup

Child Neuropsychol. 2009 Mar;15(2):179-94. doi: 10.1080/09297040802186899. Epub 2008 Jul 11.

Abstract

Evidence from past studies indicates that adults and children with Obsessive-Compulsive Disorder (OCD) and Tourette syndrome (TS) experience subtle neuropsychological deficits. Less is known about neuropsychological functioning of children and adolescents with a symptom course consistent with the PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infection) subgroup of OCD and tics. To provide such information, we administered three tests of attention control and two of executive function to 67 children and adolescents (ages 5-16) diagnosed with OCD and/or tics and a symptom course consistent with the PANDAS subgroup and 98 healthy volunteers (HV) matched by age, sex, and IQ. In a paired comparison of the two groups, the PANDAS subjects were less accurate than HV in a test of response suppression. Further, in a two-step linear regression analysis of the PANDAS group in which clinical variables were added stepwise into the model and in the second step matching variables (age, sex, and IQ) were added, IQ emerged as a predictor of performance on this task. In the same analysis, ADHD diagnosis and age emerged as predictors of response time in a continuous performance task. Subdividing the PANDAS group by primary psychiatric diagnosis revealed that subjects with TS or OCD with tics exhibited a longer response time compared to controls than subjects with OCD only, replicating previous findings within TS and OCD. This study demonstrates that children with PANDAS exhibit neuropsychological profiles similar to those of their primary psychiatric diagnosis.

Publication types

  • Research Support, N.I.H., Intramural

MeSH terms

  • Adolescent
  • Attention Deficit Disorder with Hyperactivity / diagnosis
  • Attention Deficit Disorder with Hyperactivity / epidemiology*
  • Autoimmune Diseases / epidemiology*
  • Brain / physiopathology*
  • Child
  • Child, Preschool
  • Cognition Disorders / diagnosis
  • Cognition Disorders / epidemiology*
  • Comorbidity
  • Female
  • Humans
  • Male
  • Mental Disorders / epidemiology*
  • Mental Disorders / physiopathology*
  • Obsessive-Compulsive Disorder / epidemiology*
  • Reaction Time
  • Streptococcal Infections / epidemiology*
  • Tourette Syndrome / epidemiology*
  • Tourette Syndrome / physiopathology*