Dinoto Alessandro, Flanagan Eoin P
Department of Neurology and Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, Minnesota, USA.
Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy.
Curr Opin Psychiatry. 2025 Mar 1;38(2):101-111. doi: 10.1097/YCO.0000000000000980. Epub 2025 Jan 22.
The aim of this review is to summarize clinical, radiological and laboratory findings in autoimmune dementia, to help clinicians in promptly identify this elusive condition.
The rapid advances in the field of autoimmune neurology have led to the discovery of novel antibodies and associated disorders, which are more frequent than previously hypothesized. The correct and prompt identification of cognitive decline of autoimmune origin is vital to ensure early treatment and better outcomes. The diagnosis of autoimmune dementia relies on specific clinical and radiological features and on the detection of specific autoantibodies. Autoantibody specificities predict response to treatment and the occurrence of cancer. In recent years, the differential diagnosis of autoimmune dementia has become more relevant, as the overinterpretation of antibody results, clinical and radiological findings may lead to an erroneous diagnosis of autoimmune dementia, with potential harm to patients due to inappropriate exposure to immunosuppressants.
Autoimmune dementia is a potentially treatable condition and should not be missed in clinical practice given the potential for reversibility with immunotherapy. The diagnosis of autoimmune dementia relies on a comprehensive review of clinical, radiological and laboratory data, and exclusion of other causes of dementia.
