Anti-<i>N</i>-methyl-<scp>d</scp>-aspartate receptor encephalitis triggered by emotional stress

Chukwuemeka, Andrew; Thompson, E. W.; Mordukhaev, Lauren; Khan, Imran; Zhang, Nasen J.

doi:10.1080/08998280.2019.1647713

Cited by 3 publications

(4 citation statements)

References 3 publications

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“…Rare studies have reported the association between stress and anti-NMDARE, and the mechanism was still unclear [5,23,24]. Obi CA and their colleagues suggested that emotional stress triggered immune dysregulation, which ultimately resulted in anti-NMDARE [4]. The other suggested mechanism was the preexisting anti-NMDAR antibody in the peripheral blood [25,26].…”

Section: Discussionmentioning

confidence: 99%

“…The antibodies crosslink NMDAR, change its surface dynamics and interaction with other synaptic proteins, inhibit receptor internalization, and lead to severe impairment of synaptic plasticity and NMDAR network function [2]. It is well known that anti-NMDARE may be associated with teratoma and herpes virus infection [3], and also, there are reports in the literature that stress can induce anti-NMDARE [4,5].…”

Section: Introductionmentioning

confidence: 99%

“…There has been a case reported that emotional stress-related factors induce anti-NMDARE [4]. To evaluate the correlation between stress and severe anti-NMDARE, and to elucidate the clinical features of severe anti-NMDARE with LSE, we conducted this retrospective single center cohort study.…”

Section: Introductionmentioning

confidence: 99%

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Stress is Associated with Severe Anti-NMDA Receptor Encephalitis: A Single-Center Retrospective Cohort Study

Wang

Pan

et al. 2021

Preprint

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Background: Stress was reported to trigger and exacerbate a lot of autoimmune diseases. The underlying mechanisms include disturbed hormone homeostasis, dysregulated immune function, neuroinflammation by macrophages and microglia, and so on. There have been case reports of stress-induced anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis (anti-NMDARE). To elucidate the association between stress events and anti-NDMARE, we conducted a retrospective single-center cohort study.Materials and Methods: All severe anti-NMDARE patients admitted to neuro-intensive care unit (NICU) of Nanfang Hospital between September 2013 and July 2020 were screened. The stress events within 1 year before the onset were evaluated by a questionnaire survey using the Chinese Life Event Scale. The demographic information, clinical features, laboratory results and prognosis were collected and compared between patients with and without life stress events (LSE). Patients were further classified based on the existence of teratoma and herpes viruses in cerebrospinal fluid to investigate the association between stress and anti-NMDARE. Results: Of the 26 severe anti-NMDARE patients, 9 (34.6%) patients reported LSE. Among them, 5 (55.6%) had family stress, 3 (33.3%) had work stress and 1 (11.1%) had both family and work stress. No significant differences were observed in disease severity upon admission, NICU stay time, mechanical ventilation time or other laboratory results. The comorbid rate of teratoma and herpes virus was not significantly different between patients with and without LSE. However, 7 of the patients without teratoma and herpes virus (7/17, 41.2%) experienced LSE before the disease onset. The prognosis of patients with LSE was significantly better than that of patients without LSE (P=0.023).Conclusions: Up to 34.6% of severe anti-NMDARE patients had LSE within 1 year before the onset, which might even be underestimated. This study suggested that stress might be another risk factor for anti-NMDARE besides teratoma and herpes virus. Neurologists should pay attention to the stress of the patients and provide psychological therapy to the patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Stress is Associated with Severe Anti-NMDA Receptor Encephalitis: A Single-Center Retrospective Cohort Study

Wang

Pan

et al. 2021

Preprint

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“…Развитие ANMDARE могут спровоцировать герпес [38], грипп [39], коронавирусная инфекция COVID-19 [40,41], вакцинация против COVID-19 [40,41], вакцинация против дифтерии, столбняка, коклюша и полиомиелита [42], криптококковый менингит [43], демиелинизирующий процесс [44], послеродовая гормональная перестройка [45], иммунотерапия после трансплантации органов [46], эмоциональный стресс [47] -одним словом, любое состояние, сопровождаемое энергичным иммунным ответом [28,31], и это веский аргумент в пользу идиопатической природы заболевания.…”

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Is anti-NMDA receptor encephalitis real? I. Diagnostic challenges

Snedkov,

Volchek,

Lemeshev

2024

Neurology bulletin

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After conducting a thorough analysis of clinical, neurophysiological, neuroimmunological, neurobiological, and neuropathological research findings, the authors of the review question on the validity of the anti-NMDA receptor encephalitis concept. The review highlights the significance of studying sanogenetic mechanisms in medicine and warns against hasty interpretations of neurobiological data without clinical knowledge.

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Stress as a possible trigger in anti–N-methyl-ᴅ-aspartate receptor encephalitis: a case series

Ahmad,

Kawoosa,

Hassan

et al. 2024

encephalitis

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Anti-<i>N</i>-methyl-ᴅ-aspartate receptor (NMDAR) encephalitis is a rare disease with a range of neurological and psychiatric presentations. Antibodies against NMDAR receptor are purported to be pathologic, and the two known potential immunological triggers are tumors and viral infection. In half of the cases, the trigger is not known. We present two cases where stress seemed to have triggered encephalitis. These cases illustrate the possible role of stress in leading to immune dysregulation, which can lead to encephalitis. We review the role of stress in anti-NMDAR encephalitis and possible mechanisms by which stress can trigger an immune dysregulation.

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Anti-N-methyl-d-aspartate receptor encephalitis triggered by emotional stress

Cited by 3 publications

References 3 publications

Stress is Associated with Severe Anti-NMDA Receptor Encephalitis: A Single-Center Retrospective Cohort Study

Stress is Associated with Severe Anti-NMDA Receptor Encephalitis: A Single-Center Retrospective Cohort Study

Is anti-NMDA receptor encephalitis real? I. Diagnostic challenges

Stress as a possible trigger in anti–N-methyl-ᴅ-aspartate receptor encephalitis: a case series

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