Why should lithium therapy for KLS work in some cases and fail in other cases? The lack of a KLS animal model makes the preceding question extremely difficult to answer. How might KLS researches discover or develop animal models for KLS? Why am I personally interested in the preceding question?
Consider the following hypothetical table:
********************Prolonged high level****Prolonged low level
http://www.medical-hypotheses.com/article/0306-9877(93)90011-E/abstract Brown, D. W. “Abnormal fluctuations of acetylcholine and serotonin.” Medical hypotheses 40, no. 5 (1993): 309-310.
Do prolonged abnormal levels of serotonin and/or acetylcholine occur in PANDAS?
http://online.liebertpub.com/doi/abs/10.1089/cap.2014.0064?journalCode=cap Gerardi, D. M., Casadonte, J., Patel, P., & Murphy, T. K. (2015). PANDAS and Comorbid Kleine–Levin Syndrome. Journal of child and adolescent psychopharmacology, 25(1), 93-98.
Investigations of animal models of PANDAS might lead to insights concerning Tourette syndrome and, possibly, KLS.
Consider the following experiment: Over a 10-day period inject a group of mice with acetylcholinesterase and compare the injected group to a control group of non-injected mice. Repeat the experiment with an acetylcholinesterase-injected group of PANDAS-model mice and a control group of non-injected PANDAS-model mice.
“… A prospective cohort study was conducted with a sample of 77 non-consecutive patients observed between May 2009 and September 2010. … Results In the present study, 38 (49.6%) patients developed delirium during their intensive care unit stays. Neither serum acetylcholinesterase activity nor serotonin level was independently associated with delirium. No significant correlations of acetylcholinesterase activity or serotonin level with delirium/coma-free days were observed, but in the patients who developed delirium, there was a strong negative correlation between the acetylcholinesterase level and the number of delirium/coma-free days, indicating that higher acetylcholinesterase levels are associated with fewer days alive without delirium or coma. …”
Tomasi, C.D., Salluh, J., Soares, M., Vuolo, F., Zanatta, F., Constantino, L.D.S., Zugno, A.I., Ritter, C. and Dal-Pizzol, F., 2015. Baseline acetylcholinesterase activity and serotonin plasma levels are not associated with delirium in critically ill patients. Revista Brasileira de terapia intensiva, 27(2), pp.170-177.