Spectrum of Novel Anti–Central Nervous System Autoantibodies in the Cerebrospinal Fluid of 119 Patients With Schizophreniform and Affective Disorders

Endres, Dominique; Zedtwitz, Katharina von; Matteit, Isabelle; Bünger, I; Rasmussen, Helle Foverskov; Runge, Kimon; Feige, Bernd; Schlump, Andrea; Maier, Simon; Nickel, Kathrin; Berger, Benjamin; Schiele, Miriam A.; Cunningham, Janet L.; Domschke, Katharina; Prüß, Harald; Elst, Ludger Tebartz van

doi:10.1016/j.biopsych.2022.02.010

Cited by 29 publications

(22 citation statements)

References 58 publications

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“…They also shared the staining pattern similarity of another case with limited astrocytic‐like staining that responded to steroid treatment [23]. In a screening for antineuronal autoantibodies in CSF using a similar method, only one case with astrocytic staining pattern was described among the 121 patients with severe psychiatric states [24]. The frequency of this specific pattern in other postinfectious contexts is not yet known.…”

Section: Discussionmentioning

confidence: 84%

Myoclonus in patients with COVID‐19: Findings of autoantibodies against brain structures in cerebrospinal fluid

Lindqvist

Cunningham

Mulder

et al. 2023

Euro J of Neurology

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Background and purposeCOVID‐19 is associated with multiple neurological manifestations. The clinical presentation, trajectory, and treatment response for three cases of myoclonus during COVID‐19 infection, with no previous neurological disease, are decsribed.MetodsAnalysis of cerebrospinal fluid from the cases using indirect immunohistochemistry.ResultsAntibodies against rodent brain tissue, and similarities in staining patterns were observed, indicating the presence of antineuronal immunoglobulin G autoantibodies targeting astrocytes in the hippocampus.ConclusionOur results demontrate cerebrospinal fluid antineuronal antibodies indicating an an autoimmune involvment in the pathogenesis in COVID‐19 associated myoclonus.

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Section: Discussionmentioning

confidence: 84%

Myoclonus in patients with COVID‐19: Findings of autoantibodies against brain structures in cerebrospinal fluid

Lindqvist

Cunningham

Mulder

et al. 2023

Euro J of Neurology

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“…In a report on the first described cases ( n = 4) of postpartum autoimmune encephalitis with psychotic symptoms, two patients exhibited autoantibodies with novel antigen targets ( 13 ). The present work represents the first postpartum case with a specific autoantibody pattern in OCD ( 14 ). Dopamine and glutamate levels in the CSF seemed to be dysregulated.…”

Section: Discussionmentioning

confidence: 90%

Case Report: Possible autoimmune obsessive-compulsive disorder with postpartum onset

et al. 2022

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Autoimmune obsessive–compulsive disorder (OCD) is rare. The case presented here is that of a female patient in her mid-thirties who developed postpartum OCD. Magnetic resonance imaging showed multiple juxtacortical hyperintensities that may have been post-inflammatory in origin. In tissue-based assays using mouse brain slices, the patient’s cerebrospinal fluid (CSF) showed novel anti-nucleoli autoantibodies in cerebellar Purkinje cells and cortical neurons. The CSF dopamine and glutamate concentrations were dysregulated. The clinical course and diagnostic findings were compatible with possible autoimmune OCD with postpartum onset.

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“…Blood analyses were offered to all patients as a routine procedure upon admission. The methodology of the tests has been described in previous publications [23,[25][26][27]. In addition to these routine diagnostic tests, 15 selected patients with suspected autoimmune OCD [16,28] received a lumbar puncture to investigate an inflammatory cause of OCD.…”

Section: Fdp-ocd Screeningmentioning

confidence: 99%

Deep clinical phenotyping of patients with obsessive-compulsive disorder: an approach towards detection of organic causes and first results

et al. 2023

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In the revised diagnostic classification systems ICD-11 and DSM-5, secondary, organic forms of obsessive-compulsive disorder (OCD) are implemented as specific nosological entities. Therefore, the aim of this study was to clarify whether a comprehensive screening approach, such as the Freiburg-Diagnostic-Protocol for patients with OCD (FDP-OCD), is beneficial for detecting organic OCD forms. The FDP-OCD includes advanced laboratory tests, an expanded magnetic resonance imaging (MRI) protocol, and electroencephalography (EEG) investigations as well as automated MRI and EEG analyses. Cerebrospinal fluid (CSF), [18F]fluorodeoxyglucose positron emission tomography, and genetic analysis were added for patients with suspected organic OCD. The diagnostic findings of the first 61 consecutive OCD inpatients (32 female and 29 male; mean age: 32.7 ± 12.05 years) analyzed using our protocol were investigated. A probable organic cause was assumed in five patients (8%), which included three patients with autoimmune OCD (one patient with neurolupus and two with specific novel neuronal antibodies in CSF) and two patients with newly diagnosed genetic syndromes (both with matching MRI alterations). In another five patients (8%), possible organic OCD was detected (three autoimmune cases and two genetic cases). Immunological serum abnormalities were identified in the entire patient group, particularly with high rates of decreased “neurovitamin” levels (suboptimal vitamin D in 75% and folic acid in 21%) and increased streptococcal (in 46%) and antinuclear antibodies (ANAs; in 36%). In summary, the FDP-OCD screening led to the detection of probable or possible organic OCD forms in 16% of the patients with mostly autoimmune forms of OCD. The frequent presence of systemic autoantibodies such as ANAs further support the possible influence of autoimmune processes in subgroups of patients with OCD. Further research is needed to identify the prevalence of organic OCD forms and its treatment options.

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Spectrum of Novel Anti–Central Nervous System Autoantibodies in the Cerebrospinal Fluid of 119 Patients With Schizophreniform and Affective Disorders

Cited by 29 publications

References 58 publications

Myoclonus in patients with COVID‐19: Findings of autoantibodies against brain structures in cerebrospinal fluid

Myoclonus in patients with COVID‐19: Findings of autoantibodies against brain structures in cerebrospinal fluid

Case Report: Possible autoimmune obsessive-compulsive disorder with postpartum onset

Deep clinical phenotyping of patients with obsessive-compulsive disorder: an approach towards detection of organic causes and first results

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