MRI assessment of children with obsessive-compulsive disorder or tics associated with streptococcal infection

Am J Psychiatry. 2000 Feb;157(2):281-3. doi: 10.1176/appi.ajp.157.2.281.


Objective: The authors assessed selective basal ganglia involvement in a subgroup of children with obsessive-compulsive disorder (OCD) and/or tics believed to be associated with streptococcal infection.

Method: Using computer-assisted morphometric techniques, they analyzed the cerebral magnetic resonance images of 34 children with presumed streptococcus-associated OCD and/or tics and 82 healthy comparison children who were matched for age and sex.

Results: The average sizes of the caudate, putamen, and globus pallidus, but not of the thalamus or total cerebrum, were significantly greater in the group of children with streptococcus-associated OCD and/or tics than in the healthy children. The differences were similar to those found previously for subjects with Sydenham's chorea compared with normal subjects.

Conclusions: These results support the hypothesis that there is a distinct subgroup of subjects with OCD and/or tics who have enlarged basal ganglia. These findings are consistent with the hypothesis of an autoimmune response to streptococcal infection.

Publication types

  • Comparative Study

MeSH terms

  • Autoimmune Diseases / etiology
  • Autoimmunity
  • Basal Ganglia / anatomy & histology*
  • Basal Ganglia / immunology
  • Brain / anatomy & histology
  • Caudate Nucleus / anatomy & histology
  • Child
  • Chorea / diagnosis
  • Chorea / etiology
  • Chorea / immunology
  • Female
  • Globus Pallidus / anatomy & histology
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Obsessive-Compulsive Disorder / diagnosis*
  • Obsessive-Compulsive Disorder / etiology
  • Obsessive-Compulsive Disorder / immunology
  • Putamen / anatomy & histology
  • Streptococcal Infections / complications*
  • Streptococcal Infections / immunology
  • Thalamus / anatomy & histology
  • Tics / diagnosis*
  • Tics / etiology
  • Tics / immunology