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Neuronal surface autoantibodies in dementia: a systematic review and meta-analysis.

Published version
Peer-reviewed

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Authors

Gibson, Lucy L 
McKeever, Anna 
Cullen, Alexis E 
Nicholson, Timothy R 
Aarsland, Dag 

Abstract

INTRODUCTION: Neuronal antibodies can cause encephalopathy syndromes often presenting with subacute cognitive impairment, sometimes resembling neurodegenerative dementias. METHODS: We searched Medline and Embase for studies reporting associations between neuronal surface antibodies in all-cause dementia versus controls. Random-effects meta-analysis was used to pool adjusted estimates across studies. RESULTS: Six studies were included, all reporting frequency of serum NMDAR antibodies in dementia with four also reporting frequency in atypical dementias. Both IgG [OR = 8.09 (1.51; 56.85), p = 0.036] and IgA/IgM NMDAR antibodies [OR = 42.48 (11.39; 158.52), p < 0.001] were associated with atypical dementia, but neither were associated with all-cause dementia. DISCUSSION: In the first meta-analysis to explore this literature, serum IgG and IgA/IgM NMDAR antibodies were significantly more common in atypical dementias. However, methodological issues and small-sample sizes necessitate caution interpreting this result. Further studies measuring both serum and CSF antibodies are needed to investigate the role of neuronal antibodies in dementia, since evidence of pathogenicity in even a subset of patients could pave the way for novel treatment options.

Description

Funder: UCLH Biomedical Research Centre; doi: http://dx.doi.org/10.13039/501100012317


Funder: National Institute for Health Research; doi: http://dx.doi.org/10.13039/501100000272

Keywords

Antibodies in dementia, Atypical dementia, Autoimmune dementia, NMDAR antibody, Autoantibodies, Dementia, Humans, Immunoglobulin A, Immunoglobulin M, Receptors, N-Methyl-D-Aspartate

Journal Title

J Neurol

Conference Name

Journal ISSN

0340-5354
1432-1459

Volume Title

268

Publisher

Springer Science and Business Media LLC
Sponsorship
NARSAD Young Investigator Grant from the Brain & Behavior Research Foundation (28336)