Increased prevalence of diverse N-methyl-D-aspartate glutamate receptor antibodies in patients with an initial diagnosis of schizophrenia: specific relevance of IgG NR1a antibodies for distinction from N-methyl-D-aspartate glutamate receptor encephalitis.
Johann Steiner,Martin Walter,Wenzel Glanz,Zoltán Sarnyai,Hans-Gert Bernstein,Stefan Vielhaber,A. Kästner,Martin Skalej,Wolfgang Jordan,Kolja Schiltz,Christine Klingbeil,Klaus-Peter Wandinger,Bernhard Bogerts,Winfried Stoecker +13 more
Reads0
Chats0
TLDR
Acutely ill patients with an initial schizophrenia diagnosis show an increased prevalence of NMDA-R antibodies and the repertoire of antibody subtypes in schizophrenia and MD is different from that with NMda-R encephalitis.Abstract:
Context: Evidence for symptomatic convergence of schizophrenia and N-methyl-D-aspartate glutamate receptor (NMDA-R) encephalitis highlights the need for an assessment of antibody prevalence and specificity for distinct disease mechanisms in patients with a diagnosis of schizophrenia among glutamatergic pathophysiologic abnormalities in psychiatric disorders. Objectives: To compare the specificity and prevalence of NMDA-R antibodies in schizophrenia (DSM-IV criteria) with those of other psychiatric diagnoses and to determine whether antibody subtypes characterize overlap withanddistinctionfromthoseinNMDA-Rencephalitis. Design: Serum from 459 patients admitted with acute schizophrenia, major depression (MD), and borderline personality disorder (BLPD) or individuals serving as matched controls was obtained from our scientific blood bank. To explore epitope specificity and antibody subtype, IgA/IgG/IgM NMDA-R (NR1a or NR1a/NR2b) and -amino-3-hydroxyl-5-methyl-4-isoxazole-propionatereceptors(AMPA-R)(GluR1/GluR2)serumantibodieswere determined. Participants:Twohundredthirtymatchedhealthycontrols were compared with patients (unmedicated for at least6weeks)withschizophrenia(n=121),MD(n=70), or BLPD (n=38). Main Outcome Measures: The primary outcome was theoverallnumberofseropositivecasesforNMDA-Rand AMPA-R antibodies; the secondary outcome was disease specificity of IgA/IgG/IgM antibodies and epitope specificity for clinical subgroups. Results: Diverse NMDA-R antibodies were identified in 15 subjects, primarily those with an initial schizophrenia diagnosis (9.9%), opposed to MD (2.8%), BLPD (0), and controls (0.4%). Retrospectively, 2 patients initially classifiedashavingcatatonicordisorganizedschizophreniawere reclassified as having misdiagnosed NMDA-R encephalitis(presenceofspecificserumandcerebrospinalfluidIgG NR1a antibodies). In all other seropositive cases, the antibodies consisted of classes IgA and/or IgM or were directedagainstNR1a/NR2b(notagainstNR1aalone).None ofthepatientsorcontrolshadantibodiesagainstAMPA-R. Conclusions: Acutely ill patients with an initial schizophrenia diagnosis show an increased prevalence of NMDA-R antibodies. The repertoire of antibody subtypesinschizophreniaandMDisdifferentfromthatwith NMDA-Rencephalitis.Thelatterdisordershouldbeconsidered as a differential diagnosis, particularly in young females with acute disorganized behavior or catatonia.read more
Citations
More filters
Journal ArticleDOI
The effects of blood serum from schizophrenia patients under olanzapine monotherapy on the ultrastructure of astrocytes in human fetal brain organotypic culture
TL;DR: BS from patients with schizophrenia before and after olanzapine treatment induced opposite types of ultrastructural changes of astrocytes in the human fetal brain organotypic culture.
Journal ArticleDOI
[Effects of schizophrenic blood serum on astrocytes in human fetal brain organotypic culture: a morphometric study].
TL;DR: The application of BS from untreated schizophrenia patients does not influence the cell survival in human fetal brain organotypic culture and the ultrastructure of neurons and neuropil but induces the hypotrophy of astrocytes and increase in the number of lypofuscin inclusions.
Book ChapterDOI
Störung des Denkens (schizophrene Psychose)
TL;DR: Storungen des Denkens und Halluzinationen konnen auf eine schizophrene Erkrankung hinweisen. Allerdings, in der Anfangsphase, eine ahnliche Symptomatik aufweisen, so sollte der Arzt zum Beispiel auch an Enzephalitiden aufgrund von Infektionen oder an Autoimmunerkrankungen denken und diese in die differenzialdiagnostischen Uberlegungen
Journal ArticleDOI
When the body attacks the brain
TL;DR: This issue of the Journal also looks at childhood disorders, from several different perspectives, and immune dysregulation and autoimmunity in bipolar disorder, concluding that the links between these conditions are closer than previously thought.
Journal ArticleDOI
Is Schizophrenia a Neuroinflammatory Disorder
TL;DR: Genetic association and peripheral blood immune studies have suggested that neuroinflammation plays a pathophysiologic role in schizophrenia; a link between these studies and clinical practice is suggested.
References
More filters
Journal Article
The Mini-International Neuropsychiatric Interview (M.I.N.I.) : The development and validation of a Structured Diagnostic Psychiatric Interview for DSM-IV and ICD-10
David V. Sheehan,Yves Lecrubier,Kathy Harnett Sheehan,P. Amorim,J. Janavs,Emmanuelle Weiller,T. Hergueta,Ross A. Baker,Dunbar Geoffrey Charles +8 more
TL;DR: The Mini-International Neuropsychiatric Interview is designed to meet the need for a short but accurate structured psychiatric interview for multicenter clinical trials and epidemiology studies and to be used as a first step in outcome tracking in nonresearch clinical settings.
Journal ArticleDOI
Subanesthetic effects of the noncompetitive NMDA antagonist, ketamine, in humans: Psychotomimetic, perceptual, cognitive, and neuroendocrine responses.
John H. Krystal,Laurence P. Karper,John Seibyl,Glenna K. Freeman,Richard C. Delaney,J. Douglas Bremner,George R. Heninger,Malcolm B. Bowers,Dennis S. Charney +8 more
TL;DR: These data indicate that N-methyl-D-aspartate antagonists produce a broad range of symptoms, behaviors, and cognitive deficits that resemble aspects of endogenous psychoses, particularly schizophrenia and dissociative states.
Journal ArticleDOI
Recent advances in the phencyclidine model of schizophrenia.
TL;DR: It was found that PCP-induced psychotomimetic effects are associated with submicromolar serum concentrations of PCP and the findings suggest that endogenous dysfunction of NMDA receptor-mediated neurotransmission might contribute to the pathogenesis of schizophrenia.
Book
Dementia praecox and paraphrenia
TL;DR: "Dementia Praecox and Paraphrenia" (1919) was the book in which Kraepelin first presented his work on schizophrenia to the English-speaking world, and it was probably the most influential psychiatric text of the entire 20th century, and has now become rare.
Related Papers (5)
Treatment and prognostic factors for long-term outcome in patients with anti-NMDA receptor encephalitis: an observational cohort study
Maarten J. Titulaer,Lindsey McCracken,Iñigo Gabilondo,Thaís Armangue,Carol A. Glaser,Takahiro Iizuka,Lawrence S. Honig,Susanne M. Benseler,Izumi Kawachi,Eugenia Martinez-Hernandez,Eugenia Martinez-Hernandez,Esther Aguilar,Nuria Gresa-Arribas,Nicole Ryan-Florance,Abiguei Torrents,Albert Saiz,Myrna R. Rosenfeld,Myrna R. Rosenfeld,Rita J. Balice-Gordon,Francesc Graus,Josep Dalmau,Josep Dalmau,Josep Dalmau +22 more