Department of Neurology, Mayo Clinic, Rochester, United States; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, United States; Department of Neurology, Massachusetts's General Hospital, Boston, United States.
Department of Neurology, Mayo Clinic, Rochester, United States.
J Neuroimmunol. 2018 Oct 15;323:62-72. doi: 10.1016/j.jneuroim.2018.07.009. Epub 2018 Jul 25.
Recognition of autoimmunity as a cause of encephalopathy has increased. Recent studies have validated the use of Antibody-Prevalence-in-Epilepsy (APE) and Responsive-to-immunotherapy-in-Epilepsy (RITE) scores in the evaluation and management of autoimmune-epilepsy. We aim to assess the utility of these models for patients with cognitive dysfunction. Among the evaluated patients, 17% had antibodies universally associated with autoimmune-encephalopathy. NMDA-R-IgG and LGI1-IgG were the most common antibody specificities. Antibody-Prevalence-in-Epilepsy-and-Encephalopathy (APE) score ≥ 4 was 99% sensitive and 93% specific for neural-specific-antibodies. Responsive-to-immunotherapy-in-Epilepsy-and-Encephalopathy (RITE) score ≥ 7 had 96% sensitivity and 86% specificity for favorable initial immunotherapy response. Application of these models may optimize autoantibody evaluations and immunotherapeutic trials.
自身免疫性疾病被认为是脑病的一个原因，这一点已经得到了越来越多的认可。最近的研究已经验证了抗体阳性率在癫痫中的应用（Antibody-Prevalence-in-Epilepsy，APE）和癫痫免疫治疗反应性评分（Responsive-to-immunotherapy-in-Epilepsy，RITE）在评估和管理自身免疫性癫痫中的作用。我们旨在评估这些模型在认知功能障碍患者中的应用价值。在所评估的患者中，有 17%的患者存在与自身免疫性脑病普遍相关的抗体。NMDA-R-IgG 和 LGI1-IgG 是最常见的抗体特异性。抗体阳性率在癫痫和脑病中的评分（APE）≥4 分对神经特异性抗体的敏感性为 99%，特异性为 93%。癫痫和脑病免疫治疗反应性评分（RITE）≥7 分对初始免疫治疗反应良好的敏感性为 96%，特异性为 86%。应用这些模型可以优化自身抗体评估和免疫治疗试验。
