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The Journal of Neuroscience, February 18, 2004, 24(7):1780-1791; doi:10.1523/JNEUROSCI.0887-03.2004

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Neurobiology of Disease
A Murine Model for Neuropsychiatric Disorders Associated with Group A -Hemolytic Streptococcal Infection

Kurt L. Hoffman, Mady Hornig, Kavitha Yaddanapudi, Omar Jabado, and W. Ian Lipkin

Greene Infectious Disease Laboratory, Mailman School of Public Health, Columbia University, New York, New York 10032

A syndrome of motoric and neuropsychiatric symptoms comprising various elements, including chorea, hyperactivity, tics, emotional lability, and obsessive-compulsive symptoms, can occur in association with group A -hemolytic streptococcal (GABHS) infection. We tested the hypothesis that an immune response to GABHS can result in behavioral abnormalities. Female SJL/J mice were immunized and boosted with a GABHS homogenate in Freund's adjuvant, whereas controls received Freund's adjuvant alone. When sera from GABHS-immunized mice were tested for immunoreactivity to mouse brain, a subset was found to be immunoreactive to several brain regions, including deep cerebellar nuclei (DCN), globus pallidus, and thalamus. GABHS-immunized mice having serum immunoreactivity to DCN also had increased IgG deposits in DCN and exhibited increased rearing behavior in open-field and hole-board tests compared with controls and with GABHS-immunized mice lacking serum anti-DCN antibodies. Rearing and ambulatory behavior were correlated with IgG deposits in the DCN and with serum immunoreactivity to GABHS proteins in Western blot. In addition, serum from a GABHS mouse reacted with normal mouse cerebellum in nondenaturing Western blots and immunoprecipitated C4 complement protein and -2-macroglobulin. These results are consistent with the hypothesis that immune response to GABHS can result in motoric and behavioral disturbances and suggest that anti-GABHS antibodies cross-reactive with brain components may play a role in their pathophysiology.

Key words: obsessive-compulsive disorder; PANDAS; group A -hemolytic streptococcus; Tourette syndrome; attention-deficit/hyperactivity disorder; autoimmunity

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Received March 26, 2003; revised December 12, 2003; accepted December 19, 2003.

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