PANDAS - Research Directions

Research Directions

In a 2010 paper calling for "a way forward", Murphy, Kurlan and Leckman said: "It is time for the National Institutes of Health, in combination with advocacy and professional organizations, to convene a panel of experts not to debate the current data, but to chart a way forward. For now we have only to offer our standard therapies in treating OCD and tics, but one day we may have evidence that also allows us to add antibiotics or other immune-specific treatments to our armamentarium." A 2011 paper by Singer proposed a new, "broader concept of childhood acute neuropsychiatric symptoms (CANS)", removing some of the PANDAS criteria in favor or requiring only acute-onset. Singer said there were "numerous causes for CANS", which was proposed because of the "inconclusive and conflicting scientific support" for PANDAS, including "strong evidence suggesting the absence of an important role for GABHS, a failure to apply published criteria, and a lack of scientific support for proposed therapies". A 2012 paper by Swedo, Leckman and Rose proposed instead a new working proposal called pediatric acute-onset neuropsychiatric syndrome (PANS); it was "favored because 'childhood' would exclude adolescents, while 'pediatric' extends to at least age 18 years (and in some definitions, 21 years)".