{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T07:16:15Z","timestamp":1788419775348,"version":"build-2803163510"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>PANS and PANDAS are neuroimmune conditions characterized by neuropsychiatric symptoms, including obsessive-compulsive features, cognitive dysfunction, and emotional dysregulation, that may persist despite multimodal treatment. Adjunctive neuromodulation approaches remain underexplored in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective observational case series describes two adolescents with persistent PANS\/PANDAS symptoms despite more than 10 years of multidisciplinary care who received home-based transcranial photobiomodulation (tPBM) using a 1070 nm near-infrared device and adjunctive swLORETA neurofeedback as part of routine clinical care. Multimodal outcomes included the PANS 31-Item Symptom Rating Scale, Yale-Brown Obsessive Compulsive Scale, CogniFit CAB-Pro, BrainGauge, caregiver-reported functional outcomes, and qEEG.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Reductions in neuropsychiatric symptom burden and functional gains were observed during the observation windows. One participant showed a 73% reduction in PANS-31 severity with improvements across multiple cognitive domains; the other showed a 50% reduction in obsessive-compulsive symptom severity and progressed from homebound status to full school participation. Changes were observed across clinical, cognitive, functional, and qEEG measures; however, outcome timing differed across participants and instruments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings should be interpreted as preliminary, hypothesis-generating observations only. Because of the retrospective design, very small sample size, prior and concurrent interventions, and non-uniform assessment schedules, no conclusions regarding efficacy, causality, or attribution to either intervention or their combined use can be drawn. Prospective controlled studies are needed to evaluate efficacy, optimal sequencing, and intervention parameters.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2026.1865423","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:44:21Z","timestamp":1788417861000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Combined transcranial photobiomodulation and neurofeedback in PANS\/PANDAS: a retrospective case series"],"prefix":"10.3389","volume":"17","author":[{"given":"Brooke","family":"Hill","sequence":"first","affiliation":[{"name":"Neuronic","place":["Austin, TX, United States"]},{"name":"Butmeyer","place":["Austin, TX, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.4172\/2161-0665.1000113","article-title":"From research subgroup to clinical syndrome: modifying the PANDAS criteria to describe PANS","volume":"2","author":"Swedo","year":"2012","journal-title":"Pediatr Ther"},{"key":"B2","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1089\/cap.2014.0084","article-title":"Clinical evaluation of youth with pediatric acute-onset neuropsychiatric syndrome (PANS): recommendations from the 2013 PANS Consensus Conference","volume":"25","author":"Chang","year":"2015","journal-title":"J Child Adolesc Psychopharmacol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1176\/appi.ajp.2020.19070698","article-title":"Antibodies from children with PANDAS bind specifically to striatal cholinergic interneurons and alter their activity","volume":"178","author":"Xu","year":"2021","journal-title":"Am J Psychiatry"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbacli.2016.09.002","article-title":"Shining light on the head: photobiomodulation for brain disorders","volume":"6","author":"Hamblin","year":"2016","journal-title":"BBA Clin"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3934\/biophy.2017.3.337","article-title":"Mechanisms and applications of the anti-inflammatory effects of photobiomodulation","volume":"4","author":"Hamblin","year":"2017","journal-title":"AIMS Biophys"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3390\/photonics13050488","article-title":"Photobiomodulation therapy and central nervous system disorders: a systematic review of delivery routes, mechanisms, parameters and clinical evidence","volume":"13","author":"Cronshaw","year":"2026","journal-title":"Photonics"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1177\/1550059413512796","article-title":"LORETA neurofeedback in the precuneus: operant conditioning in basic mechanisms of self-regulation","volume":"45","author":"Cannon","year":"2014","journal-title":"Clin EEG Neurosci"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2017.00051","article-title":"EEG-neurofeedback as a tool to modulate cognition and behavior: a review tutorial","volume":"11","author":"Enriquez-Geppert","year":"2017","journal-title":"Front Hum Neurosci"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.15412\/J.BCN.03070208","article-title":"Neurofeedback: a comprehensive review on system design, methodology and clinical applications","volume":"7","author":"Marzbani","year":"2016","journal-title":"Basic Clin Neurosci"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1089\/cap.2023.0088","article-title":"Psychometric properties of the PANS 31-item symptom rating scale","volume":"34","author":"Bernstein","year":"2024","journal-title":"J Child Adolesc Psychopharmacol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.37714\/JOSAM.V1I1.4","article-title":"The Brain Gauge: a novel tool for assessing brain health","volume":"1","author":"Tommerdahl","year":"2019","journal-title":"J Sci Med"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1002\/hup.2782","article-title":"A pilot study assessing the Brain Gauge as an indicator of cognitive recovery in alcohol dependence","volume":"36","author":"Powell","year":"2021","journal-title":"Hum Psychopharmacol - Clin Exp"},{"key":"B13","unstructured":"Cognitive Assessment Battery (CAB)\u00ae: Science and Validation [Technical Report]. 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