The significance of anti-neuronal antibodies for acute psychiatric disorders: a retrospective case-controlled study

BMC Neurosci. 2018 Nov 3;19(1):68. doi: 10.1186/s12868-018-0471-7.

Abstract

Background: The clinical significance of anti-neuronal antibodies in patients with psychiatric disorders, but without encephalitis, remains unknown. In patients admitted to acute psychiatric inpatient care we aimed to identify clinical features distinguishing anti-neuronal antibody positive patients from matched controls.

Results: Patients who were serum-positive to N-methyl D-aspartate receptor (NMDAR) (n = 21), contactin-associated protein 2 (CASPR2) (n = 14) and/or glutamic acid decarboxylase 65 (GAD65) (n = 9) antibodies (cases) were age and sex matched (1:2) with serum-negative patients from the same cohort (controls). The prevalence and severity of psychiatric symptoms frequently encountered in NMDAR, CASPR2 and GAD65 antibody associated disorders were compared in cases and controls. NMDAR, CASPR2 and GAD65 antibody positive patients did not differ in their clinical presentation from matched serum negative controls.

Conclusion: In this cohort, patients with and without NMDAR, CASPR2 and GAD65 antibodies admitted to acute psychiatric inpatient care had similar psychiatric phenotypes. This does not exclude their clinical relevance in subgroups of patients, and studies further investigating the clinical significance of anti-neuronal antibodies in patients with psychiatric symptomatology are needed.

Keywords: Anti-neuronal antibodies; Mental disorders; NMDA receptor antibodies; Psychoneuroimmunology.

MeSH terms

  • Acute Disease
  • Adult
  • Autoantibodies / blood*
  • Case-Control Studies
  • Female
  • Glutamate Decarboxylase / immunology*
  • Hospitalization
  • Humans
  • Male
  • Membrane Proteins / immunology*
  • Mental Disorders / blood
  • Mental Disorders / epidemiology
  • Mental Disorders / immunology*
  • Mental Disorders / therapy
  • Middle Aged
  • Nerve Tissue Proteins / immunology*
  • Prevalence
  • Psychiatric Status Rating Scales
  • Receptors, N-Methyl-D-Aspartate / immunology*
  • Retrospective Studies
  • Severity of Illness Index

Substances

  • Autoantibodies
  • CNTNAP2 protein, human
  • Membrane Proteins
  • Nerve Tissue Proteins
  • Receptors, N-Methyl-D-Aspartate
  • Glutamate Decarboxylase
  • glutamate decarboxylase 2