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

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 alterati...

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Autores principales: Endres, Dominique, Meixensberger, Sophie, Dersch, Rick, Feige, Bernd, Stich, Oliver, Venhoff, Nils, Matysik, Miriam, Maier, Simon J., Michel, Maike, Runge, Kimon, Nickel, Kathrin, Urbach, Horst, Domschke, Katharina, Prüss, Harald, Tebartz van Elst, Ludger
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7419532/
https://www.ncbi.nlm.nih.gov/pubmed/32782247
http://dx.doi.org/10.1038/s41398-020-00967-3
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author Endres, Dominique
Meixensberger, Sophie
Dersch, Rick
Feige, Bernd
Stich, Oliver
Venhoff, Nils
Matysik, Miriam
Maier, Simon J.
Michel, Maike
Runge, Kimon
Nickel, Kathrin
Urbach, Horst
Domschke, Katharina
Prüss, Harald
Tebartz van Elst, Ludger
author_facet Endres, Dominique
Meixensberger, Sophie
Dersch, Rick
Feige, Bernd
Stich, Oliver
Venhoff, Nils
Matysik, Miriam
Maier, Simon J.
Michel, Maike
Runge, Kimon
Nickel, Kathrin
Urbach, Horst
Domschke, Katharina
Prüss, Harald
Tebartz van Elst, Ludger
author_sort Endres, Dominique
collection PubMed
description 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.
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spelling pubmed-74195322020-08-18 Cerebrospinal fluid, antineuronal autoantibody, EEG, and MRI findings from 992 patients with schizophreniform and affective psychosis Endres, Dominique Meixensberger, Sophie Dersch, Rick Feige, Bernd Stich, Oliver Venhoff, Nils Matysik, Miriam Maier, Simon J. Michel, Maike Runge, Kimon Nickel, Kathrin Urbach, Horst Domschke, Katharina Prüss, Harald Tebartz van Elst, Ludger Transl Psychiatry Article 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. Nature Publishing Group UK 2020-08-12 /pmc/articles/PMC7419532/ /pubmed/32782247 http://dx.doi.org/10.1038/s41398-020-00967-3 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Endres, Dominique
Meixensberger, Sophie
Dersch, Rick
Feige, Bernd
Stich, Oliver
Venhoff, Nils
Matysik, Miriam
Maier, Simon J.
Michel, Maike
Runge, Kimon
Nickel, Kathrin
Urbach, Horst
Domschke, Katharina
Prüss, Harald
Tebartz van Elst, Ludger
Cerebrospinal fluid, antineuronal autoantibody, EEG, and MRI findings from 992 patients with schizophreniform and affective psychosis
title Cerebrospinal fluid, antineuronal autoantibody, EEG, and MRI findings from 992 patients with schizophreniform and affective psychosis
title_full Cerebrospinal fluid, antineuronal autoantibody, EEG, and MRI findings from 992 patients with schizophreniform and affective psychosis
title_fullStr Cerebrospinal fluid, antineuronal autoantibody, EEG, and MRI findings from 992 patients with schizophreniform and affective psychosis
title_full_unstemmed Cerebrospinal fluid, antineuronal autoantibody, EEG, and MRI findings from 992 patients with schizophreniform and affective psychosis
title_short Cerebrospinal fluid, antineuronal autoantibody, EEG, and MRI findings from 992 patients with schizophreniform and affective psychosis
title_sort cerebrospinal fluid, antineuronal autoantibody, eeg, and mri findings from 992 patients with schizophreniform and affective psychosis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7419532/
https://www.ncbi.nlm.nih.gov/pubmed/32782247
http://dx.doi.org/10.1038/s41398-020-00967-3
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