TY - JOUR
T1 - Antibodies to neuronal surface antigens in patients with a clinical diagnosis of neurodegenerative disorder
AU - Giannoccaro, Maria Pia
AU - Gastaldi, Matteo
AU - Rizzo, Giovanni
AU - Jacobson, Leslie
AU - Vacchiano, Veria
AU - Perini, Giulia
AU - Capellari, Sabina
AU - Franciotta, Diego
AU - Costa, Alfredo
AU - Liguori, Rocco
AU - Vincent, Angela
N1 - Copyright © 2021 Elsevier Inc. All rights reserved.
PY - 2021/5/19
Y1 - 2021/5/19
N2 - OBJECTIVES: Autoimmune encephalitis due to antibodies against neuronal surface antigens (NSA-Ab) frequently presents with cognitive impairment, often as the first and prevalent manifestation, but few studies have systematically assessed the frequency of NSA-Ab in consecutive patients with established neurodegenerative disorders.METHODS: We studied sera of 93 patients (41F, 52M), aged 69.2 ± 9.4 years, with neurodegenerative conditions, and of 50 population controls aged over 60 years. Specific NSA-Abs were investigated by antigen-specific cell-based assays (CBAs).After testing, we evaluated the association between the NSA-Abs and clinical, CSF and radiological features.RESULTS: The patients included 13/93 (13.8%) who had specific antibodies to neuronal surface antigens: 6 GlyR, 3 GABAAR (1 also positive for AMPAR), 2 LGI1, 1 CASPR2 and 1 GABABR. One of the 50 controls (2%) was positive for NMDAR antibody and the others were negative on all tests (P = 0.020). No difference was observed in antibody frequency between patients presenting with parkinsonism and those presenting with dementia (P=0.55); however, NSA-Ab were more frequent in those with unclassified forms of dementia (5/13, 38.5%) than in those with unclassified parkinsonism (2/9, 22.2%) or with classified forms of dementia (4/43, 9.3%) or parkinsonism (2/28, 7.1%) (P=0.03). A logistic regression analysis demonstrated that an unclassified diagnosis (P=0.02) and an irregular progression (P=0.024) were predictors of seropositive status.CONCLUSIONS: NSA-Abs are relatively frequent in patients with neurodegenerative disorders, particularly in those with an irregular disease progression of atypical clinical features, inconsistent with a recognized diagnosis. The significance of these antibodies and their possible primary or secondary roles need to be investigated in prospective studies.
AB - OBJECTIVES: Autoimmune encephalitis due to antibodies against neuronal surface antigens (NSA-Ab) frequently presents with cognitive impairment, often as the first and prevalent manifestation, but few studies have systematically assessed the frequency of NSA-Ab in consecutive patients with established neurodegenerative disorders.METHODS: We studied sera of 93 patients (41F, 52M), aged 69.2 ± 9.4 years, with neurodegenerative conditions, and of 50 population controls aged over 60 years. Specific NSA-Abs were investigated by antigen-specific cell-based assays (CBAs).After testing, we evaluated the association between the NSA-Abs and clinical, CSF and radiological features.RESULTS: The patients included 13/93 (13.8%) who had specific antibodies to neuronal surface antigens: 6 GlyR, 3 GABAAR (1 also positive for AMPAR), 2 LGI1, 1 CASPR2 and 1 GABABR. One of the 50 controls (2%) was positive for NMDAR antibody and the others were negative on all tests (P = 0.020). No difference was observed in antibody frequency between patients presenting with parkinsonism and those presenting with dementia (P=0.55); however, NSA-Ab were more frequent in those with unclassified forms of dementia (5/13, 38.5%) than in those with unclassified parkinsonism (2/9, 22.2%) or with classified forms of dementia (4/43, 9.3%) or parkinsonism (2/28, 7.1%) (P=0.03). A logistic regression analysis demonstrated that an unclassified diagnosis (P=0.02) and an irregular progression (P=0.024) were predictors of seropositive status.CONCLUSIONS: NSA-Abs are relatively frequent in patients with neurodegenerative disorders, particularly in those with an irregular disease progression of atypical clinical features, inconsistent with a recognized diagnosis. The significance of these antibodies and their possible primary or secondary roles need to be investigated in prospective studies.
U2 - 10.1016/j.bbi.2021.05.017
DO - 10.1016/j.bbi.2021.05.017
M3 - Article
C2 - 34022370
VL - 96
SP - 106
EP - 112
JO - Brain, Behavior, and Immunity
JF - Brain, Behavior, and Immunity
SN - 0889-1591
ER -