Etemadifar Masoud, Abhari Amir Parsa, Sabeti Fatemeh, Ganjalikhani-Hakemi Mazdak, Salari Mehri, Hashemi Fatemeh, Aghababaee Ali, Khorvash Reza, Khayati Mohammad Hasan, Nouri Hosein
Department of Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran.
Medical School, Isfahan University of Medical Sciences, Isfahan, Iran.
Neurol Sci. 2021 Jan;42(1):151-157. doi: 10.1007/s10072-020-04518-y. Epub 2020 Jun 20.
The aim of this study was to investigate the frequency of anti-N-methyl-D-aspartate receptor (anti-NMDAR) antibody positivity in patients presenting with transverse myelitis (TM) and/or optic neuritis (ON), to describe their neurologic and radiological characteristics, and to compare these characteristics with those reported in previous studies.
This study included 179 patients (ON: 96, TM: 74, ON and TM: 9) who visited Isfahan Multiple Sclerosis Center from January 2017 to September 2019, for approximately 32 months. The respective neurological examinations were performed. Demographic data of the patients, as well as findings from radiological and serological investigations were obtained.
Frequencies of anti-NMDAR seropositivity in patients with TM, ON, and concurrent TM and ON were approximately 3.4%, 1.4%, and 11.1%, respectively. None exhibited any psychiatric symptoms.
Based on the frequency of seropositivity for anti-NMDAR antibody in our patients, positivity for this antibody appears to be more frequent than previously anticipated in patients presenting with these conditions. We recommend that the anti-NMDAR antibody presence in CSF/serum be checked and considered in addition to the routine examinations performed upon confronting demyelinating conditions such as TM and ON. We suggest considering the term "NMDAR spectrum disorder" to more clearly distinguish the potentially overlapping conditions with different etiologies in patients with CNS disorders.
本研究旨在调查患有横贯性脊髓炎（TM）和/或视神经炎（ON）的患者中抗N-甲基-D-天冬氨酸受体（抗NMDAR）抗体阳性的频率，描述其神经学和放射学特征，并将这些特征与先前研究报告的特征进行比较。
本研究纳入了2017年1月至2019年9月期间在伊斯法罕多发性硬化症中心就诊约32个月的179例患者（ON：96例，TM：74例，ON合并TM：9例）。进行了各自的神经学检查。获取了患者的人口统计学数据以及放射学和血清学检查结果。
TM、ON以及并发TM和ON的患者中抗NMDAR血清阳性的频率分别约为3.4%、1.4%和11.1%。均未表现出任何精神症状。
基于我们患者中抗NMDAR抗体血清阳性的频率，在患有这些疾病的患者中，该抗体阳性似乎比先前预期更为常见。我们建议，除了在面对TM和ON等脱髓鞘疾病时进行的常规检查外，还应检查并考虑脑脊液/血清中抗NMDAR抗体的存在。我们建议考虑使用“NMDAR谱系障碍”这一术语，以更清楚地区分中枢神经系统疾病患者中不同病因的潜在重叠情况。
