Autoantibodies to the N-Methyl-D-Aspartate Receptor in Adolescents with Early Onset Psychosis and Healthy Controls
Laura Anne Wortinger,
Kjetil Nordbø Jørgensen,
Runar Elle Smelror,
Anne Margrethe Myhre,
Posted 10 Jan 2020
medRxiv DOI: 10.1101/2020.01.06.20016626
Posted 10 Jan 2020
BackgroundAutoantibodies to the N-methyl-D-aspartate receptor (NMDAR-Abs) in autoimmune encephalitis have been associated with prominent psychiatric symptoms. The aims of the present study are to identify the prevalence of NMDAR-Abs in adolescents with early onset psychosis disorders (EOP) and healthy controls (HC) and examine its clinical significance. MethodPlasma samples were acquired from 46 adolescent EOP patients and 69 age- and sex matched HC, and assessed for the presence of immunoglobulin G NMDAR-Abs. All participants underwent psychiatric evaluation, neurological examination and head magnetic resonance imaging. ResultsNMDAR-Abs were detected in three of 46 (6.5%) EOP patients and in two of 69 (2.9%) HC. One NMDAR-Abs EOP patient presented with unusual psychopathology and minor T1 weighted lesions of vasculopathological origin located bi-frontally and in the basal ganglia, and had a recent diagnosis of a separate autoimmune disease. One NMDAR-Abs HC displayed a T2 weighted FLAIR hyperintensity lesion in the left frontal lobe. The remaining three NMDAR-Abs participants were two EOP patients without neurological or radiological findings, and one HC without any clinical findings. ConclusionsWe report the presence of NMDAR-Abs in both adolescent EOP patients and HC, similar to the incidence in other studies. This may support the hypothesis of an immunological disease component in a small proportion of adolescent psychosis, but the positive antibody tests must be carefully interpreted and reviewed within the individual clinical context.
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