Neuronal autoantibodies in mesial temporal lobe epilepsy with hippocampal sclerosis

Autor: Ebru Nur Vanlı-Yavuz, Ece Erdağ, Sian Peach, Leyla Baysal-Kirac, Canan Ulusoy, Gokcen Gundogdu, Cem İsmail Küçükali, Betül Baykan, Esme Ekizoglu, Candan Gürses, Nerses Bebek, Aysen Gokyigit, Serra Sencer, Altay Sencer, Erdem Tüzün
Rok vydání: 2016
Předmět:
0301 basic medicine
Adult
Male
Pathology
medicine.medical_specialty
Psychosis
Drug Resistant Epilepsy
Cross-sectional study
Status epilepticus
Gastroenterology
Hippocampus
03 medical and health sciences
Epilepsy
0302 clinical medicine
Status Epilepticus
Reference Values
Internal medicine
Image Interpretation
Computer-Assisted
medicine
Humans
Autoantibodies
Neurons
Hippocampal sclerosis
Sclerosis
business.industry
Autoantibody
Middle Aged
medicine.disease
Magnetic Resonance Imaging
nervous system diseases
Psychiatry and Mental health
030104 developmental biology
Cross-Sectional Studies
Epilepsy
Temporal Lobe
Psychotic Disorders
Potassium Channels
Voltage-Gated
Epilepsy syndromes
Immunohistochemistry
Surgery
Female
Neurology (clinical)
medicine.symptom
business
Cognition Disorders
030217 neurology & neurosurgery
Follow-Up Studies
Zdroj: Journal of neurology, neurosurgery, and psychiatry. 87(7)
ISSN: 1468-330X
Popis: Objective Our aim was to investigate the prevalence of neuronal autoantibodies (NAbs) in a large consecutive series with mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) and to elucidate the clinical and laboratory clues for detection of NAbs in this prototype of frequent, drug-resistant epilepsy syndrome. Methods Consecutive patients diagnosed with MTLE fulfilling the MRI criteria for HS were enrolled. The sera of patients and various control groups (80 subjects) were tested for eight NAbs after ethical approval and signed consents. Brain tissues obtained from surgical specimens were also investigated by immunohistochemical analysis for the presence of inflammatory infiltrates. The features of seropositive versus seronegative groups were compared and binary logistic regression analysis was performed to explore the differentiating variables. Results We found antibodies against antigens, contactin-associated protein-like 2 in 11 patients, uncharacterised voltage-gated potassium channel (VGKC)-complex antigens in four patients, glycine receptor (GLY-R) in 5 patients, N -methyl-d-aspartate receptor in 4 patients and γ-aminobutyric acid receptor A in 1 patient of 111 patients with MTLE-HS and none of the control subjects. The history of status epilepticus, diagnosis of psychosis and positron emission tomography or single-photon emission CT findings in temporal plus extratemporal regions were found significantly more frequently in the seropositive group. Binary logistic regression analysis disclosed that status epilepticus, psychosis and cognitive dysfunction were statistically significant variables to differentiate between the VGKC-complex subgroup versus seronegative group. Conclusions This first systematic screening study of various NAbs showed 22.5% seropositivity belonging mostly to VGKC-complex antibodies in a large consecutive series of patients with MTLE-HS. Our results indicated a VGKC-complex autoimmunity-related subgroup in the syndrome of MTLE-HS.
Databáze: OpenAIRE
Externí odkaz: