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Neurologist to Check Possible Link Between Strep, Neurological Disorders

Wednesday, June 18, 2003

            A University of Rochester neurologist has been asked to resolve the question of whether common strep infections somehow make children more likely to develop tics, obsessive-compulsive disorder or other conditions marked by behavioral difficulties.

            The research team plans to study at least 10 Rochester-area children between the ages of 7 and 14 as part of a nationwide study of 80 children who have physical or vocal tics and/or have been diagnosed with obsessive-compulsive disorder. Roger Kurlan, chief of the Cognitive and Behavioral Neurology Unit at the university’s Strong Memorial Hospital, will lead the study at 11 medical centers around the country. The study is funded with $3 million from the National Institutes of Health.

            The work will help answer a question that has unsettled parents and pediatricians alike: Do strep infections, which are very common in children and adults, either trigger or worsen obsessive-compulsive disorder and other conditions marked by tics? Strep infections are easily treated with antibiotics, but some parents and doctors have noticed a potential link between the infections and sudden behavioral changes in children. Doctors have noticed that some children who were previously playful and carefree had dramatic behavioral changes around the time they were diagnosed with strep.

            “This has gotten a lot of parents and pediatricians worried, but there’s no firm evidence that this really does exist,” says Kurlan. “This study is designed to get at the bottom of the question whether a strep infection can lead to neurobehavioral problems.

            “Most kids who have strep don’t get these illnesses. They have strep, they get better, and they move on. We’re talking about children who had sudden changes in behavior after getting a strep infection.”

            Some doctors suspect that a strep infection triggers the body to produce antibodies that then attack or damage a part of the brain known as the basal ganglia, in an errant attempt to rid the body of the infection. The basal ganglia is affected in people who have attention deficit-hyperactivity disorder (ADHD), Tourette’s syndrome, obsessive-compulsive disorder, and some learning disabilities. While the cause of these disorders is not known, most of these conditions are being diagnosed in children more and more often. Kurlan recently published results showing that the rate of Tourette’s among students in the general population is 50 to 75 times higher than has been traditionally thought by doctors.

            In this study, doctors and nurses will track children for two years, logging both strep infections and behavioral difficulties in an attempt to uncover any link between the two. Since many strep infections go unnoticed by both children and their parents, every three months the children will have a physical exam, including a blood test, regardless of how they feel. In addition, nurses will obtain throat cultures from the children every month, and whenever children have a sore throat, or when their obsessive-compulsive symptoms or tics worsen, doctors will examine them.

            Children who have been diagnosed as obsessive-compulsive or who have tics, whether or not they have a history of strep infections, are needed for the study. Anyone interested in more information should call (585) 341-7515.

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