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Prevalence of Neural Autoantibodies in Paired Serum and Cerebrospinal Fluid in Adult Patients with Drug-Resistant Temporal Lobe Epilepsy of Unknown Etiology

In order to determine the prevalence of neural autoantibodies in adult patients with drug-resistant temporal lobe epilepsy (DRTLE) of unknown etiology, we compared the characteristics of patients with and without autoantibodies and applied antibody predictive scores to the patients. Patients aged ≥1...

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Autores principales: Cabezudo-García, Pablo, Ciano-Petersen, Nicolás L., Mena-Vázquez, Natalia, Ortega-Pinazo, Jesús, Postigo-Pozo, María J., García-Martín, Guillermina, Antolí-Martínez, Helena, Sánchez-Sánchez, Violeta, Quiroga-Subirana, Pablo, Serrano-Castro, Pedro J., Estivill-Torrús, Guillermo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8584597/
https://www.ncbi.nlm.nih.gov/pubmed/34768363
http://dx.doi.org/10.3390/jcm10214843
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author Cabezudo-García, Pablo
Ciano-Petersen, Nicolás L.
Mena-Vázquez, Natalia
Ortega-Pinazo, Jesús
Postigo-Pozo, María J.
García-Martín, Guillermina
Antolí-Martínez, Helena
Sánchez-Sánchez, Violeta
Quiroga-Subirana, Pablo
Serrano-Castro, Pedro J.
Estivill-Torrús, Guillermo
author_facet Cabezudo-García, Pablo
Ciano-Petersen, Nicolás L.
Mena-Vázquez, Natalia
Ortega-Pinazo, Jesús
Postigo-Pozo, María J.
García-Martín, Guillermina
Antolí-Martínez, Helena
Sánchez-Sánchez, Violeta
Quiroga-Subirana, Pablo
Serrano-Castro, Pedro J.
Estivill-Torrús, Guillermo
author_sort Cabezudo-García, Pablo
collection PubMed
description In order to determine the prevalence of neural autoantibodies in adult patients with drug-resistant temporal lobe epilepsy (DRTLE) of unknown etiology, we compared the characteristics of patients with and without autoantibodies and applied antibody predictive scores to the patients. Patients aged ≥18 years with DRTLE of unknown etiology and ≥12 months of evolution were prospectively recruited. Neural autoantibodies in serum and CSF were systematically determined in all patients. We created the ARTE (antibody in drug-resistant temporal lobe epilepsy) score based on the variables associated with the presence of neural autoantibodies. Twenty-seven patients were included. The mean (SD) age in years at the index date was 52 (±14.2) and at epilepsy onset was 32 (±17.1). The mean epilepsy duration was 19 (±12.5) years. Neural autoantibodies were detected in 51.85% (14/27) of patients. The presence of bitemporal, independent, interictal epileptiform discharges (BIIED) had a higher frequency in patients with neural autoantibodies (57.1% vs. 15.4%; p = 0.025) as well as those patients with a previous history of status epilepticus (49.2% vs. 0.0%; p = 0.007). The ARTE score showed an area under the curve (AUC) of 0.854. Using a cut-off point of ≥1, the sensitivity was 100% and the specificity was 46.1%, whereas when using a cut-off point of ≥3, the results were 35.7% and 100%, respectively. We found a high prevalence of neural autoantibodies in patients with DRTLE of unknown etiology, indicating an autoimmune mechanism. The presence of BIIED and a history of SE in DRTLE of unknown etiology are possible markers for autoimmune-associated epilepsy. The proposed ARTE score requires future validation in larger independent cohorts.
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spelling pubmed-85845972021-11-12 Prevalence of Neural Autoantibodies in Paired Serum and Cerebrospinal Fluid in Adult Patients with Drug-Resistant Temporal Lobe Epilepsy of Unknown Etiology Cabezudo-García, Pablo Ciano-Petersen, Nicolás L. Mena-Vázquez, Natalia Ortega-Pinazo, Jesús Postigo-Pozo, María J. García-Martín, Guillermina Antolí-Martínez, Helena Sánchez-Sánchez, Violeta Quiroga-Subirana, Pablo Serrano-Castro, Pedro J. Estivill-Torrús, Guillermo J Clin Med Article In order to determine the prevalence of neural autoantibodies in adult patients with drug-resistant temporal lobe epilepsy (DRTLE) of unknown etiology, we compared the characteristics of patients with and without autoantibodies and applied antibody predictive scores to the patients. Patients aged ≥18 years with DRTLE of unknown etiology and ≥12 months of evolution were prospectively recruited. Neural autoantibodies in serum and CSF were systematically determined in all patients. We created the ARTE (antibody in drug-resistant temporal lobe epilepsy) score based on the variables associated with the presence of neural autoantibodies. Twenty-seven patients were included. The mean (SD) age in years at the index date was 52 (±14.2) and at epilepsy onset was 32 (±17.1). The mean epilepsy duration was 19 (±12.5) years. Neural autoantibodies were detected in 51.85% (14/27) of patients. The presence of bitemporal, independent, interictal epileptiform discharges (BIIED) had a higher frequency in patients with neural autoantibodies (57.1% vs. 15.4%; p = 0.025) as well as those patients with a previous history of status epilepticus (49.2% vs. 0.0%; p = 0.007). The ARTE score showed an area under the curve (AUC) of 0.854. Using a cut-off point of ≥1, the sensitivity was 100% and the specificity was 46.1%, whereas when using a cut-off point of ≥3, the results were 35.7% and 100%, respectively. We found a high prevalence of neural autoantibodies in patients with DRTLE of unknown etiology, indicating an autoimmune mechanism. The presence of BIIED and a history of SE in DRTLE of unknown etiology are possible markers for autoimmune-associated epilepsy. The proposed ARTE score requires future validation in larger independent cohorts. MDPI 2021-10-21 /pmc/articles/PMC8584597/ /pubmed/34768363 http://dx.doi.org/10.3390/jcm10214843 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Cabezudo-García, Pablo
Ciano-Petersen, Nicolás L.
Mena-Vázquez, Natalia
Ortega-Pinazo, Jesús
Postigo-Pozo, María J.
García-Martín, Guillermina
Antolí-Martínez, Helena
Sánchez-Sánchez, Violeta
Quiroga-Subirana, Pablo
Serrano-Castro, Pedro J.
Estivill-Torrús, Guillermo
Prevalence of Neural Autoantibodies in Paired Serum and Cerebrospinal Fluid in Adult Patients with Drug-Resistant Temporal Lobe Epilepsy of Unknown Etiology
title Prevalence of Neural Autoantibodies in Paired Serum and Cerebrospinal Fluid in Adult Patients with Drug-Resistant Temporal Lobe Epilepsy of Unknown Etiology
title_full Prevalence of Neural Autoantibodies in Paired Serum and Cerebrospinal Fluid in Adult Patients with Drug-Resistant Temporal Lobe Epilepsy of Unknown Etiology
title_fullStr Prevalence of Neural Autoantibodies in Paired Serum and Cerebrospinal Fluid in Adult Patients with Drug-Resistant Temporal Lobe Epilepsy of Unknown Etiology
title_full_unstemmed Prevalence of Neural Autoantibodies in Paired Serum and Cerebrospinal Fluid in Adult Patients with Drug-Resistant Temporal Lobe Epilepsy of Unknown Etiology
title_short Prevalence of Neural Autoantibodies in Paired Serum and Cerebrospinal Fluid in Adult Patients with Drug-Resistant Temporal Lobe Epilepsy of Unknown Etiology
title_sort prevalence of neural autoantibodies in paired serum and cerebrospinal fluid in adult patients with drug-resistant temporal lobe epilepsy of unknown etiology
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8584597/
https://www.ncbi.nlm.nih.gov/pubmed/34768363
http://dx.doi.org/10.3390/jcm10214843
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