Neuropsychological course of voltage-gated potassium channel and glutamic acid decarboxylase antibody related limbic encephalitis

Eur J Neurol. 2013 Sep;20(9):1297-304. doi: 10.1111/ene.12186. Epub 2013 May 17.

Abstract

Background and purpose: Autoantibodies (abs) to glutamic acid decarboxylase (GAD) and to voltage-gated potassium channels (VGKC) induce distinct courses of limbic encephalitis, related to MRI findings, seizure outcome and cognition.

Methods: A detailed analysis of the cognitive course of the two forms is presented, spanning a median time interval of 28 months, including parameters of attention, learning and memory in 15 VGKC-ab-positive and 16 GAD-ab-positive patients.

Results: In both groups, the initially significantly impaired attention performance recovered to a putatively premorbid level. In VGKC patients the partially severely impaired learning and memory performance improved under treatment but remained subnormal at last follow-up. By contrast, GAD-ab-positive patients had initially less impaired learning and memory scores but did not show an improvement under treatment.

Conclusions: The results provide evidence of distinct relations between inductive processes and cognitive outcome in VGKC-ab-positive and GAD-ab-positive subforms of limbic encephalitis, which possibly depend on differences in pathogenic molecular mechanisms and affected cerebral loci.

Keywords: attention; epilepsy; limbic encephalitis subforms; long term; memory.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Autoantibodies / immunology*
  • Autoantigens / immunology
  • Brain / pathology
  • Child
  • Female
  • Glutamate Decarboxylase / immunology*
  • Humans
  • Immunoprecipitation
  • Limbic Encephalitis / immunology*
  • Limbic Encephalitis / pathology
  • Limbic Encephalitis / psychology*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Potassium Channels, Voltage-Gated / immunology*
  • Young Adult

Substances

  • Autoantibodies
  • Autoantigens
  • Potassium Channels, Voltage-Gated
  • Glutamate Decarboxylase