Autoimmune OCD
The Cunningham Panel™ – testing for autoimmune OCD
The Cunningham Panel™ is a high-complexity blood test that measures the levels of autoantibodies directed against specific targets in the brain associated with psychiatric and neurologic symptoms, including obsessive-compulsive symptoms.
Elevated levels indicate that symptoms may be due to an underlying infection-triggered autoimmune response.
What is autoimmune OCD?
Increasing evidence suggests that in some individuals, obsessive compulsive symptoms, particularly those that are treatment-resistant, may be due to an infection-triggered autoimmune response, known as basal ganglia encephalitis.
In these cases, the immune system malfunctions. In response to an infection, the immune system produces antibodies which mistakenly attack healthy cells in the brain, leading to the onset of neurologic and psychiatric symptoms, including obsessive compulsive symptoms.
PANS/PANDAS and OCD
When children and adolescents develop a sudden onset of OCD-like symptoms, along wth other neuropsychiatric manifestations, they may suffer from Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infections (PANDAS) or Pediatric Acute-onset Neuropsychiatric Syndrome (PANS), a type of basal ganglia encephalitis.
How does this occur?
Common bacterial, viral and parasitic infections can trigger an abnormal immune response, whereby antibodies produced to destroy the infectious agent, mistakenly attack healthy cells in the basal ganglia region of the brain.
This misdirected attack can lead to inflammation in the brain and disrupt normal neuronal cell functioning, resulting in the onset of neurologic and psychiatric symptoms, including obsessive-compulsive behaviors.
Note: The infection(s) may be subclinical. That is, there are no outward physical signs or symptoms of an infection.
- Attwells S, Setiawan E, Wilson AA, Rusjan PM, Mizrahi R, Miler L, Xu C, Richter MA, Kahn A, Kish SJ, Houle S, Ravindran L, Meyer JH. Inflammation in the Neurocircuitry of Obsessive-Compulsive Disorder. JAMA Psychiatry. 2017 Aug 1;74(8):833-840. doi: 10.1001/jamapsychiatry.2017.1567. PMID: 28636705; PMCID: PMC5710556. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5710556/
- Gerentes M, Pelissolo A, Rajagopal K, Tamouza R, Hamdani N. Obsessive-compulsive disorder: autoimmunity and neuroinflammation. Curr Psychiatry Rep. 2019. https://doi.org/10.1007/s11920-019-1062-8. https://link.springer.com/article/10.1007/s11920-019-1062-8
