Anti-NMDA-receptor antibody detected in encephalitis, schizophrenia, and narcolepsy with psychotic features

BMC Psychiatry

Research Article

Akane Mori¹  Takashi Kanbayashi¹  Ko Tsutsui¹  Tetsuo Shimizu¹  Jun Tokunaga¹  Wakako Ito²  Yasuo Hishikawa³  Keiko Tanaka⁴  Shuken Boku⁵  Seiji Nishino⁶ 

[1] Akita University, Department of Neuropsychiatry, Akita, Japan;Akita University, Department of Neuropsychiatry, Akita, Japan;Department of Exercise Science, University of South Carolina, ColumbiaSC, USA;Akita University, Department of Neuropsychiatry, Akita, Japan;Department of Psychiatry, Akita Kaiseikai Hospital, Akita, Japan;Department of Neurology, Kanazawa Medical University, Ishikawa, Japan;Department of Neuropsychiatry, Hokkaido University, Sapporo, Japan;Sleep and Circadian Neurobiology Laboratory, Stanford University, Palo Alto, CA, USA;

关键词: Schizophrenia;    Encephalitis;    Psychotic Symptom;    Narcolepsy;    Limbic Encephalitis;   

DOI  :  10.1186/1471-244X-12-37

 received in 2011-09-27, accepted in 2012-03-30,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundCausative role of encephalitis in major psychotic features, dyskinesias (particularly orofacial), seizures, and autonomic and respiratory changes has been recently emphasized. These symptoms often occur in young females with ovarian teratomas and are frequently associated with serum and CSF autoantibodies to the NMDA receptor (NMDAR).MethodsThe study included a total of 61 patients from age 15 to 61 and was carried out between January 1, 2005, and Dec 31, 2010. The patients were divided into the following three clinical groups for comparison. Group A; Patients with typical clinical characteristics of anti-NMDAR encephalitis. Group B; Patients with narcolepsy with severe psychosis. Group C; Patients with schizophrenia or schizo-affective disorders.ResultsTen out of 61 cases were anti-NMDAR antibody positive in typical encephalitis cases (group A: 3 of 5 cases) and cases in a broader range of psychiatric disorders including narcolepsy (group B: 3 of 5 cases) and schizophrenia (group C: 4 of 51 cases).ConclusionIn addition to 3 typical cases, we found 7 cases with anti-NMDAR antibody associated with various psychotic and sleep symptoms, which lack any noticeable clinical signs of encephalitis (seizures and autonomic symptoms) throughout the course of the disease episodes; this result suggest that further discussion on the nosology and pathophysiology of autoimmune-mediated atypical psychosis and sleep disorders is required.

【 授权许可】

Unknown   
© Tsutsui et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.