Cerebrospinal fluid biomarkers in psychiatric autoimmune encephalitis: a retrospective cohort study

Hansen, Niels; Juhl, Aaron Levin; Grenzer, Insa Maria; Teegen, Bianca; Wiltfang, Jens; Fitzner, Dirk

doi:10.3389/fpsyt.2023.1165153

Cited by 1 publication

(1 citation statement)

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“…However, although the large Daguano Gastaldi cohort study (Daguano Gastaldi et al, 2022) also demonstrated that the presence of autoantibodies in psychotic disorders (with similar prevalence in healthy subjects) is not disease-defining, it is also clear that at least their overall prevalence of 17% in psychotic disorders certainly affects a considerable proportion of patients, which clearly limits the need to clarify at least theoretically conceivable pathogenicity. The second most frequent syndrome in definitive psychiatric autoimmune encephalitis was a parahallucinatory syndrome (after the most frequent psychoorganic syndrome (Hansen et al, 2023) -a finding consistent with autoimmune psychosis as one of the major subtypes of autoimmune encephalitis.…”

Section: Discussionmentioning

confidence: 80%

Current Findings on the Spectrum of Neuronal Autoantibodies Associated with Psychotic Disorders

Hansen

2023

J. Psychol. Psychother.Res

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Background: Neural autoantibodies are observed in a subtype of psychotic disorders ranging from first-episode psychosis to schizophrenia. The clinical spectrum has so far been incompletely described, as new neuronal autoantibodies are emerging in the context of psychosis. This review is dedicated to describing the current spectrum of neural autoantibodies associated with psychotic disorders. Methods: In our narrative review, we searched for neural autoantibodies addressed in the PubMed database in the last 15 years focusing on the last three years after publication of the international guidelines for autoimmune psychosis. We relied on small and large cohort studies and case series descriptions related to neural autoantibodies in psychotic disorders. Results: Mainly neural autoantibodies against membrane surface structures such as N-Methyl-D-aspartate receptors (NMDAR) and against intracellular targets are present in psychotic disorders, but also in healthy controls. There is current suspicion that these neuronal autoantibodies (ie., NMDAR autoantibodies) play a potentially relevant role in the development of brain pathologies in psychotic disorders, especially when detected in cerebrospinal fluid. Autoantibodies against cell adhesion molecules and synaptic proteins such as neuronal cell adhesion molecule 1 (NCAM1) and antigen neurexin 1 alpha (NRXN1)-alpha occur in schizophrenia, but not in controls, suggesting that these are highly disease-specific antibodies. These lines of evidence are further supported by animal-model evidence showing a role of these autoantibodies in brain pathology and the development of schizophrenia-like symptoms. Conclusions: In recent years, a new landscape of potentially relevant neural autoantibodies has emerged in a subtype of psychotic disorders. Their significance remains unclear. Large-scale investigations should particularly investigate what triggers the pathogenicity of these autoantibodies, as they probably do not cause the psychotic disorder per se, but might be involved as one factor in the immunopathophysiology. Psychotic disorders remain elusive, and differential diagnosis is required to determine the role neural autoantibodies play in the manifestation of psychoses.

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Section: Discussionmentioning

confidence: 80%