Cerebrospinal fluid, antineuronal autoantibody, EEG, and MRI findings from 992 patients with schizophreniform and affective psychosis

被引：62

作者：

Endres, Dominique ^{[1
,2
]}

Meixensberger, Sophie ^{[1
,2
]}

Dersch, Rick ^{[3
]}

Feige, Bernd ^{[1
,2
]}

Stich, Oliver ^{[3
,4
]}

Venhoff, Nils ^{[5
]}

Matysik, Miriam ^{[1
,2
]}

Maier, Simon J. ^{[1
,2
]}

Michel, Maike ^{[2
]}

Runge, Kimon ^{[1
,2
]}

Nickel, Kathrin ^{[1
,2
]}

Urbach, Horst ^{[6
]}

Domschke, Katharina ^{[2
,7
]}

Pruss, Harald ^{[8
,9
]}

van Elst, Ludger Tebartz ^{[1
,2
]}

机构：

[1] Univ Freiburg, Fac Med, Med Ctr, Sect Expt Neuropsychiat,Dept Psychiat & Psychothe, D-79104 Freiburg, Germany

[2] Univ Freiburg, Fac Med, Med Ctr, Dept Psychiat & Psychotherapy, D-79104 Freiburg, Germany

[3] Univ Freiburg, Fac Med, Med Ctr, Clin Neurol & Neurophysiol, D-79106 Freiburg, Germany

[4] Med Care Ctr, Neurol, D-78464 Constance, Germany

[5] Univ Freiburg, Fac Med, Med Ctr, Dept Rheumatol & Clin Immunol, D-79106 Freiburg, Germany

[6] Univ Freiburg, Fac Med, Med Ctr, Dept Neuroradiol, D-79106 Freiburg, Germany

[7] Univ Freiburg, Fac Med, Ctr Basics Neuromodulat, D-79106 Freiburg, Germany

[8] Charite Univ Med Berlin, Dept Neurol & Expt Neurol, D-10117 Berlin, Germany

[9] German Ctr Neurodegenerat Dis DZNE Berlin, D-10117 Berlin, Germany

来源：

TRANSLATIONAL PSYCHIATRY | 2020年 / 10卷 / 01期

关键词：

ASPARTATE RECEPTOR AUTOANTIBODIES; 1ST-EPISODE PSYCHOSIS; BARRIER DYSFUNCTION; ENCEPHALITIS; DIAGNOSIS; PREVALENCE; ANTIBODIES;

D O I：

10.1038/s41398-020-00967-3

中图分类号：

R749 [精神病学];

学科分类号：

100205 ;

摘要：

The central role played by cerebrospinal-fluid (CSF) examinations including antineuronal autoantibody (Ab) testing is increasingly recognized in psychiatry. The rationale of this study was to present a multimodally investigated group of patients. In total, 992 patients were analyzed for CSF alterations: 456 patients with schizophreniform and 536 with affective syndromes. Ab measurement included testing for established antineuronal IgG-Abs against intracellular antigens in serum (Yo/Hu/Ri/cv2[CRMP5]/Ma1/Ma2/SOX1/TR[DNER]/Zic4/amphiphysin/GAD65) and for cell surface antigens in the CSF (NMDAR/AMPA-1/2-R/GABA-B-R/LGI1/CASPR2/DPPX). In 30 patients with "red flags" for autoimmune psychosis, "tissue tests" were performed. Additional diagnostics included MRI and EEG analyses. CSF white-blood-cell counts were increased in 4% and IgG indices in 2%; CSF-specific oligoclonal bands were detected in 4%; overall, 8% displayed signs of neuroinflammation. In addition, 18% revealed increased albumin quotients. Antineuronal Abs against intracellular antigens were detected in serum in 0.6%. Antineuronal Abs against established cell surface antigens were detected in serum of 1% and in the CSF of 0.3% (CSF samples were only questionably positive). Abnormal IgG binding in "tissue tests" was detected in serum of 23% and in CSF of 27%. In total, 92% of the Ab-positive patients demonstrated at least one sign of brain involvement in additional diagnostics using CSF, MRI, EEG, and FDG-PET. In summary, CSF basic analyses revealed signs of blood-brain-barrier dysfunction and neuroinflammation in relevant subgroups of patients. Established antineuronal IgG-Abs were rare in serum and even rarer in the CSF. "Tissue tests" revealed frequent occurrences of Ab-binding; therefore, novel antineuronal Abs could play a relevant role in psychiatry.

引用

页数：20

共 48 条

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