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抗神经元抗体在急性精神障碍中的意义:一项回顾性病例对照研究。

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

作者信息

Schou Morten B, Sæther Sverre Georg, Drange Ole Kristian, Krane-Gartiser Karoline, Reitan Solveig K, Vaaler Arne E, Kondziella Daniel

机构信息

Department of Mental Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.

Division of Mental Health Care, St Olavs Hospital HF, avd Østmarka, Trondheim University Hospital, Postboks 3250, Torgarden, 7006, Trondheim, Norway.

出版信息

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.

摘要

背景

抗神经元抗体在无脑炎的精神障碍患者中的临床意义尚不清楚。在入住急性精神科住院治疗的患者中,我们旨在确定区分抗神经元抗体阳性患者与匹配对照组的临床特征。

结果

血清N-甲基-D-天冬氨酸受体(NMDAR)(n = 21)、接触蛋白相关蛋白2(CASPR2)(n = 14)和/或谷氨酸脱羧酶65(GAD65)(n = 9)抗体阳性的患者(病例组)与来自同一队列的血清阴性患者(对照组)进行年龄和性别匹配(1:2)。比较病例组和对照组中NMDAR、CASPR2和GAD65抗体相关疾病中常见精神症状的患病率和严重程度。NMDAR、CASPR2和GAD65抗体阳性患者的临床表现与匹配的血清阴性对照组无差异。

结论

在该队列中,入住急性精神科住院治疗的有无NMDAR、CASPR2和GAD65抗体的患者具有相似的精神表型。这并不排除它们在亚组患者中的临床相关性,需要进一步研究抗神经元抗体在有精神症状的患者中的临床意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6c5/6215671/f6f93ba0e1f3/12868_2018_471_Fig1_HTML.jpg

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