N -methyl- d -aspartate receptor autoimmunity affects cognitive performance in herpes simplex encephalitis

Westman, Gabriel; Studahl, Marie; Ahlm, Clas; Eriksson, Björn; Persson, Bo‐Eric; Rönnelid, Johan; Schliamser, Silvia E.; Aurelius, Elisabeth

doi:10.1016/j.cmi.2016.07.028

Cited by 40 publications

(41 citation statements)

References 29 publications

(21 reference statements)

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“…Interestingly, no significant clinical differences were observed between the anti‐NMDAR seropositive and seronegative subgroups of HSE patients reported by Prüss et al., questioning whether the anti‐NMDAR antibodies in these patients are therefore contributing to the disease . On the contrary, the development of anti‐NMDAR autoantibodies was associated with significantly impaired recovery of neurocognitive performance in another prospective series …”

Section: Discussionmentioning

confidence: 80%

“…In the prospective series by Westman et al., antibodies were detectable only after 3 months in 10 of 12 positive cases. The rate of detection of anti‐NMDAR antibodies (IgG type) in patients with HSE was 9% and 25% respectively, in the two studies . In the prospective series by Westman et al., the development of anti‐NMDAR autoantibodies was associated with significantly impaired recovery of neurocognitive performance.…”

Section: Resultsmentioning

confidence: 89%

“…The detection of anti-NMDAR antibodies during or after an episode of HSE, in the absence of a clinical episode of anti-NMDAR encephalitis, was reported in 25 adult patients described in one retrospective and one prospective series (both had available full text; top part of Table SII, online supporting information). 9,34 All these patients had HSE confirmed by positive CSF HSV PCR, and positive anti-NMDAR antibodies in CSF and/or serum (n=25/25; 100%). In the prospective series by Westman et al, 34 antibodies were detectable only after 3 months in 10 of 12 positive cases.…”

Section: Main Differences Between Children and Adults During The Antimentioning

confidence: 97%

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Herpes simplex virus‐induced anti‐N‐methyl‐d‐aspartate receptor encephalitis: a systematic literature review with analysis of 43 cases

Nosadini

Mohammad

Corazza

et al. 2017

Develop Med Child Neuro

131

103

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Our review suggests that movement disorder may help differentiate clinically an episode of HSV-induced anti-NMDAR encephalitis from HSE relapse. Compared with adults, children have shorter latency between HSE and anti-NMDAR encephalitis and, during anti-NMDAR encephalitis, more movement disorder, fewer psychiatric symptoms, and slightly more severe disease. According to our results, immune therapy given for HSV-induced anti-NMDAR encephalitis does not predispose patients to HSE recurrence.

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Section: Discussionmentioning

confidence: 80%

Section: Resultsmentioning

confidence: 89%

Section: Main Differences Between Children and Adults During The Antimentioning

confidence: 97%

See 1 more Smart Citation

Herpes simplex virus‐induced anti‐N‐methyl‐d‐aspartate receptor encephalitis: a systematic literature review with analysis of 43 cases

Nosadini

Mohammad

Corazza

et al. 2017

Develop Med Child Neuro

131

103

View full text Add to dashboard Cite

show abstract

“…Anti-NMDAR encephalitis occurs also as post-HSE choreoathetosis [36]. There is a novel opinion that HSE plays a vital role in triggering the synthesis of anti-NMDAR antibodies, which has been confirmed by many investigators [3, 17, 37–40]. Those patients usually benefit from immunotherapy [38].…”

Section: Pathogenesismentioning

confidence: 99%

Anti-N-Methyl-D-aspartate Receptor Encephalitis: A Severe, Potentially Reversible Autoimmune Encephalitis

Liu

Zhu

Zheng

et al. 2017

Mediators of Inflammation

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Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is potentially lethal, but it is also a treatable autoimmune disorder characterized by prominent psychiatric and neurologic symptoms. It is often accompanied with teratoma or other neoplasm, especially in female patients. Anti-NMDAR antibodies in cerebrospinal fluid (CSF) and serum are characteristic features of the disease, thereby suggesting a pathogenic role in the disease. Here, we summarize recent studies that have clearly documented that both clinical manifestations and the antibodies may contribute to early diagnosis and multidisciplinary care. The clinical course of the disorder is reversible and the relapse could occur in some patients. Anti-NMDAR encephalitis coexisting with demyelinating disorders makes the diagnosis more complex; thus, clinicians should be aware of the overlapping diseases.

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“…Children often present with prominent choreoathetosis, abnormal behavior, and cognitive impairment: this syndrome appears identical to a primary NMDAR‐antibody encephalitis and distinctive from a relapse of HSVE . In adults, a similar pathophysiological phenomenon is observed but is not associated with a clear clinical relapse, rather a prolonged cognitive syndrome associated with a lower rate of abnormal movements . Mechanistically, the necrotic disease process of HSVE may release a variety of neuronal antigens, including neuronal surface proteins.…”

Section: The Nsab‐mediated Syndromes and Their Related Immunologymentioning

confidence: 99%

The clinical features, underlying immunology, and treatment of autoantibody‐mediated movement disorders

et al. 2018

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An increasing number of movement disorders are associated with autoantibodies. Many of these autoantibodies target the extracellular domain of neuronal surface proteins and associate with highly specific phenotypes, suggesting they have pathogenic potential. Below, we describe the phenotypes associated with some of these commoner autoantibody‐mediated movement disorders, and outline increasingly well‐established mechanisms of autoantibody pathogenicity which include antigen downregulation and complement fixation. Despite these advances, and the increasingly robust evidence for improved clinical outcomes with early escalation of immunotherapies, the underlying cellular immunology of these conditions has received little attention. Therefore, here, we outline the likely roles of T cells and B cells in the generation of autoantibodies, and reflect on how these may guide both current immunotherapy regimes and our future understanding of precision medicine in the field. In addition, we summarise potential mechanisms by which these peripherally‐driven immune responses may reach the central nervous system. We integrate this with the immunologically‐relevant clinical observations of preceding infections, tumours and human leucocyte antigen‐associations to provide an overview of the therapeutically‐relevant underlying adaptive immunology in the autoantibody‐mediated movement disorders. © 2018 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

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N -methyl- d -aspartate receptor autoimmunity affects cognitive performance in herpes simplex encephalitis

Abstract: Anti-NMDAR autoimmunity is a common complication to HSE that develops within 3 months after onset of disease. The association to impaired neurocognitive recovery could have therapeutical implications, as central nervous system autoimmunity is potentially responsive to immunotherapy.

Cited by 40 publications

References 29 publications

Herpes simplex virus‐induced anti‐N‐methyl‐d‐aspartate receptor encephalitis: a systematic literature review with analysis of 43 cases

Herpes simplex virus‐induced anti‐N‐methyl‐d‐aspartate receptor encephalitis: a systematic literature review with analysis of 43 cases

Anti-N-Methyl-D-aspartate Receptor Encephalitis: A Severe, Potentially Reversible Autoimmune Encephalitis

The clinical features, underlying immunology, and treatment of autoantibody‐mediated movement disorders

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