PANS and Related Inflammatory Brain Disorders – Advances in Immunopsychiatry
Hosted by Neuroimmune Foundation and accredited
in collaboration with The Wisconsin Medical Society
On Demand Material
A virtual on-demand CME – up to 20.0 AMA PRA Category 1 Credits™
Date of release: Sept 15, 2024; Date of expiration: Sept 14, 2026
Join Us for On-demand CME
PANS and Related Inflammatory Brain Disorders – Advances in Immunopsychiatry features nationally and internationally renowned experts skilled in diagnostic and therapeutic approaches who will present a diverse range of emerging clinical and research challenges, insights, and advances in the field of inflammatory brain disorders.
The intended audience is pediatric and adult physicians. Both generalists as well as specialists will find this on-demand CME content valuable to their practices. The content is designed for pediatricians, family physicians, psychiatrists, rheumatologists, immunologists, neurologists, and infectious disease physicians. Though the content is designed for physicians, physician assistants and nurse practitioners will find the series valuable to their practices as well.
Additional follow up support will be provided through weekly Neuroimmune Foundation hosted events in collaboration with Project ECHO®.
© Copyright to this series is held by Neuroimmune Foundation.
Contents
Also join us in an ongoing opportunity for physicians to consult face-to-face virtually on challenging cases with leading experts in the field of neuroimmunology. Our Expert Case Consultation Panel meets monthly.
PANS and Related Inflammatory Brain Disorders – Advances in Immunopsychiatry Syllabus
Hosted by Neuroimmune Foundation
and accredited in collaboration with
The Wisconsin Medical Society
Contents
PANS and Related Inflammatory Brain Disorders: Advances in Immunopsychiatry features nationally and internationally renowned experts skilled in diagnostic and therapeutic approaches who will present a diverse range of emerging clinical and research challenges, insights, and advances in the field of inflammatory brain disorders.
Target Audience
The intended audience is pediatric and adult physicians. Both generalists as well as specialists will find this on-demand CME content valuable to their practices. The content is designed for pediatricians, family physicians, psychiatrists, rheumatologists, immunologists, neurologists, and infectious disease physicians. Though the content is designed for physicians, physician assistants and nurse practitioners will find the series valuable to their practices as well.
Statement of Need
The field of neuroimmunopsychiatry is rapidly evolving especially due to new research on COVID-19 sequelae that is relevant to other post-infectious illnesses. Immune-mediated causes of neuropsychiatric deteriorations are often misdiagnosed. There is a pressing need for medical knowledge in this area to advance due to the increasing number of ill patients. Failure to utilize immunomodulatory therapies can lead to a dramatic worsening in symptoms and even permanent neurologic impairment as well as dramatically reduced quality of life for patients with these conditions and physicians are not adequately educated in these areas.
Additional Information
Neuroimmune Foundation subscribes to the articles of Title III of the Americans with Disabilities Act of 1990. Should you or anyone accompanying you require special assistance, please notify us by contacting cme@neuroimmune.org or 608-381-0367. Requests should be made as early as possible to allow time to arrange the accommodation.
If you are a North Carolina physician wishing to access this CME series free of charge, please emailing info@neuroimmune.org. Once your credentials have been verified, you will be provided access to the materials.
Copyright to this series is held by Neuroimmune Foundation.
Date of release: September 15, 2024
Date of expiration: September 14, 2026
Instructions to Receive Credit
This continuing medical education enduring material is in a video format. References are linked to online resources. In order to receive credit for this activity, the participant must view the video presentations and complete the post-test and evaluation. Upon completing this activity as designed, participants should complete the post-test on the website. After achieving a passing score on the post-test (80%), participants will submit their signed evaluation and registration form on the website below and will receive their CME certificates via email. Multiple attempts of the post-test are allowed.
List of references from the literature for future reading
- Exploratory analysis of the potential for advanced diagnostic testing to reduce healthcare expenditures of patients hospitalized with meningitis or encephalitis, Fulton BD et al, PLoS One. 2020 Jan 15
- Clinical Metagenomic Sequencing for Diagnosis of Meningitis and Encephalitis, Wilson MR et al, N Engl J Med. 2019 Jun 13
- Pan-viral serology implicates enteroviruses in acute flaccid myelitis, Schubert RD et al, Nat Med. 2019 Nov
- Kelch-like Protein II Antibodies in Seminoma-Associated Paraneoplastic Encephalitis, Mandel-Brehm C et al, N Engl J Med. 2019
- PANS Research Consortium Treatment Recommendations 2017: JCAP Volume: 27 Issue 7: September 1, 2017, Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome:
- Part I—Psychiatric and Behavioral Interventions. Thienemann M et al.
- Part II—Use of Immunomodulatory Therapies. Frankovich J et al.
- Part III—Treatment and Prevention of Infections. Cooperstock MS et al.
- BiteSized Immunology: https://www.immunology.org/public-information/bitesized-immunology
- Neuroscientifically Challenged: https://www.neuroscientificallychallenged.com
- CDC page on Group A Strep: https://www.cdc.gov/groupastrep/diseases-hcp/index.html
Activity Director:
Anna Conkey
Executive Director and Founder, Neuroimmune Foundation
Ms. Conkey has no relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
Planning committee member:
Jenny Frankovich, MD, MS
Dr. Frankovich has no relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
Hosts/Moderators:
Anna Conkey
Executive Director and Founder, Neuroimmune Foundation
Lawrence Steinman, MD
Professor of Neurology and Pediatrics, Stanford University School of Medicine
Dr. Lawrence Steinman is Professor of Neurology, Neurological Sciences and Pediatrics at Stanford University. He was Chair of the Stanford Program in Immunology from 2001 to 2011. His research focuses on what provokes relapses and remissions in multiple sclerosis (MS), and on the quest for antigen specific therapy in autoimmune disease. Steinman was senior author on the 1992 Nature article that led to the drug Tysabri, approved for MS and Crohn’s disease. He is currently applying insights from Tysabri to develop new therapies for neurodegenerative diseases, aimed at blocking macrophages and microglia from eating neurons and axons “in danger.” Dr. Steinman graduated from Dartmouth College, Magna Cum Laude in Physics. His MD is from Harvard Medical School. He was a post-doctoral fellow in chemical immunology at the Weizmann Institute of Science. After neurology residency, he remained on the faculty in 1980. He has received numerous honors, including the John M. Dystel Prize in 2004, the Javits Neuroscience Investigator Award from the NINDS twice, the Charcot Prize in MS research, and the Cerami Prize in Translational Medicine. Dr. Steinman is a member of the National Academy of Sciences, and the National Academy of Medicine. Dr. Steinman cofounded several biotech companies, including Neurocrine, Atreca, 180 Life Sciences, 5 Integrin LLC, and Pasithea. He was a Director of Centocor from 1988 until its sale to Johnson and Johnson. He is a Director of BioAtla, an immune-oncology company, co-Executive Chair of 180 Life Sciences, and Executive Chair of Pasithea.
Dr. Steinman is a consultant for BristolMeyersSquibb. All of the relevant financial relationships for this individual have been mitigated.
Samuel Pleasure, MD, PhD
Glenn W. Johnson, Jr. Memorial Endowed Chair Professor, Department of Neurology, University of California, San Francisco (UCSF) Director Neuroscience Graduate Program, UCSF
Dr. Samuel Pleasure is the Glenn W. Johnson, Jr. Memorial Endowed Chair in Neurology at UCSF. Dr. Pleasure is a neurologist who specializes in caring for patients with multiple sclerosis. He also has expertise in caring for patients with epilepsy as well as years of experience in managing a variety of neurological conditions in both clinic and hospital settings. Dr. Pleasure has two main areas of inquiry for his research. He studies processes that regulate early brain development in both normal and diseased situations. He also studies autoimmune forms of meningoencephalitis, where inflammation in specific brain areas causes severe neurologic dysfunction. He received his medical degree and a doctorate in neuroscience from the University of Pennsylvania. He was chief resident during his neurology residency at UCSF, where he then completed a research fellowship in neuroscience. Dr. Pleasure is a fellow of the American Neurological Association and a member of the American Academy of Neurology, American Epilepsy Society, Society for Neuroscience, Society for Developmental Biology, and Cajal Club. He has won numerous awards for his research and has received research funding from a wide variety of private, state, and federal sources. He has served in leadership roles in national organizations and in the UCSF Department of Neurology.
Dr. Pleasure has no relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
Eyal Muscal, MD
Section Chief, Pediatric Rheumatology, Baylor College of Medicine
Dr. Eyal Muscal is a pediatric rheumatologist with a MS Degree in Clinical Research whose activities include patient care, fellowship education, quality improvement, and clinical research. His research, quality improvement, and clinical interests include neurologic manifestations of systemic autoimmune disorders (primarily autoimmune encephalitis, NPSLE, APS, and CNS vasculitis), systemic vasculitides, and patient-powered research in rare diseases. Dr. Muscal is the Childhood Arthritis and Rheumatology Research Alliance (CARRA) registry PI and co-director of the CARRA autoimmune encephalitis work group. An increased portion of his clinical effort is spent on standardizing and enhancing care of children with inflammatory brain disorders. As part of this effort, he obtained additional training in advanced QI. During the COVID-19 pandemic Dr. Muscal has been one of his section’s champions on the pathophysiology and treatment of MIS-C. This has included providing educational sessions at his institution and also to international audiences. He has coordinated evidence-based guidelines for MIS-C at his institution and has insured timely, rational, and multi-disciplinary MIS-C care in both general floor and critical care areas. He is also the rheumatology lead for a joint cardiology-rheumatology clinic that follows MIS-C patients after hospital discharge. Dr. Muscal is well suited to support institutional efforts regarding COVID-19 and MIS-C care and specifically the Artificial Intelligence COVID-19 Risk Assessment for Kids (AICORE-kids) program.
Dr. Muscal has no relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
Learning and Outcome Objectives
- Learn how to accurately diagnose and effectively treat inflammatory brain conditions including PANS.
- Recognize that neuropsychiatric sequelae can result from infections, autoimmune, and inflammatory conditions.
- List several immune and inflammatory markers that can be present in patients with inflammatory brain disorders.
- Report the cognitive and psychiatric effects that can occur post-infection.
- Describe appropriate treatments for patients with inflammatory brain disorders.
Accreditation / Credit Designation Statement
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Wisconsin Medical Society and Neuroimmune Foundation. The Wisconsin Medical Society is accredited by the ACCME to provide continuing medical education for physicians.
The Wisconsin Medical Society designates this enduring material activity for a maximum of 20 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
This activity has been produced with no commercial support.
Speakers and Videos
Overview of the JCAP Clinical Management and Treatment of PANS Guidelines – Panel Presentation and Discussion
Jennifer Frankovich, MD
Clinical Professor of Pediatrics, Rheumatology; Director of PANS Research Program – Stanford University School of Medicine
Dr. Frankovich is an Associate Clinical Professor in the Department of Pediatrics, Division of Allergy, Immunology Rheumatology (AIR) at Stanford University/Lucile Packard Children’s Hospital (LPCH). Her clinical expertise is in systemic inflammatory and autoimmune diseases that co-occur with psychiatric symptoms. She completed her training in pediatrics, pediatric rheumatology, and clinical epidemiology at Stanford University/LPCH. She directs the Stanford PANS Program (2012–present) where she and her collaborators have created a longitudinal clinical database and large biorepository of patient and control biospecimens. In addition to generating clinical data to better understand the PANS illness, she is collaborating with 10 basic science labs who aim to understand the immunological underpinnings of the illness.
Chris Ikonomidou, MD, PhD
Chief, Section of Pediatric Neurology, University of Wisconsin American Family Children’s Hospital Faculty, University of Wisconsin School of Medicine and Public Health
Dr. Hrissanthi (Chris) Ikonomidou is a Child Neurologist and physician researcher with expertise in neurodegenerative and neurodevelopmental disorders. She is the Division Chief of Pediatric Neurology at the University of Wisconsin Madison and American Family Children’s Hospital. She received her MD and PhD degrees from the University of Goettingen in Germany. She completed her residency and Pediatric Neurology fellowship at Washington University in St Louis and holds board certification in Neurology with Special Qualification in Child Neurology and UCNS certification in Headache. Dr Ikonomidou and her team discovered that imbalance between excitatory and inhibitory signals in the developing brain can lead to brain injuries and subsequent neurologic, cognitive, and mental disabilities. Several pediatric drugs, including sedatives, anesthetics and anticonvulsants, utilize these mechanisms to elicit their therapeutic effects and bear the potential to cause brain injury during critical periods of brain development. Her current research aims to investigate ways to prevent neurotoxicity of these classes of medications in infants and children. Her second research focus entails adverse effects of cancer chemotherapy agents on the developing central nervous system. She has authored over 140 peer reviewed publications and book chapters and serves on several editorial boards of scientific journals.
Dr. Ikonomidou has no relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
Mark Pasternack, MD
Chief of Infectious Disease, Massachusetts General Hospital; Associate Professor of Pediatrics, Massachusetts General Hospital, Harvard
Dr. Mark Pasternack serves as Chief, Pediatric Infectious Disease Unit, at Massachusetts General Hospital. Educated at Harvard Medical School, Dr. Pasternack completed his residency and clinical infectious disease fellowship at Massachusetts General Hospital and a research fellowship at the Center for Cancer Research, Massachusetts Institute of Technology. Author of numerous papers and articles for prestigious medical journals, Dr. Pasternack is an officer of the Massachusetts Infectious Diseases Society and a member of the Pediatric Infectious Disease Society as well as the Infectious Diseases Society of America. His broad clinical interests include Infectious Disease and Pediatric Infectious Disease. Dr. Pasternack has provided clinical care to PANS/PANDAS patients for over a decade and has participated in the PANS/PANDAS Research Consortium to develop clinical guidelines for the management of these patients.
Dr. Pasternack receives equity from Merck and author royalties from Up To Date. All of the relevant financial relationships for this individual have been mitigated
Gail Bernstein, MD
Professor, Department of Psychiatry and Behavioral Sciences, Head, Program in Child & Adolescent Anxiety & Mood Disorders, University of Minnesota Medical School, Masonic Institute for the Developing Brain
Dr. Gail Bernstein is a Professor with Tenure in the Department of Psychiatry & Behavioral Sciences at the Masonic Institute for the Developing Brain at the University of Minnesota. She holds the Endowed Professorship in Child and Adolescent Anxiety Disorders. Dr. Bernstein’s areas of research and clinical expertise over the years have been anxiety disorders in children and adolescents and pediatric obsessive-compulsive disorder (OCD). She opened a PANS Clinic at the University of Minnesota in 2016. Dr. Bernstein has studied many aspects of pediatric anxiety disorders including assessment, nosology, family studies, pharmacological treatments, and cognitive-behavioral interventions. She served as Principal Investigator on a NIMH study entitled Effects of Sertraline on Brain Connectivity in Adolescents with OCD. She recently completed a NIMH study evaluating two forms of digital cognitive-behavioral group therapy for teenagers with social anxiety. Currently Dr. Bernstein is Co-Investigator on studies using fMRI and other measures to determine if engagement in creative activities may enhance cognitive flexibility and improve symptoms of depression in teenagers.
Dr. Bernstein has no relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
Cynthia Kapphahn, MD
Medical Director, Eating Disorders Program, Lucile Packard Children’s Hospital, Stanford; Clinical Professor, Division of Adolescent Medicine, Stanford University School of Medicine
Dr. Cynthia Kapphahn is a Clinical Professor in the Division of Adolescent Medicine at Stanford University School of Medicine. She is Medical Director of the Eating Disorders Program at Stanford Medicine Children’s Health, which specializes in the treatment of adolescents and young adults with eating disorders. She completed medical training at Yale Medical School, a pediatric residency at the Johns Hopkins Hospital, and an adolescent medicine fellowship at the University of California, San Francisco. She received a master’s degree in Public Health and Policy from Johns Hopkins University. In addition to her clinical and administrative responsibilities, she is involved in research regarding eating disorders, medical complications, and care outcomes, and has a special interest in Avoidant Restrictive Food Intake Disorder (ARFID). She is a member of the National Eating Disorders Quality Improvement Research Collaborative, and has served as Chairman of the Society for Adolescent Health and Medicine’s Eating Disorder Clinical Committee.
Dr. Kapphahn has no relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
Kiki Chang, MD
Child, Adolescent, and Adult Psychiatrist, Adjunct Professor of Psychiatry, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston
Dr. Kiki Chang is a child, adolescent and adult psychiatrist in private practice in Palo Alto, CA. From 1999–2017 he was on the faculty of the Stanford University School of Medicine, Division of Child Psychiatry, where he was Director of the Pediatric Bipolar Disorders Clinic and Research Program, specializing in pediatric psychopharmacology and treatment of depression and bipolar disorder in children and adolescents. His research includes brain imaging, genetics, and medication and psychotherapy trials, designed to identify those at highest risk for bipolar disorder and methods to intervene to prevent its onset. In 2012, Dr. Chang co-founded the Stanford Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) Clinic and Research Program at the Lucille Packard Children’s Hospital at Stanford. He then expanded his research to include immunologic, inflammatory, and brain imaging research in PANS in order to understand the medical etiology and better treatment algorithms for these afflicted youth. Dr. Chang graduated cum laude from Princeton University in 1988 and received his MD from the Tufts University School of Medicine in 1993. He completed his general psychiatry residency at the University of Cincinnati and his child psychiatry fellowship at Stanford University. After a postdoctoral research fellowship, Dr. Chang joined the Stanford faculty in 1999. Dr. Chang is the recipient of the 2003 American Psychiatric Association/AstraZeneca Young Minds in Psychiatry Award. His research has been funded by the NIMH, NARSAD, the Prechter Fund, the Hahn Family, and other private donors. He is the recipient of multiple K-Awards and R01 grants from the NIMH. Dr. Chang is the author of over 130 papers and book chapters regarding bipolar disorder and PANS and has presented widely at national and international scientific conferences and meetings.
Dr. Chang is a consultant for Sunovion, AbbVie, and Compass Pathways. All the relevant financial relationships for this individual have been mitigated.
Overview of the JCAP Clinical Management and Treatment Guidelines – Panel Presentation and Discussion is a five hour recording featuring a panel presentation of nationally renowned experts skilled in diagnostic and therapeutic approaches who present an in depth training on the PANS Research Consortium Treatment Recommendations 2017: JCAP Volume: 27 Issue 7: September 1, 2017, Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome.
Jennifer Frankovich, MD
Rheumatology & Psychiatry – What We Can Learn From Overlapping Conditions
Dr. Frankovich reviews rheumatic conditions that overlap with psychiatric disease, clinical evaluation pearls or clues that the child has rheumatic conditions, and a general approach to treatment.
Jennifer Frankovich, MD
Clinical Professor of Pediatrics, Rheumatology; Director of PANS Research Program – Stanford University School of Medicine
Dr. Frankovich is an Associate Clinical Professor in the Department of Pediatrics, Division of Allergy, Immunology Rheumatology (AIR) at Stanford University/Lucile Packard Children’s Hospital (LPCH). Her clinical expertise is in systemic inflammatory and autoimmune diseases that co-occur with psychiatric symptoms. She completed her training in pediatrics, pediatric rheumatology, and clinical epidemiology at Stanford University/LPCH. She directs the Stanford PANS Program (2012–present) where she and her collaborators have created a longitudinal clinical database and large biorepository of patient and control biospecimens. In addition to generating clinical data to better understand the PANS illness, she is collaborating with 10 basic science labs who aim to understand the immunological underpinnings of the illness.
Dr. Frankovich has no relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
Jennifer Frankovich, MD
Rheumatology & Psychiatry – What We Can Learn From Overlapping Conditions
Elizabeth Mellins, MD
Monocyte Research in PANS
Dr. Mellins reviews the heterogeneity of human monocytes, particularly during chronic inflammation, monocyte subsets associated with PANS, and differences in monocyte subset frequencies in different PANS clinical subgroups.
Elizabeth Mellins, MD
Professor of Pediatrics, Pediatric Rheumatologist and Molecular Immunologist – Stanford University School of Medicine
Dr. Elizabeth Mellins is a Pediatric Rheumatologist and a Molecular Immunologist at Stanford University School of Medicine. She has focused her career on laboratory-based research on normal and disease-causing immune responses, including those in PANS. She received her MD degree at Harvard Medical School and completed a Pediatric residency at the University of Colorado and the University of Washington. She did a fellowship in Pediatric Rheumatology followed by a research fellowship in Immunology, both at the University of Washington. She holds board certifications in General Pediatrics and Pediatric Rheumatology. After being an Assistant Professor at the University of Pennsylvania, she moved to Stanford, where she is now a full Professor. She has served on the NIH Cellular and Molecular Immunology study section and has received research funding from the NIH, the Arthritis Foundation and other foundations, and several pharmaceutical companies. She has authored over 165 peer-reviewed publications and is an editor of the premier textbook in Pediatric Rheumatology. She was the founder and first Chairperson of the Childhood Arthritis and Rheumatology Research Alliance, an organization that now includes almost all Pediatric Rheumatology Divisions in the US and Canada. She is a Distinguished Fellow of the American Association of Immunologists. Dr. Mellins is committed to training young investigators and has received several mentoring awards.
Dr. Mellins provides research support for GlaxoSmithKline, Codexis, Inc. and Genentech. All of the relevant financial relationships for this individual have been mitigated.
Elizabeth Mellins, MD
Monocyte Research in PANS
Jennifer Frankovich, MD And Elizabeth Mellins, MD
Evidence for PANS as an Inflammatory Brain Disorder
Dr. Frankovich and Dr. Mellins will cover objective findings that point to PANS/PANDAS as an organic brain disease, discuss the epidemiological studies that have evaluated the links between autoimmunity/inflammation, infection, and OCD, and discuss evidence for autoimmunity and inflammation in PANS/PANDAS and briefly outline management strategies.
Jennifer Frankovich, MD
Associate Clinical Professor in the Department of Pediatrics
Division of Immunology & Rheumatology, Stanford University & Lucile Packard Children’s Hospital
Dr. Frankovich is an Associate Clinical Professor in the Department of Pediatrics, Division of Allergy, Immunology Rheumatology (AIR) at Stanford University/Lucile Packard Children’s Hospital (LPCH). Her clinical expertise is in systemic inflammatory and autoimmune diseases that co-occur with psychiatric symptoms. She completed her training in pediatrics, pediatric rheumatology, and clinical epidemiology at Stanford University/LPCH. She directs the Stanford PANS Program (2012- present) where she and her collaborators have created a longitudinal clinical database and large biorepository of patient and control biospecimens. In addition to generating clinical data to better understand the PANS illness, she is collaborating with 10 basic science labs who aim to understand the immunological underpinnings of the illness.
Dr. Frankovich has no relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
Elizabeth Mellins, MD
Professor of Pediatrics, Pediatric Rheumatologist and Molecular Immunologist, Stanford University School of Medicine
Dr. Elizabeth Mellins is a Pediatric Rheumatologist and a Molecular Immunologist at Stanford University School of Medicine. She has focused her career on laboratory-based research on normal and disease-causing immune responses, including those in PANS. She received her MD degree at Harvard Medical School and completed a pediatric residency at the University of Colorado and the University of Washington. She did a fellowship in Pediatric Rheumatology followed by a research fellowship in Immunology, both at the University of Washington. She holds board certifications in General Pediatrics and Pediatric Rheumatology. After being an Assistant Professor at the University of Pennsylvania, she moved to Stanford, where she is now a full Professor. She has served on the NIH Cellular and Molecular Immunology study section and has received research funding from the NIH, the Arthritis Foundation and other foundations, and several pharmaceutical companies. She has authored over 165 peer-reviewed publications and is an editor of the premier textbook in Pediatric Rheumatology. She was the founder and first Chairperson of the Childhood Arthritis and Rheumatology Research Alliance, an organization that now includes almost all Pediatric Rheumatology Divisions in the US and Canada. She is a Distinguished Fellow of the American Association of Immunologists. Dr. Mellins is committed to training young investigators and has received several mentoring awards.
Dr. Mellins provides research support for GlaxoSmithKline, Codexis, Inc. and Genentech. All of the relevant financial relationships for this individual have been mitigated.
Jennifer Frankovich, MD & Elizabeth Mellins, MD
Evidence for PANS as an Inflammatory Brain Disorder (2 videos)
Shreyas Vasanawala, MD, PhD and Meiqian Ma, MD
Arthritis, Enthesitis, and Development of Autoimmune/Inflammatory Disease in Patients with PANS (Presented by Dr. Jenny Frankovich, Dr. Meiqian Ma, and Dr. Shreyas Vasanawala)
Drs. Frankovich, Vasanawala, and Ma will present on the increased incidence of enthesitis/arthritis among patients meeting criteria for PANS, the three types of arthritis found in patients with PANS, including clinical features. Participants will learn to recognize that children with PANS have severe psychiatric symptoms and sensory dysregulation which may interfere with normal perception of pain (under or over report of pain) and thus prompting clinicians to use objective tools for evaluating arthritis.
Shreyas Vasanawala, MD, PhD
Division Chief of Pediatric Radiology, Associate Chair of Radiology
Radiologist-in-Chief for Pediatric Radiology, Stanford University School of Medicine
Dr. Shreyas Vasanawala is the William R. Brody Professor of Pediatric Radiology and Child Health and serves as Radiologist-in-Chief for Stanford Children’s Health and Chief of Pediatric Radiology at Stanford University. After completing undergraduate studies in mathematics at the California Institute of Technology, he pursued a medical degree and doctorate in biophysics at Stanford University, where his studies led to a resurgence of signal efficient methods in magnetic resonance imaging. After a surgical internship, a residency in radiology, and a fellowship in pediatric radiology, Dr. Vasanawala joined the faculty at Stanford University. He then focused on building the MRI programs at Lucile Packard Children’s Hospital and at Stanford Hospital and Clinics, and building the Division of Body MRI.
He leads a multidisciplinary research group focused on developing fast and quantitative pediatric medical imaging methods. The group’s efforts include development of new medical imaging hardware, new pediatric-friendly image acquisition methods, novel image reconstruction approaches, and unique strategies to image analysis. These endeavors have led to the first routine clinical translational deployment of high density pediatric specific MRI receiver coils, the first routine clinical use of innovative compressive sensing and deep learning medical image reconstruction methods, and the routine ability to obtain high resolution pediatric images with reduced anesthesia. Together, these efforts, and those of other pediatric radiology faculty, have contributed to Lucile Packard Children’s Hospital at Stanford becoming a leading pediatric MRI program internationally. With over 150 peer-reviewed publications and 25 patents, he has developed a deep collaborative network within Stanford and beyond.
Dr. Vasanawala is a consultant for Heart Vista and Inkspace, a founder of Arterys, Inc, and research collaborator for GE Healthcare. All of the relevant financial relationships for this individual have been mitigated.
Meiqian Ma, MD
Clinical Assistant Professor, Pediatrics – Rheumatology
Stanford University School of Medicine
Dr. Ma is an Assistant Clinical Professor in the Department of Pediatrics, Division of Allergy, Immunology Rheumatology (AIR) at Stanford University/Lucile Packard Children’s Hospital. She completed her medical training at the Medical College of Wisconsin. She then went to Cohen Children’s Medical Center/Northwell Health to complete her training in pediatrics and pediatric rheumatology. Her research in fellowship focused on the validation of the 2019 European League Against Rheumatism/American College of Rheumatology Criteria Compared to the 1997 American College of Rheumatology Criteria and the 2012 Systemic Lupus International Collaborating Clinics Criteria in Pediatric Systemic Lupus Erythematosus . She joined the Stanford PANS Program in July 2020.
Dr. Ma has no relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
Shreyas Vasanawala, MD, PhD & Meiqian Ma, MD
Arthritis, Enthesitis, and Development of Autoimmune / Inflammatory Disease in Patients with PANS
Juliette C. Madan, MD, MS & Pawel R. Kiela, DVM, PhD
The Emerging Role of the Gut Microbiome in the Gut-Brain Axis and Neuroinflammation in PANS/PANDAS
The developing microbiome in early life plays a seminal role in shaping the immune system and balancing inflammation. As the immune system develops, the brain develops in parallel. The role of the intestinal microbiome in neurodevelopment and shaping brain and behavior provides an important window into an alterable aspect of neurodevelopment. Understanding the role of infection, post infectious shifts in the microbiome, and the relationship with inflammatory mediated neuropsychiatric illness is critical as we identify novel biomarkers for diagnostics, mechanisms behind disease, and opportunities for intervention.
Juliette C. Madan, MD, MS
Associate Professor, Pediatrics, Psychiatry, Epidemiology & Quantitative Biomedical Data Sciences, Department of Psychiatry, Division of Child and Adolescent Psychiatry, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth
Dr. Madan is a physician scientist trained in pediatrics and psychiatry and is the Director of Research in the Division of Child Psychiatry at the Children’s Hospital at Dartmouth. She is the Clinical Director of the Dartmouth Children’s Environmental Health and Disease Prevention Research Center, and the focus of her research is on the developing microbiome in infants and children and the relationship to immune training and health outcomes that are alterable. She is a graduate of Brown University School of Medicine and trained in pediatrics followed by fellowship in neonatal-perinatal medicine at Tufts University, where she also completed a master’s degree in clinical and translational research. She completed psychiatry training at Dartmouth to align her practice with her research focus on neurodevelopmental and neuroinflammatory conditions in childhood. Dr. Madan is an expert in the developing microbiome in large infant cohorts examining the relationship between exposures, the microbiome, and health outcomes (infectious disease risk, respiratory outcomes, and neurodevelopment). She is the founding co-director of the Psychiatry Immunology and Neurology Group at Dartmouth, which aims to provide clinical care and translational research initiatives in infection and inflammation mediated neuropsychiatric illnesses in children and young adults. Dr. Madan’s lab is focused on the relationship between the gut microbiome and neurodevelopmental and neuropsychiatric outcomes and interventions such as nutritional, probiotic regimens and fecal transplant.
Dr. Madan has no relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
Pawel R. Kiela, DVM, PhD
Professor of Pediatrics and Immunobiology, PANDA Endowed Professor in Autoimmune Disease Research, Associate Director for Basic Science Research, Steele Children’s Research Center, University of Arizona
Dr. Pawel Kiela received his DVM degree from the Warsaw University of Life Science in Poland, followed by a PhD at the same university and the Lund University in Sweden in the developmental physiology of the gastrointestinal tract. He completed his postdoctoral training in the laboratory of Fayez K. Ghishan, MD at the University of Arizona, where he currently holds the rank of Professor of Pediatrics and Immunobiology, and PANDA Endowed Chair in Autoimmune Disease Research. His main research interest is autoimmune and autoinflammatory diseases, with particular focus on Crohn’s disease and ulcerative colitis, gut microbiota, mucosal immunology, and extraintestinal manifestations of intestinal inflammation, including bone metabolism and gut-brain axis.
Dr. Kiela has no relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
Juliette C. Madan, MD, MS & Pawel R. Kiela, DVM, PhD
The Emerging Role of the Gut Microbiome in the Gut-Brain Axis and Neuroinflammation in PANS/PANDAS
Brian A. Fallon, MD, MPH
Neuropsychiatric Lyme Disease: Symptoms, The Immune Response, and the Vagus Nerve
Dr. Fallon will describe the neuropsychiatric profile of Lyme disease, neuroimmune and neuroimaging findings, results from a nationwide epidemiologic study in Denmark assessing mental disorders and suicide after Lyme disease, and new directions in treatment, focusing on vagus nerve stimulation. Emerging neuropsychiatric findings in a related vector infection, Bartonella, will also be described.
Brian A. Fallon, MD, MPH
Director of the Center for Neuroinflammatory and Somatic Disorders, Director of the Lyme and Tick-Borne Diseases Research Center, Columbia University
Dr. Brian Fallon, Professor of Clinical Psychiatry, directs the Lyme and Tick-borne Diseases Research Center and the Clinical Trials Network for Tick-borne Diseases at Columbia University Irving Medical Center and directs the Center for Neuroinflammatory and Somatic Disorders at the New York State Psychiatric Institute. Dr. Fallon’s work started with a focus on obsessive compulsive disorder and hypochondriasis and evolved into a focus on persistently symptomatic Lyme disease – a disorder which overlaps medicine, neurology, and psychiatry. Dr. Fallon has served on HHS, NIH and CDC review committees and given presentations to Congress and the Institute of Medicine. Dr. Fallon currently serves on the NIH RECOVER steering committee for clinical trials on Post-acute Sequelae of SARS CoV-2 Infection. Dr. Fallon has received numerous NIH, foundation, and industry grants to conduct studies of Lyme disease and other disorders. Dr. Fallon was principal investigator on the NINDS-funded study of post-treatment Lyme Encephalopathy which included neuroimaging (PET and MRI), neurocognitive testing, spinal fluid and blood studies, and antibiotic retreatment. The biorepository of samples at the Lyme Research Center has led to an array of diagnostic and biomarker investigations in collaboration with researchers around the country. Dr. Fallon’s book entitled Conquering Lyme Disease: Science Bridges the Great Divide (Columbia Univ Press, 2018) summarizes the clinical challenges and latest scientific advances. Dr. Fallon, with his colleague Dr. Mara Kuvaldina, is currently conducting a safety and feasibility study of transauricular vagus nerve stimulation for post-treatment Lyme Disease Syndrome.
Dr. Fallon has no relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
Brian A. Fallon, MD, MPH
Neuropsychiatric Lyme Disease: Symptoms, the Immune Response, and the Vagus Nerve
Terence Sanger, MD, PhD
Movement Disorders in Pediatric Inflammatory Brain Disease
Movement disorders including myoclonus, dystonia, chorea, ataxia, and eye movement abnormalities are frequently the presenting or defining symptoms of inflammatory brain disease in children. Importantly, inflammatory brain disease is one of the very few treatable causes of many of these movement disorders. Therefore, a close understanding of the clinical and physiological relationship between these symptoms and underlying neuroinflammation is essential for appropriate diagnosis and clinical care. Dr. Sanger will review video cases, discuss the diagnostic workup, and offer some preliminary conjectures as to the mechanisms linking neuroinflammation and disorders of movement in children.
Terence Sanger, MD, PhD
Vice President, Chief Scientific Officer, CHOC Children’s Hospital; Professor of Electrical Engineering and Computer Science, UCI Samueli School of Engineering; Vice Chair for Research, Department of Pediatrics, UCI School of Medicine; Child Neurology and Movement Disorders, CHOC Children’s Hospital, University of California, Irvine
Dr. Terence Sanger holds an SM in Applied Mathematics (Harvard), PhD in Electrical Engineering and Computer Science (MIT), and MD (Harvard), with medical specialization in Child Neurology and Movement Disorders. He is currently Professor of Electrical Engineering at the University of California Irvine (UCI), Vice Chair of Research, Pediatrics, (UCI) Director of the Pediatric Movement Disorders Clinic and Deep Brain Stimulation Program at Children’s Hospital of Orange County (CHOC), and the Vice President, Chief Scientific Officer at CHOC. Dr. Sanger is a member of CHOC’s medical staff and is tenured faculty in the department of pediatrics at UC Irvine.
Prior to CHOC, Dr. Sanger served as Provost Professor in the biomedical engineering, neurology and biokinesiology departments at the University of Southern California. He was an attending neurologist at Children’s Hospital Los Angeles, where he served as Director of the Pediatric Movement Disorders Program, the David Lee and Simon Ramo Chair in Health Sciences and Technology, and the Founding Director of the Health, Technology and Engineering Program at The University of Southern California. Previously, he was a tenured Professor of Child Neurology at Stanford University and on medical staff at Lucille Packard Children’s Hospital.
Dr. Sanger’s research focuses on understanding the origins of pediatric movement disorders from both a biological and a computational perspective. The primary goal of his research is to discover new methods for treating children with disorders of developmental motor control, including dystonia, chorea, ataxia, spasticity, and dyspraxia. His research includes computational neuroscience and large-scale neural circuit modeling of basal ganglia and cerebellum, nonlinear signal processing, machine learning, and control theory applied to robot models of motor disorders, and processing of electrophysiological data from children with implanted electrodes. Ongoing research also includes the development of electromyography-controlled soft exoskeleton orthotics for assistance with upper limb movement in children with cerebral palsy.
Dr. Sanger is on the Scientific Advisory Board for Cala Health. All of the relevant financial relationships for this individual have been mitigated.
Terence Sanger, MD, PhD
Movement Disorders in Pediatric Inflammatory Brain Disease
Josep Dalmau, MD, PhD, FAAN
The Antibody-Mediated Encephalitis from Discovery to New Clinical Insights and Mechanisms
Dr. Dalmau will be discussing the clinical and immunological observations that led to the discovery of autoimmune encephalitis, and how this group of diseases has changed the landscape of neurology and psychiatry. He will use anti-NMDA receptor encephalitis to illustrate the wide spectrum of neurologic and psychiatric symptoms, the potential triggers of these autoimmune disorders, and the underlying antibody-mediated mechanisms affecting synaptic function. Finally, Dr. Dalmau will show recent findings on the long-term effects of anti- NMDA receptor encephalitis comparing patients with animal models, and how these models may provide treatment strategies beyond immunotherapy.
Josep Dalmau, MD, PhD, FAAN
Research Professor ICREA-IDIBAPS, Service of Neurology, Hospital Clínic, University of Barcelona; Adjunct Professor of Neurology, University of Pennsylvania
Dr. Josep Dalmau received his MD and PhD from the Autonoma University of Barcelona, and trained in Neuro-oncology at Memorial Sloan-Kettering Cancer Center, New York, after which he joined the faculty. In 2002 he moved to the University of Pennsylvania (UPenn) where he was Professor of Neurology. He is currently Professor at the Catalan Institute for Research and Advanced Studies (ICREA)-IDIBAPS, University of Barcelona, and Adjunct Professor of Neurology at UPenn. Dr. Dalmau’s research is focused on a new category of immune-mediated diseases against synaptic receptors that cause prominent neurologic and psychiatric syndromes. Dr. Dalmau is the recipient of numerous awards; he is a member of the National Academy of Medicine and many other scientific societies and serves as Editor-in-Chief of Neurology: Neuroimmunology and Neuroinflammation.
Dr. Dalmau receives research funding from Sage Therapeutics and has a research contract and receives royalties from Euroimmun, Inc. All of the relevant financial relationships for this individual have been mitigated.
Josep Dalmau, MD, PhD, FAAN
The Antibody-Mediated Encephalitis from Discovery to New Clinical Insights and Mechanisms
Avindra Nath, MD
Pathophysiology of Neuropsychiatric Syndromes Post-COVID
Patients may develop a wide variety of cognitive, sleep, or mood disorders sometimes accompanied by intractable fatigue, dysautonomia, or neuropathies. Proposed pathophysiological mechanisms include persistent viral infection, innate or adaptive immune dysregulation resulting in microvascular injury and neuroinflammation. Evidence for these mechanisms and long-term consequences will be discussed.
Avindra Nath, MD
* Dr. Nath is presenting in his personal capacity. The views expressed are his own and do not necessarily represent the views of the National Institutes of Health or the United States government.
Dr. Avindra Nath is a physician–scientist who specializes in neuro-immunology and neurovirology. His research is focused on the clinical manifestations, pathophysiology and treatment of emerging neurological infections with a focus on HIV infection. In recent years, he has studied the neurological complications of endogenous retroviruses, Ebola, Zika and SARS-CoV-2 and conducts research on patients with undiagnosed neuroinflammatory disorders. He has served on advisory committees to the NIH, CDC, FDA and WHO. The International Society of NeuroVirology gave him the Pioneer in NeuroVirology Award for his contributions to HIV neuropathogenesis and elected him as the President of the Society. He received the Wybran award from the Society of Neuroimmune Pharmacology for contributions to neurovirology. He also received the NIH Director’s award for his work on SARS-CoV-2 and the HHS Secretary’s award for his work on Ebola infection.
Dr. Nath is the Clinical Director of the National Institute of Neurological Disorders and Stroke (NINDS) at NIH, where he is also Chief of the Section of Infections of the Nervous System, Director of the Translational Center for Neurological Sciences.
Dr. Nath received his medical degree from Christian Medical College in Ludhiana, India, and completed a residency in neurology from the University of Texas Health Science Center in Houston, followed by a fellowship in multiple sclerosis and neurovirology at the same institution. He then completed a fellowship in neuro-AIDS at NINDS. Having held faculty positions at the University of Manitoba and the University of Kentucky, he joined Johns Hopkins University in 2002 as Professor of Neurology and Director of the Division of Neuroimmunology and Neurological Infections. He joined NIH in 2011.
Dr. Nath has no relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
Avindra Nath, MD
Pathophysiology of Neuropsychiatric Syndromes Post-COVID
Mark Pasternack, MD
Use of Antibiotics in Infection Associated Neuropsychiatric Syndromes Including PANS
Dr. Pasternack will review the evolution in understanding the role of group A streptococci as a trigger for postinfectious neurobehavioral disorders, address the diversity of group A streptococci as a possible explanation to the challenge of “Why PANDAS? Why now?” and review the natural history of PANDAS and PANS and the challenges inherent in their diagnoses and management.
Mark Pasternack, MD
Chief of Infectious Disease, Massachusetts General Hospital; Associate Professor of Pediatrics, Massachusetts General Hospital, Harvard
Dr. Mark Pasternack is Chief, Pediatric Infectious Disease Unit, at Massachusetts General Hospital. Educated at Harvard Medical School, Dr. Pasternack completed his residency and clinical infectious disease fellowship at Massachusetts General Hospital and a research fellowship at the Center for Cancer Research, Massachusetts Institute of Technology. Author of numerous papers and articles for prestigious medical journals, Dr. Pasternack is an officer of the Massachusetts Infectious Diseases Society and a member of the Pediatric Infectious Disease Society as well as the Infectious Diseases Society of America. His broad clinical interests include Infectious Disease and Pediatric Infectious Disease. Dr. Pasternack has provided clinical care to PANS/PANDAS patients for over a decade and has participated in the PANS/PANDAS Research Consortium to develop clinical guidelines for the management of these patients.
Dr. Pasternack receives equity from Merck and author royalty from Up To Date. All of the relevant financial relationships for this individual have been mitigated.
Mark Pasternack, MD
Use of Antibiotics in Infection Associated Neuropsychiatric Syndromes Including PANS
Sudarshini Ramanathan, BSc (Med), MBBS (Hons), FRACP, PhD
Immunotherapy in Autoimmune Encephalitis
Dr. Ramanathan will review the existing evidence and approaches for the management of autoimmune encephalitis and highlight how understanding underlying disease immunobiology enables targeted treatment and a precision medicine approach.
Sudarshini Ramanathan, BSc (Med), MBBS (Hons), FRACP, PhD
Neurology Staff Specialist, Concord Hospital, Sydney; Head, Translational Neuroimmunology Group, NHMRC Emerging Leadership Fellow (EL2), Associate Professor, Sydney Medical School; Faculty of Medicine and Health, University of Sydney
Dr. Sudarshini Ramanathan is a neurologist and clinician-scientist, with subspecialty expertise in neuroimmunology. Dr. Ramanathan is a staff specialist neurologist at Concord Hospital in Sydney, and heads the Translational Neuroimmunology Group at the University of Sydney. She leads a translational fundamental science and clinical research program. She completed her PhD in neuroimmunology at the University of Sydney, and a post-doctoral fellowship at the University of Oxford working with the Oxford Autoimmune Neurology Group. Dr. Ramanathan has received 14 continuous years of NHMRC fellowship funding, and is currently an NHMRC Investigator Fellow. In 2013, Dr. Ramanathan established and has since been the lead investigator of the Australian and New Zealand MOGAD Study Group, which encompasses over 150 clinicians from 45 centers in Australasia, and she leads evaluation of a cohort of over 700 patients with myelin oligodendrocyte glycoprotein antibody-associated disease. In 2018 she initiated and, in collaboration with Professor Sarosh Irani, is co-lead investigator of an international LGI1 Antibody Encephalitis Study Group. She works with thirty experts from twenty international centers to record data on over 200 patients in order to develop therapeutic guidelines for this condition. Dr. Ramanathan leads a research program focused on understanding disease pathogenesis and improving the diagnosis and treatment of autoimmune neurological disorders including antibody-associated demyelination and autoimmune encephalitis.
Dr. Ramanathan is an advisor for UCB, received honorarium from Limbic Neurology, and was awarded National Health and Medical Research Council Australia Investigator Grant Fellowship for research. All of the relevant financial relationships for this individual have been mitigated.
Sudarshini Ramanathan, BSc (Med), MBBS (Hons), FRACP, PhD
Immunotherapy in Autoimmune Encephalitis
Michael Eriksen Benros, MD, PhD
Immunopsychiatry – Evidence from Large-Scale Studies to Detailed Clinical CSF Studies
Utilizing Danish nationwide registers, we have consistently displayed that infections and autoimmune diseases increase the risk of developing severe mental disorders in a dose-response relationship, where the risk of severe mental disorders particularly increases with the number of infections exposed to and in a temporal manner. Utilizing large national biobank data, we have shown a small immunogenetic contribution with moderate correlation between the genetic susceptibility for infections and mental disorders. Moreover, at diagnosis there are elevated levels of inflammatory markers in the blood, and studies on the cerebrospinal fluid surrounding the brain have shown some evidence for elevated immune markers in the CSF and signs of disrupted blood-brain barrier in some of the patients. Interestingly, our meta-analyses of randomized clinical trials have shown that anti-inflammatory treatment seems to be effective for depression and depressive symptoms and to some extent also for psychotic disorders. However, studies identifying subgroups that would be most likely to respond to immune modulating add-on treatment are still warranted to pave the field forward.
Michael Eriksen Benros, MD, PhD
Professor, Immuno-Psychiatry, Department of Immunology & Microbiology, Health and Medical Sciences, University of Copenhagen; Head of Research, Biological and Precision Psychiatry, Copenhagen Research Centre for Mental Health, Mental Health Centre Copenhagen, Copenhagen University Hospital
Professor Michael E. Benros is chief physician and head of research on Biological and Precision Psychiatry at the Mental Health Centre Copenhagen, Copenhagen University Hospital and at the University of Copenhagen. He is recognized internationally for being at the forefront of the emerging field of ImmunoPsychiatry aiming to disentangle the role of the immune system in the development of severe mental disorders, combining immune exposures from the nationwide Danish registers, with immunogenetic investigations, and novel research on cerebrospinal fluid and blood obtained from biobank and clinical studies of patients with psychotic and affective disorders.
Dr. Benros has no relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
Michael Eriksen Benros, MD, PhD
Immunopsychiatry – Evidence from Large-Scale Studies to Detailed Clinical CSF Studies
Theresa Willett, MD, PhD
Clues from the Clinical Exam
Dr. Willet reviews findings to support PANS/PANDAS diagnosis or support alternative diagnoses including skin findings for alternative diagnosis (rheumatic fever) and comorbidity (psoriasis) and findings on joint exam that indicate need for rheumatology evaluation
Theresa Willett, MD, PhD
Clinical Assistant Professor, Pediatrics – Immunology, Allergy Medical Director, SCH Immune Behavioral Health Clinic – Stanford University School of Medicine
Dr. Theresa Willett is a general pediatrician and current medical director of the Stanford PANS/Immune Behavioral Health Clinic. She pursued her MD-PhD at Tufts University in Boston, where she completed her thesis work on t-cell mediated autoimmunity in treatment resistant Lyme arthritis, and antigenic mimicry in OspA. She then trained and worked as a primary care pediatrician. After returning to California, she found her cross-specialized people in the Stanford PANS clinic.
Dr. Willett has no relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
Theresa Willett, MD, PhD
Clues from the Clinical Exam
Theresa Willett, MD, PhD
PANS/PANDAS for the Busy Primary Care Provider
Geared toward the pediatrician or primary care provider, Dr. Willett provides an overview of diagnosis, treatment, physical exam, and lab findings in patients with PANS and PANDAS.
Theresa Willett, MD, PhD
Clinical Assistant Professor, Pediatrics – Immunology, Allergy Medical Director, SCH Immune Behavioral Health Clinic – Stanford University School of Medicine
Dr. Theresa Willett is a general pediatrician and current medical director of the Stanford PANS/Immune Behavioral Health Clinic. She pursued her MD-PhD at Tufts University in Boston, where she completed her thesis work on t-cell mediated autoimmunity in treatment resistant Lyme arthritis, and antigenic mimicry in OspA. She then trained and worked as a primary care pediatrician. After returning to California, she found her cross-specialized people in the Stanford PANS clinic.
Dr. Willett has no relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
Theresa Willett, MD, PhD
PANS/PANDAS for the Busy Primary Care Provider
Chris Pittenger, MD, PhD
Antibodies in Children with PANDAS Bind to and Inhibit Specific Interneurons in the Basal Ganglia
Dr. Pittinger presents data suggesting that antibodies from children with PANDAS can bind to and inhibit specific interneurons in the basal ganglia and covers how dysregulation of interneurons in the basal ganglia may contribute to the development of symptoms in PANDAS.
Chris Pittenger, MD, PhD
Professor of Psychiatry – Yale University
Chris Pittenger earned his MD and Ph.D. degrees from Columbia University, where his graduate work was done with Nobel Prize recipient Eric Kandel. He returned to Yale University, his undergraduate alma mater, for residency and research training in psychiatry in 2003. He joined the faculty as an Assistant Professor in 2007 and is now a tenured Associate Professor and Assistant Chair for Translational Research in the Department of Psychiatry .
During his Ph.D. studies in basic neurobiology, he became fascinated by the brain’s ability to go on autopilot — to perform complex series of actions or thoughts, after sufficient rehearsal, with almost no conscious effort. Then, during his clinical training, he recognized how this process, when disrupted by disease, can lead to the maladaptive and disruptive automaticity seen in many neuropsychiatric disorders. His research, both with patients and in animal models, aims to elucidate the mechanisms of learned automatic behaviors and to better understand the consequences when they go awry, with the ultimate goal of developing new understandings and better treatments for a variety of neuropsychiatric conditions.
Dr. Pittenger’s research and clinical work have been acknowledged by a number of prestigious awards, including grant funding from the National Institute of Mental Health, the National Institute of Neurological Disease and Stroke, NARSAD, the Tourette Syndrome of America, the Doris Duke Charitable Trust, and other organizations. He has won a number of honorific awards, including from the National Institute of Mental Health, the Society for Neuroscience, the American College of Neuropsychopharmacology, the American Psychiatric Association, and the American College of Psychiatrists. He is a member of the Scientific Advisory Board of the International OCD Foundation and Chair of both their Grant Review Committee and their Annual Research Symposium Planning Committee. He is a Fellow of the American College of Neuropsychopharmacology, the American Psychiatric Association, and the American Neurological Association.
Dr. Pittenger provides research support for Biohaven Pharmaceuticals. He is a consultant for Biohaven Pharmaceuticals, Ceruvia, and Lundbeck Pharmaceuticals. He is author for Oxford University Press. All of the relevant financial relationships for this individual have been mitigated.
Chris Pittenger, MD, PhD
Antibodies in Children with PANDAS Bind to and Inhibit Specific Interneurons in the Basal Ganglia
Janet Cunningham, MD
Clinical and Biological Heterogeneity in An Adult Patient Cohort with Psychiatric Symptoms Enriched for Suspected Immunological Involvement
This talk will discuss the establishment of the Uppsala Immunopsychiatry Clinic which started as a pilot project in 2015 and has now been implemented into standard care. Illustrative cases and the high rates of CNS pathology but also heterogeneity in the data from the first 127 patients will be presented.
Janet Cunningham, MD
Associate Professor in the Department of Neuroscience; Associate Professor in Experimental Psychiatry; Psychiatrist, Uppsala University, Sweden
Dr. Janet Cunningham is an Associate Professor in Experimental Psychiatry at Uppsala University, is also affiliated with the Department of Neurosciences at Karolinska Institute and a board-certified specialist in Clinical Psychiatry at Uppsala University Hospital. She has an unusual background for a psychiatrist. She completed a BSc in Immunology and Microbiology with Honors at McGill University, Canada and thereafter a preclinical PhD and postdoc in Uppsala, Sweden, where she applied molecular techniques to further characterize and subgroup rare serotonin producing endocrine tumors. Dr. Cunningham shifted her focus to Psychiatry after several coinciding experiences profoundly shifted her perception of psychiatric disease and awoke her curiosity for the biological mechanisms. Dr. Cunningham. leads the Immunopsychiatry team in Uppsala which aims to develop tools to differentiate adaptive from maladaptive immunological responses in treatment-resistant patients with severe psychiatric symptoms in order to identify patients for whom immunomodulation therapy will be beneficial. The hypothesis is that different types of maladaptive immunological responses include immunodeficiencies, vulnerability such as difficulty in mobilizing anti-inflammatory processes needed for inflammation resolution, and autoimmunity. To ensure relevance for clinical psychiatry, research is tightly integrated with patient care at Uppsala University Hospital. Cross sectional and longitudinal data and samples are continuously collected from daily practice and clinical trials. The strategy is to use and compare knowledge gained by in-depth analysis of individual cases and large-scale analysis of markers related to the immune system in broad patient cohorts to identify markers with variation within the patient group with potential relevance for diagnosis and clinical prognosis. The research questions have the potential to directly impact clinical practice in psychiatry. Dr. Cunningham is the coordinator for a professional network, The Swedish Immunopsychiatry Alliance. She is a member of the Research Network, European College of Neuropsychopharmacology (ECNP) Immuno NeuroPsychiatry work-group and is a member the Scientific and Medical Advisory Board for The European Immunopsychiatric Association (EXPAND).
Dr. Cunningham receives speaker honorarium from Otswka Pharma Scand, Janseen-Lil ag AB, and H Lundbeck AB. All of the relevant financial relationships for this individual have been mitigated.
Janet Cunningham, MD
Clinical and Biological Heterogeneity in an Adult Patient Cohort with Psychiatric Symptoms Enriched for Suspected Immunological Involvement
Sarosh Irani, FRCP, DPhil, FEAN
The Immunology Underlying Autoantibody Associated CNS Diseases
Dr. Irani will discuss the clinical features and emerging immunobiology underlying autoantibody-mediated CNS disease syndromes with a focus on LGI1, CASPR2, and NMDAR-antibody encephalitis and their antigen-specific B cell populations.
Sarosh Irani, FRCP, DPhil, FEAN
Associate Professor – University of Oxford; Head of Autoimmune Neurology Group at University of Oxford
Dr. Sarosh Irani is a consultant neurologist and clinician-scientist with clinical and laboratory experiences in the field of autoantibody mediated diseases of the nervous system, in particular the central nervous system. He cares for patients with these disorders and leads a research group to learn more about the origins and treatments of these diseases. He has studied the antigenic targets of autoantibodies in patients with encephalitis and epilepsies. In particular, his research has focused on LGI1, CASPR2, and the NMDA-receptor. In addition, he has been involved with projects examining autoantibodies against the GABAA-receptor, glycine receptors, and aquaporin-4.
He has looked after more than 200 patients with these disorders and characterized their clinical responses to therapies. These findings have generated clinical features, often distinctive, which correlate well with a high likelihood of an immunotherapy-responsive condition. They have also identified novel clinical descriptions of patients with cognitive, movement, and seizure
disorders, in particular faciobrachial dystonic seizures – a novel autoimmune epilepsy syndrome which often responds better to immunotherapies than conventional anti-epileptic drugs.
He leads a research group combining approximately 15 talented clinicians, clinician-scientists, and basic scientists with the aim of better understanding the causes and potential treatments of this condition. In particular, they study the role of B cell subsets in propagating autoantibody responses and the effects of antibodies in the brain. They are funded by the Wellcome Trust, Medical Research Council, British Medical Association, Association of British Neurologists and industry partners.
Dr. Irani receives honorarium for consulting for UCB, Immunovannt, MedImmune, Brain and ADC therapeutics, and Medlink Neurology. He receives royalty for being an inventor of the patent for LGI1/Caspr2 antibodies. He also provides research support as PI for CSL Behring, UCB, and ONO Pharma. All of the relevant financial relationships for this individual have been mitigated.
Sarosh Irani, FRCP, DPhil, FEAN
The Immunology Underlying Autoantibody Associated CNS Diseases
Wei Zhao, MD, PhD
Plasmapheresis in Treatment of PANS
Dr. Zhao presents use of plasmapheresis in management of PANS and PANDAS, summarizing the results and outcomes of patients receiving plasmapheresis in his institution.
Wei Zhao, MD, PhD
Professor and Chief, Division of Allergy and Immunology at Virginia Commonwealth University
Dr. Wei Zhao received his medical degree from Wenzhou Medical University in China. He received his PhD in Immunology from West Virginia University. He then completed his pediatric residency at West Virginia University and his fellowship in Allergy and Immunology at Virginia Commonwealth University. He has been on faculty with VCU since 2003. Currently he is a Professor in Pediatrics and Division Chief of Allergy and Immunology. Dr. Zhao is board certified with the American Board of Pediatrics and American Board of Allergy and Immunology. He is also a member of the American Academy of Allergy, Asthma, and Immunology and American College of Allergy, Asthma, and Immunology. He served as the President of the Allergy and Asthma Society of Virginia from 2012-2014. He has been named as Top-Doctor since 2012 by Richmond Magazine. His research interest has been human mast cells and their role in allergic and immunologic disorders. He has been the principal investigator of NIH sponsored projects and key member of asthma and allergic disease center in VCU.
Dr. Zhao has no relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
Wei Zhao, MD, PhD
Plasmapheresis in Treatment of PANS
Jill Hollenbach, PhD, MPH
Immunogenetic Variation in PANS and Neuroinflammatory Disease
Dr. Hollenbach presents an overview of that immunogenetic variation plays in neuroinflammatory diseases like multiple sclerosis, and implications for ongoing research in PANS.
Jill Hollenbach, PhD, MPH
Associate Professor, Department of Neurology, University of California, San Francisco
Jill Hollenbach is Associate Professor in the Department of Neurology and Department of Epidemiology and Biostatistics at the University of California, San Francisco. She was raised in California and completed her undergraduate studies in Physiology and Master’s degree in Public Health at the University of California, Berkeley. After several years working in public health in the Caribbean and Bay Area, she returned to UC Berkeley for her doctoral studies in Immunology, with an emphasis on population genetics of the human leukocyte antigen (HLA) system. Throughout her career, Dr. Hollenbach’s work has continued to focus on the HLA loci and related systems such as the killer immunoglobulin-like receptor (KIR) genes in disease association, transplantation, and evolutionary studies. She has also been deeply involved in the establishment of community standards and software development for immunogenetic data management and analysis and is a Councilor of the International HLA and Immunogenetics Council and Associate Editor for disease association studies at HLA Journal. Dr. Hollenbach’s laboratory at UCSF applies study of these complex systems to advance efforts to elucidate the genetic basis of underlying immune dysregulation in neurological, autoimmune, and infectious disease.
Dr. Hollenbach has no relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
