BRAIN Streptococcal seroreactivity and symptom patterns

BRAIN Journal Interactive Companion

Streptococcal Seroreactivity and Symptom Patterns

Article companion for “Streptococcal Seroreactivity and Neuropsychiatric Symptom Patterns Relevant to PANS/PANDAS in Young Adults”.

ASO × PANS-31 association
Primary association Continuous ASO showed a modest association with total symptom burden.

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The study examined 50 young adult psychiatric patients selected using a pragmatic history consistent with previous streptococcal exposure. Its clearest corrected associations linked continuous ASO titres with tic and cognitive/motor symptom domains.

01Global signal

A modest total-score association

Continuous ASO correlated with PANS-31 total score (Spearman ρ = 0.305, p = 0.031), with a broad 95% bootstrap interval from 0.014 to 0.568.

02Threshold result

The 200 IU/mL split was not significant

The binary comparison produced a 2.85-point mean difference, but its confidence interval included zero and the Mann–Whitney result was p = 0.139.

03Robust domains

Tics and cognitive/motor symptoms

Tics (ρ = 0.496, q = 0.0025) and cognitive/motor symptoms (ρ = 0.421, q = 0.0117) remained significant after BH-FDR correction.

ResultReported estimateInterpretation used here
Total scoreSpearman ρ = 0.305; p = 0.0312.Modest unadjusted continuous association.
Ticsρ = 0.496; q = 0.0025.Strongest multiplicity-robust domain result.
Cognitive/motorρ = 0.421; q = 0.0117.Second multiplicity-robust domain result.
Adjusted ASOB = 0.83 after adjustment for age, sex and paediatric history; p = 0.3846.The crude association was sensitive to measured developmental context.

Experimental Pathway

From cohort selection to adjusted interpretation

Stage 01

Cohort

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    Relationship between continuous ASO and PANS-31 total score

    Figure 01

    ASO and PANS-31 total score

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