Specific B- and T-cell populations are associated with cognition in patients with epilepsy and antibody positive and negative suspected limbic encephalitis
| Autor: | Kerstin Schwing, Rainer Surges, Niels Hansen, Guido Widman, Pitshaporn Leelaarporn, Demet Oender, Juri-Alexander Witt, Albert J. Becker, Attila Rácz, Christoph Helmstaedter |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Adult medicine.medical_specialty Neurology B-cells Disease CD8-Positive T-Lymphocytes Antibodies 03 medical and health sciences Epilepsy 0302 clinical medicine Cognition Antigen Limbic Encephalitis medicine Humans Autoantibodies Original Communication business.industry T-cells Limbic encephalitis Autoantibody medicine.disease 030104 developmental biology Mood Cross-Sectional Studies Immunology Neurology (clinical) Verbal memory business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Neurology |
| ISSN: | 1432-1459 |
| Popis: | Objective Neuropsychological impairments are major symptoms of autoimmune limbic encephalitis (LE) epilepsy patients. In LE epilepsy patients with an autoimmune response against intracellular antigens as well as in antibody-negative patients, the antibody findings and magnetic resonance imaging pathology correspond poorly to the clinical features. Here, we evaluated whether T- and B-cells are linked to cognitive impairment in these groups. Methods In this cross-sectional, observational, case–controlled study, we evaluated 106 patients with adult-onset epilepsies with a suspected autoimmune etiology. We assessed verbal and visual memory, executive function, and mood in relation to the presence or absence of known auto-antibodies, and regarding T- and B-cell activity as indicated by flow cytometry (fluorescence-activated cell sorting = FACS, peripheral blood = PB and cerebrospinal fluid = CSF). Results 56% of the patients were antibody-negative. In the other patients, auto-antibodies were directed against intracellular antigens (GAD65, paraneoplastic: 38%), or cellular surface antigens (LGI1/CASPR2/NMDA-R: 6%). Excluding LGI1/CASPR2/NMDA-R, the groups with and without antibodies did not differ in disease features, cognition, or mood. CD4+ T-cells and CD8+ T-cells in blood and CD4+ T-cells in CSF were prominent in the auto-antibody positive group. Regression analyses indicated the role education, drug load, amygdala and/or hippocampal pathology, and CD4+ T-cells play in verbal memory and executive function. Depressed mood revealed no relation to flow cytometry results. Conclusion Our results indicate a link between T- and B-cell activity and cognition in epilepsy patients with suspected limbic encephalitis, thus suggesting that flow cytometry results can provide an understanding of cognitive impairment in LE patients with autoantibodies against intracellular antigens. |
| Databáze: | OpenAIRE |
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