Browsing by Author "Zong, Shenghua"
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- Autoimmune encephalitis With mGluR1 antibodies presenting with Epilepsy, but without cerebellar signsPublication . Vinke, Anita M.; Zong, Shenghua; Janssen, Josien H.; Hoffmann, Carolin Correia; Mané-Damas, Marina; Damoiseaux, Jan G.M.C.; de Vries, J.M.; Pröpper, Dirk; Molenaar, Peter; Losen, Mario; Martinez Martinez, Pilar; Rouhl, Rob P.W.Objective To describe the unique case history of a patient with mGluR1 antibodies, with mainly limbic and without cerebellar symptoms. Methods A 50-year-old woman initially presented with focal seizures with epigastric rising and deja-vu sensations, next to cognitive complaints, and musical auditory hallucinations. MRI, EEG, and neuronal autoantibody tests were performed. Results EEG findings showed slow and sharp activity (sharp waves and sharp-wave-slow-wave complex) in the left temporal lobe. A test for autoantibodies was negative initially. Because of persistent symptoms, serum and CSF were tested 4 years later and found positive for mGluR1 antibodies. Treatment started with monthly IV immunoglobulins and azathioprine that was replaced by mycophenolate mofetil later. Especially cognitive symptoms and hallucinations did not respond well to the treatment. During treatment, mGluR1 antibodies remained present in CSF. Discussion Whereas cerebellar symptoms are present in 97% of mGluR1-positive cases, our patient presented without ataxia. Therefore, we suggest that the clinical presentation of patients with mGluR1 antibodies is probably more diverse than previously described. Testing for mGluR1 antibodies should be considered in patients with limbic encephalitis and epilepsy, especially when negative for more common antibodies.
- Novel neuronal surface autoantibodies in plasma of patients with depression and anxietyPublication . Zong, Shenghua; Hoffmann, Carolin Correia; Mané-Damas, Marina; Kappelmann, Nils; Molenaar, Peter C.; van Grootheest, Gerard; Penninx, Brenda W. J. H.; Rouhl, Rob P. W.; Losen, Mario; Martinez-Martinez, PilarNeuronal surface autoantibodies (NSAbs) against various antigens cause autoimmune encephalitis. Some of these antigens are also involved in the pathology of depression and anxiety. To study whether NSAbs are more common in plasma of individuals with depression and anxiety than in controls, and to investigate if NSAbs correlate with disease status, plasma samples of 819 individuals with a current diagnosis of depression and/or anxiety, 920 in remission and 492 individuals without these disorders were included in this study. Samples were tested by a combination of immunohistochemistry (IHC), staining on live rat hippocampus neurons and cell-based assay (CBA). By IHC, 50 (2.2%) samples showed immunoreactivity to rat brain tissue, with no significant differences between the aforementioned groups (22/819 vs 18/920 vs 11/492, P > 0.99). In addition, eight IHC positive samples were positive for NSAbs on live neurons (7/819 vs 0/920 vs 1/492, P = 0.006). The IHC-staining patterns of these eight samples were atypical for autoimmune encephalitis and accordingly, they tested negative for known NSAbs by CBA. No obvious difference in the clinical characteristics between individuals with or without NSAbs was observed. In conclusion, novel NSAbs were rare but predominately found in patients with current anxiety or depression indicating they might affect mental health in a small group of patients.
- The search for an autoimmune origin of psychotic disorders: prevalence of autoantibodies against hippocampus antigens, glutamic acid decarboxylase and nuclear antigensPublication . Hoffmann, Carolin Correia; Zong, Shenghua; Mané-Damas, Marina; Stevens, Jo; Malyavantham, Kishore; Küçükali, Cem İsmail; Tüzün, Erdem; De Hert, Marc; van Beveren, Nico J.M.; González-Vioque, Emiliano; Arango, Celso; Damoiseaux, Jan G.M.C.; Rutten, Bart P.; Molenaar, Peter C.; Losen, Mario; Martinez-Martinez, PilarThe etiology of psychotic disorders is still unknown, but in a subgroup of patients symptoms might be caused by an autoimmune reaction. In this study, we tested patterns of autoimmune reactivity against potentially novel hippocampal antigens. Serum of a cohort of 621 individuals with psychotic disorders and 257 controls were first tested for reactivity on neuropil of rat brain sections. Brain reactive sera (67 diseased, 27 healthy) were further tested for antibody binding to glutamic acid decarboxylase (GAD) isotype 65 and 67 by cell-based assay (CBA). A sub-cohort of 199 individuals with psychotic disorders and 152 controls was tested for the prevalence of anti-nuclear antibodies (ANA) on HEp2-substrate as well as for reactivity to double-stranded DNA, ribosomal P (RPP), and cardiolipin (CL). Incubation of rat brain with serum resulted in unidentified hippocampal binding patterns in both diseased and control groups. Upon screening with GAD CBA, one of these patterns was identified as GAD65 in one individual with schizophrenia and also in one healthy individual. Two diseased and two healthy individuals had low antibody levels targeting GAD67 by CBA. Antibody reactivity on HEp-2-substrate was increased in patients with schizoaffective disorder, but only in 3 patients did antibody testing hint at a possible diagnosis of systemic lupus erythematosus. Although reactivity of serum to intracellular antigens might be increased in patients with psychotic disorder, no specific targets could be identified. GAD antibodies are very rare and do not seem increased in serum of patients with psychotic disorders.