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Group A streptococcal infection appears to be associated with changes in behavior and the development of a movement disorder in elementary school children, according to a report in the current issue of Biological Psychiatry.
There is renewed interest in the relationship between strep infections and behavioral and movement disorders, the authors explain, but the extent of strep’s role in these disorders has not been defined. Symptoms that characterized the movement disorder observed in these children include involuntary, rapid, jerking movements that can be subtle or pronounced, also referred to as chorea.
Dr. Tanya K. Murphy from the University of Florida, Gainesville, and associates investigated possible associations between group A streptococcal infection and the development of tics, behavioral changes and chorea in a population-based study involving 693 children between 3 and 12 years old. The children were recruited from three schools and data were collected for 8 months.
Five children (0.7 percent) developed persistent chorea after having a group A streptococcal infection, the investigators found. Sixty-four children who repeatedly tested positive for group A streptococcus also had significantly higher rates of abnormal behavior and movements.
Combined behavior ratings were strongly associated with a 71-percent increased risk of group A strep infection, currently or within the past three months. The team reports that “balance/swaying and non-tic grimacing were responsible for a significant proportion of this association.”
Murphy’s group also noted a strong seasonal effect, with group A streptococcal infections and changes in behavior and movement being more common in the fall than in the winter or spring.
“Group A streptococcus does seem to increase risk for behaviors and movements,” Murphy and colleagues conclude. “However, more research is needed to explore the role of group A streptococcus infections in childhood neuropsychiatric symptoms, particularly for those with a history of repeatedly positive throat cultures.”