B-31: Unpacking Functional Impairment in PANS/PANDAS: A Preliminary Study
Abstract
Objective: Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) are hypothesized to involve brain-based autoimmune-mediated inflammation; however, research on associated cognitive outcomes remains limited. This study aimed to begin characterizing associated cognitive and functional outcomes in this clinical population. Method/Data Selection: Thirty-two consecutively referred youth with PANS and/or PANDAS (mean age=11.19 [SD=3.17], 68.8% male, 78.1% White) were seen for neuropsychological evaluation at a rural academic medical center. Patients completed a neuropsychological battery, including a measure of intellectual functioning (FSIQ from WISC-V, WAIS-IV, WPPSI-IV, or WASI-II). Caregivers completed rating scales measuring adaptive functioning (ABAS-3) and executive functioning (BRIEF). Spearman ranked correlations were conducted to analyze relationships. Results/Data Synthesis: Mean FSIQ (107.56, SD=15.25) was in the average range, while ABAS General Adaptive Composite was approximately 20 points lower (87.78, SD=14.62). Patients were grouped based on whether caregiver-rated executive functioning (BRIEF Global Executive Composite) was clinically significant (N=16) or not (N=16). FSIQ was not significantly correlated with caregiver-rated overall adaptive functioning (rs=0.17, p=0.41) or executive dysfunction (rs=0.08, p=0.69). A significant and moderate negative correlation (rs=-0.62, p< 0.001) was found between caregiver-rated executive dysfunction and adaptive functioning. Conclusions: Results indicate that while children with PANS/PANDAS do not show IQ impairments on testing, they do demonstrate lower adaptive functioning as rated by caregivers. Those who observed clinically significant executive dysfunction were more likely to endorse adaptive weaknesses. This may reflect the impact of psychiatric distress commonly observed in this population, but further assessment of cognitive profiles is needed to better explain mediators of caregiver-observed functional challenges.