Immunological causes of obsessive-compulsive disorder: is it time for the concept of an “autoimmune OCD” subtype? - Immunologie-Immunopathologie-Immunothérapie Accéder directement au contenu
Article Dans Une Revue Translational Psychiatry Année : 2022

Immunological causes of obsessive-compulsive disorder: is it time for the concept of an “autoimmune OCD” subtype?

Dominique Endres
  • Fonction : Auteur
  • PersonId : 1140455
Thomas A Pollak
Karl Bechter
Kimon Runge
Janet L Cunningham
Katharina Domschke
  • Fonction : Auteur
  • PersonId : 886837

Résumé

Obsessive-compulsive disorder (OCD) is a highly disabling mental illness that can be divided into frequent primary and rarer organic secondary forms. Its association with secondary autoimmune triggers was introduced through the discovery of Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infection (PANDAS) and Pediatric Acute onset Neuropsychiatric Syndrome (PANS). Autoimmune encephalitis and systemic autoimmune diseases or other autoimmune brain diseases, such as multiple sclerosis, have also been reported to sometimes present with obsessive-compulsive symptoms (OCS). Subgroups of patients with OCD show elevated proinflammatory cytokines and autoantibodies against targets that include the basal ganglia. In this conceptual review paper, the clinical manifestations, pathophysiological considerations, diagnostic investigations, and treatment approaches of immune-related secondary OCD are summarized. The novel concept of "autoimmune OCD" is proposed for a small subgroup of OCD patients, and clinical signs based on the PANDAS/PANS criteria and from recent experience with autoimmune encephalitis and autoimmune psychosis are suggested. Red flag signs for "autoimmune OCD" could include (sub)acute onset, unusual age of onset, atypical presentation of OCS with neuropsychiatric features (e.g., disproportionate cognitive deficits) or accompanying neurological symptoms (e.g., movement disorders), autonomic dysfunction, treatment resistance, associations of symptom onset with infections such as group A streptococcus, comorbid autoimmune diseases or malignancies. Clinical investigations may also reveal alterations such as increased levels of anti-basal ganglia or dopamine receptor antibodies or inflammatory changes in the basal ganglia in neuroimaging. Based on these red flag signs, the criteria for a possible, probable, and definite autoimmune OCD subtype are proposed.

Domaines

Neurosciences
Fichier principal
Vignette du fichier
s41398-021-01700-4.pdf (1.91 Mo) Télécharger le fichier
Origine : Publication financée par une institution

Dates et versions

hal-03529691 , version 1 (17-01-2022)

Identifiants

Citer

Dominique Endres, Thomas A Pollak, Karl Bechter, Dominik Denzel, Karoline Pitsch, et al.. Immunological causes of obsessive-compulsive disorder: is it time for the concept of an “autoimmune OCD” subtype?. Translational Psychiatry, 2022, 12 (1), pp.5. ⟨10.1038/s41398-021-01700-4⟩. ⟨hal-03529691⟩
145 Consultations
88 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More