Cabezudo-García Pablo, Mena-Vázquez Natalia, Ciano-Petersen Nicolás L, García-Martín Guillermina, Estivill-Torrús Guillermo, Serrano-Castro Pedro J
Instituto de Investigación Biomédica de Málaga-IBIMA, 29010 Málaga, Spain.
Unidad de Gestión Clínica de Neurociencias, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain.
Brain Sci. 2021 Mar 19;11(3):392. doi: 10.3390/brainsci11030392.
The prevalence of neural autoantibodies in epilepsy of unknown etiology varies among studies. We aimed to conduct a systematic review and meta-analysis to determine the pooled global prevalence and the prevalence for each antibody.
A systematic search was conducted for studies that included prospectively patients ≥16 years old with epilepsy of unknown etiology and systematically determined neural autoantibodies. A meta-analysis was undertaken to estimate pooled prevalence in total patients with a positive result for at least one neural autoantibody in serum and/or cerebrospinal fluid (CSF) and for each autoantibody.
Ten of the eleven studies that met the inclusion criteria and a total of 1302 patients with epilepsy of unknown etiology were included in themeta-analysis. The global pooled prevalence (IC95%) was 7.6% (4.6-11.2) in a total of 82 patients with a positive result for any neural autoantibody. None of the controls available in the studies had a positive result. Individual pooled prevalence for each autoantibody was: glycine receptor (GlyR) (3.2%), glutamic acid decarboxylase (GAD) (1.9%), -methyl-d-aspartate receptor (NMDAR) (1.8%), leucine-rich glioma inactivated-1 protein (LGI1) (1.1%), contactin-2-associated protein (CASPR2) (0.6%) and onconeuronal (0.2%).
The pooled prevalence of neural autoantibodies in patients with epilepsy of unknown etiology is small but not irrelevant. None of the controls had a positive result. There was high heterogeneity among studies. In the future, a homogeneous protocol for testing neural autoantibodies is recommended.
在病因不明的癫痫患者中，神经自身抗体的患病率在不同研究中有所差异。我们旨在进行一项系统评价和荟萃分析，以确定总体合并患病率以及每种抗体的患病率。
对纳入前瞻性≥16岁病因不明癫痫患者并系统检测神经自身抗体的研究进行系统检索。进行荟萃分析以估计血清和/或脑脊液（CSF）中至少一种神经自身抗体检测结果为阳性的所有患者以及每种自身抗体的合并患病率。
符合纳入标准的11项研究中的10项，共1302例病因不明的癫痫患者纳入荟萃分析。在总共82例任何神经自身抗体检测结果为阳性的患者中，总体合并患病率（IC95%）为7.6%（4.6 - 11.2）。研究中可用的对照均无阳性结果。每种自身抗体的个体合并患病率分别为：甘氨酸受体（GlyR）（3.2%）、谷氨酸脱羧酶（GAD）（1.9%）、N-甲基-D-天冬氨酸受体（NMDAR）（1.8%）、富含亮氨酸胶质瘤失活1蛋白（LGI1）（1.1%）、接触蛋白2相关蛋白（CASPR2）（0.6%）和肿瘤神经元抗体（0.2%）。
病因不明的癫痫患者中神经自身抗体的合并患病率虽低但并非无关紧要。对照均无阳性结果。研究间存在高度异质性。未来，建议采用统一方案检测神经自身抗体。
