Association of Pediatric Acute-Onset Neuropsychiatric Syndrome With Microstructural Differences in Brain Regions Detected via Diffusion-Weighted Magnetic Resonance Imaging

SUMMARY

“Association of Pediatric Acute-Onset Neuropsychiatric Syndrome With Microstructural Differences in Brain Regions Detected via Diffusion-Weighted Magnetic Resonance Imaging” investigates microstructural brain differences in children diagnosed with Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) using diffusion-weighted MRI (DWI). Utilizing atlas-based imaging analysis, the researchers measured regional brain volume, diffusion, and cerebral blood flow across multiple brain structures.

The study found significantly elevated mean diffusivity in all examined brain regions of PANS patients, with the most pronounced differences observed in the thalamus, basal ganglia, and amygdala—areas associated with obsessive-compulsive behaviors, emotional dysregulation, and sleep disturbances. No significant differences were found in cerebral blood flow or regional brain volumes, though volumetric variability was greater in the PANS group. These diffusion changes are thought to reflect underlying neuroinflammation and may correspond with the clinical symptoms observed in PANS. The increased diffusivity was present regardless of symptom severity. This research underscores the potential utility of DWI as a noninvasive biomarker for PANS, advancing understanding of its neuropathological basis and supporting its distinction from traditional childhood OCD and other neuropsychiatric conditions.

LINK TO PAPER: https://doi.org/10.1001/jamanetworkopen.2020.4063