Physician-researcher wins prestigious award for identifying brain inflammation associated with streptococcal infections in children

June 23, 2014

DETROIT, Mich., June 23, 2014 -- Ajay Kumar, M.D., Ph.D., assistant professor of pediatrics, of neurology and of radiology for the Wayne State University School of Medicine, and a member of the Positron Emission Tomography Center at the Children's Hospital of Michigan, received the Majd-Gilday Young Investigators Award from the Society of Nuclear Medicine and Molecular Imaging.

The award is given annually to young scientists for outstanding research contributions to the field of pediatric nuclear medicine.

"This is one of the most prestigious young investigator awards in the world for pediatric imaging, given by Pediatric Imaging Council of the Society of Nuclear Medicine and Molecular Imaging, the largest world body for nuclear medicine and molecular imaging," said Dr. Kumar, who received the award at the 61st annual meeting of SNMMI, held in St. Louis, Mo., June 7-11. His research also was presented during the meeting's highlight session. The Society of Nuclear Medicine and Molecular Imaging promotes the science, technology and practical application of nuclear medicine and molecular imaging.

He received the award for his study, "Basal Ganglia Inflammation in Children with Neuropsychiatric Symptoms," which may lead to better understanding of the effects of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and improved therapies to treat the condition.

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, or PANDAS, is a neurological condition seen after streptococcal as well as non-streptococcal infection in children. The disorder is characterized by prepubertal onset of odd movements, including compulsive tics that may come and go, and increase over time. Other indications include cognitive disturbances, hyperactivity and severe obsessive compulsive actions. Researchers have suggested that the pathophysiological basis for PANDAS is a form of molecular mimicry in which antibodies produced to fight streptococcal proteins also target brain proteins, particularly in the basal ganglia, which consist of structures in the brain associated with a number of functions, including voluntary movement, learning and emotion.

Because any immunological reaction is accompanied by inflammatory reaction, Dr. Kumar and his colleague, Harry Chugani, M.D., the Rosalie and Bruce Rosen professor of neurology and chief of pediatric neurology for the WSU School of Medicine and the Children's Hospital of Michigan, hypothesized that patients with PANDAS should exhibit neuroinflammatory changes, particularly in the basal ganglia. However, detection of inflammation in the basal ganglia is not possible with current radiological or biochemical techniques, except for direct examination of brain tissues, an extremely invasive procedure, or examination after death.

Dr. Kumar and his team used Positron Emission Tomography with 11C-[R]-PK11195, a marker that can be injected into patients, to evaluate inflammatory changes in basal ganglia and the thalamus in children diagnosed with PANDAS, as well as children with Tourette syndrome, who demonstrate potentially overlapping clinical symptoms. They found brain inflammation in the basal ganglia in both the groups, but with some significant differences in the pattern and extent of the inflammatory changes.

"These findings not only provide an insight into the possible pathogenetic mechanisms behind these conditions, but also suggest a possible important pathophysiological difference between these two conditions," Dr. Kumar said. "We believe that our findings will help in further demystifying and better understanding this condition, which will lead to development of rational and more appropriate therapeutic options."                                          

About the Children's Hospital of Michigan DMC,

For more than 125 years, the Children's Hospital of Michigan is the first hospital in the state dedicated exclusively to the treatment of children. With more than 40 pediatric medical and surgical specialties and services, the hospital is a leader internationally in neurology and neurosurgery, cardiology, oncology, and diagnostic services; it is ranked one of America's best hospitals for children and sees more children than any hospital in the state. More Michigan pediatricians are trained at the Children's Hospital of Michigan than at any other facility. Children's Hospital of Michigan is one of eight hospitals operated by the Detroit Medical Center (DMC).

About Wayne State University, 

Wayne State University is a premier urban research institution offering more than 400 academic programs through 13 schools and colleges to nearly 32,000 students. Its School of Medicine is the largest single-campus medical school in the nation with more than 1,200 medical students. In addition to undergraduate medical education, the school offers master's degree, Ph.D. and M.D.-Ph.D. programs in 14 areas of basic science to about 400 students annually.