Prevalence of anti-basal ganglia antibodies in adult obsessive–compulsive disorder: cross-sectional study

Abstract

BackgroundSymptoms of obsessive–compulsive disorder (OCD) have been described in neuropsychiatric syndromes associated with streptococcal infections. It is proposed that antibodies raised against streptococcal proteins cross-react with neuronal proteins (antigens) in the brain, particularly in the basal ganglia, which is a brain region implicated in OCD pathogenesis.AimsTo test the hypothesis that post-streptococcal autoimmunity, directed against neuronal antigens, may contribute to the pathogenesis of OCD in adults.MethodNinety-six participants with OCD were tested for the presence of anti-streptolysin-O titres (ASOT) and the presence of anti-basal ganglia antibodies (ABGA) in a cross-sectional study. The ABGA were tested for with western blots using three recombinant antigens; aldolase C, enolase and pyruvate kinase. The findings were compared with those in a control group of individuals with depression (n = 33) and schizophrenia (n = 17).ResultsPositivity for ABGA was observed in 19/96 (19.8%) participants with OCD compared with 2/50 (4%) of controls (Fisher's exact test P = 0.012). The majority of positive OCD sera (13/19) had antibodies against the enolase antigen. No clinical variables were associated with ABGA positivity. Positivity for ASOT was not associated with ABGA positivity nor found at an increased incidence in participants with OCD compared with controls.ConclusionsThese findings support the hypothesis that central nervous system autoimmunity may have an aetiological role in some adults with OCD. Further study is required to examine whether the antibodies concerned are pathogenic and whether exposure to streptococcal infection in vulnerable individuals is a risk factor for the development of OCD.

Are microglia minding us? Digging up the unconscious mind-brain relationship from a neuropsychoanalytic approach

“…Inflammation, oxidative stress, and immunological abnormality have been highlighted in various psychiatric disorders (Ng et al, 2008; Pasco et al, 2010; Kato et al, 2011a; Maes et al, 2011, 2012; Davison, 2012; Nicholson et al, 2012). The pathophysiology of psychiatric disorders has been dominantly believed to be solely explained by abnormalities of neurotransmitter systems.…”

Serum Cytokine Profiles of Children with Obsessive-Compulsive Disorder Shows the Evidence of Autoimmunity

“…Studies conducted in both pediatric and adult OCD patients found higher levels of antibasal ganglia antibodies and antithalamic autoantibodies compared with the control group (Dale et al, 2005; Pearlman et al, 2014). In addition, antibasal ganglia antibody was found in both seropositive (antistreptolysin O-positive) and seronegative OCD patients (Nicholson et al, 2012). Consistent with these findings, functional abnormalities in the cortico-striato-thalamo-cortical circuitry in OCD were also reported (Pittenger et al, 2011).…”

Searching for the Immune Basis of Obsessive-Compulsive Disorder

“…Nicholson et al [34] tested 96 adult OCD patients and 50 controls (33 with chronic depression and 17 with schizophrenia) for the presence of ASO and ABGA. The rates of positivity for ASO in both the OCD and control groups were low and the differences were not significant.…”