Mesial temporal lobe epilepsy with hippocampal sclerosis is infrequently associated with neuronal autoantibodies

Adaucto W. Nóbrega-Jr*, Christian P. Gregory, Rachel Schlindwein-Zanini, Fabricio de Souza Neves, Peter Wolf, Roger Walz, Mario Steindel, Katia Lin

*Corresponding author for this work

Research output: Contribution to journalLetterResearchpeer-review

Abstract

Mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) is characterized by its well-defined clinical profile. Limbic encephalitis is increasingly recognized as a possible etiology of adult-onset MTLE-HS, and neuronal autoantibodies have been detected in patients even without previous signs of encephalitis. The aim of this study is to analyze the frequency of specific autoantibodies in patients with MTLE-HS. A case-control study was carried out with 100 patients with MTLE-HS and 50 healthy controls. Sera samples from subjects were tested by indirect immunofluorescence assay for detection of anti-N-methyl-d-aspartate receptor (NMDA-R), anti-contactin-associated protein-like 2 (CASPR2), anti-leucine-rich glioma inactivated 1 (LGI1), anti-gamma aminobutyric acid B receptor (GABA-B-R), anti-alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid 1 and 2 receptors (AMPA-1-R and AMPA-2-R), and enzyme-linked immunosorbent assay for detection of anti-glutamic acid decarboxylase 65 (GAD65). Mean age of patients and controls was 41.2 vs 42 years, and 55% vs 56% were female. Mean duration of epilepsy was 27.2 years. No neuronal autoantibodies were found in either group, except for anti-GAD65 in 3 patients and 2 controls. This study adds to the mounting evidence that, in Brazilian patients, MTLE-HS without signs and symptoms of autoimmune encephalitis may be infrequently associated with these autoantibodies. Differences regarding accuracy of used methodologies for autoantibody detection and genetic and environmental characteristics are discussed. Further works with different methodologies tested simultaneously in different populations may help clarify the incongruent study results about autoantibodies in MTLE-HS.

Original languageEnglish
JournalEpilepsia
Volume59
Issue number9
Pages (from-to)e152-e156
ISSN0013-9580
DOIs
Publication statusPublished - Sep 2018

Fingerprint

Temporal Lobe Epilepsy
Sclerosis
Glutamate Decarboxylase
Limbic Encephalitis
alpha-Amino-3-hydroxy-5-methyl-4-isoxazolepropionic Acid
GABA Receptors
Indirect Fluorescent Antibody Technique
Leucine
Glioma
Case-Control Studies
Serum
Population
Proteins

Keywords

  • autoantibodies
  • hippocampal sclerosis
  • temporal lobe epilepsy
  • Autoantibodies/blood
  • Hippocampus/pathology
  • Nerve Tissue Proteins/immunology
  • Sclerosis/blood
  • Humans
  • Middle Aged
  • Male
  • Receptors, Ionotropic Glutamate/immunology
  • Case-Control Studies
  • Membrane Proteins/immunology
  • Young Adult
  • Glutamate Decarboxylase/immunology
  • Adolescent
  • Adult
  • Female
  • Aged
  • Epilepsy, Temporal Lobe/blood

Cite this

Nóbrega-Jr, A. W., Gregory, C. P., Schlindwein-Zanini, R., Neves, F. D. S., Wolf, P., Walz, R., ... Lin, K. (2018). Mesial temporal lobe epilepsy with hippocampal sclerosis is infrequently associated with neuronal autoantibodies. Epilepsia, 59(9), e152-e156. https://doi.org/10.1111/epi.14534
Nóbrega-Jr, Adaucto W. ; Gregory, Christian P. ; Schlindwein-Zanini, Rachel ; Neves, Fabricio de Souza ; Wolf, Peter ; Walz, Roger ; Steindel, Mario ; Lin, Katia. / Mesial temporal lobe epilepsy with hippocampal sclerosis is infrequently associated with neuronal autoantibodies. In: Epilepsia. 2018 ; Vol. 59, No. 9. pp. e152-e156.
@article{471d0101ec82473c9449ac15513e0ffb,
title = "Mesial temporal lobe epilepsy with hippocampal sclerosis is infrequently associated with neuronal autoantibodies",
abstract = "Mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) is characterized by its well-defined clinical profile. Limbic encephalitis is increasingly recognized as a possible etiology of adult-onset MTLE-HS, and neuronal autoantibodies have been detected in patients even without previous signs of encephalitis. The aim of this study is to analyze the frequency of specific autoantibodies in patients with MTLE-HS. A case-control study was carried out with 100 patients with MTLE-HS and 50 healthy controls. Sera samples from subjects were tested by indirect immunofluorescence assay for detection of anti-N-methyl-d-aspartate receptor (NMDA-R), anti-contactin-associated protein-like 2 (CASPR2), anti-leucine-rich glioma inactivated 1 (LGI1), anti-gamma aminobutyric acid B receptor (GABA-B-R), anti-alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid 1 and 2 receptors (AMPA-1-R and AMPA-2-R), and enzyme-linked immunosorbent assay for detection of anti-glutamic acid decarboxylase 65 (GAD65). Mean age of patients and controls was 41.2 vs 42 years, and 55{\%} vs 56{\%} were female. Mean duration of epilepsy was 27.2 years. No neuronal autoantibodies were found in either group, except for anti-GAD65 in 3 patients and 2 controls. This study adds to the mounting evidence that, in Brazilian patients, MTLE-HS without signs and symptoms of autoimmune encephalitis may be infrequently associated with these autoantibodies. Differences regarding accuracy of used methodologies for autoantibody detection and genetic and environmental characteristics are discussed. Further works with different methodologies tested simultaneously in different populations may help clarify the incongruent study results about autoantibodies in MTLE-HS.",
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author = "N{\'o}brega-Jr, {Adaucto W.} and Gregory, {Christian P.} and Rachel Schlindwein-Zanini and Neves, {Fabricio de Souza} and Peter Wolf and Roger Walz and Mario Steindel and Katia Lin",
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Nóbrega-Jr, AW, Gregory, CP, Schlindwein-Zanini, R, Neves, FDS, Wolf, P, Walz, R, Steindel, M & Lin, K 2018, 'Mesial temporal lobe epilepsy with hippocampal sclerosis is infrequently associated with neuronal autoantibodies', Epilepsia, vol. 59, no. 9, pp. e152-e156. https://doi.org/10.1111/epi.14534

Mesial temporal lobe epilepsy with hippocampal sclerosis is infrequently associated with neuronal autoantibodies. / Nóbrega-Jr, Adaucto W.; Gregory, Christian P.; Schlindwein-Zanini, Rachel; Neves, Fabricio de Souza; Wolf, Peter; Walz, Roger; Steindel, Mario; Lin, Katia.

In: Epilepsia, Vol. 59, No. 9, 09.2018, p. e152-e156.

Research output: Contribution to journalLetterResearchpeer-review

TY - JOUR

T1 - Mesial temporal lobe epilepsy with hippocampal sclerosis is infrequently associated with neuronal autoantibodies

AU - Nóbrega-Jr, Adaucto W.

AU - Gregory, Christian P.

AU - Schlindwein-Zanini, Rachel

AU - Neves, Fabricio de Souza

AU - Wolf, Peter

AU - Walz, Roger

AU - Steindel, Mario

AU - Lin, Katia

PY - 2018/9

Y1 - 2018/9

N2 - Mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) is characterized by its well-defined clinical profile. Limbic encephalitis is increasingly recognized as a possible etiology of adult-onset MTLE-HS, and neuronal autoantibodies have been detected in patients even without previous signs of encephalitis. The aim of this study is to analyze the frequency of specific autoantibodies in patients with MTLE-HS. A case-control study was carried out with 100 patients with MTLE-HS and 50 healthy controls. Sera samples from subjects were tested by indirect immunofluorescence assay for detection of anti-N-methyl-d-aspartate receptor (NMDA-R), anti-contactin-associated protein-like 2 (CASPR2), anti-leucine-rich glioma inactivated 1 (LGI1), anti-gamma aminobutyric acid B receptor (GABA-B-R), anti-alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid 1 and 2 receptors (AMPA-1-R and AMPA-2-R), and enzyme-linked immunosorbent assay for detection of anti-glutamic acid decarboxylase 65 (GAD65). Mean age of patients and controls was 41.2 vs 42 years, and 55% vs 56% were female. Mean duration of epilepsy was 27.2 years. No neuronal autoantibodies were found in either group, except for anti-GAD65 in 3 patients and 2 controls. This study adds to the mounting evidence that, in Brazilian patients, MTLE-HS without signs and symptoms of autoimmune encephalitis may be infrequently associated with these autoantibodies. Differences regarding accuracy of used methodologies for autoantibody detection and genetic and environmental characteristics are discussed. Further works with different methodologies tested simultaneously in different populations may help clarify the incongruent study results about autoantibodies in MTLE-HS.

AB - Mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) is characterized by its well-defined clinical profile. Limbic encephalitis is increasingly recognized as a possible etiology of adult-onset MTLE-HS, and neuronal autoantibodies have been detected in patients even without previous signs of encephalitis. The aim of this study is to analyze the frequency of specific autoantibodies in patients with MTLE-HS. A case-control study was carried out with 100 patients with MTLE-HS and 50 healthy controls. Sera samples from subjects were tested by indirect immunofluorescence assay for detection of anti-N-methyl-d-aspartate receptor (NMDA-R), anti-contactin-associated protein-like 2 (CASPR2), anti-leucine-rich glioma inactivated 1 (LGI1), anti-gamma aminobutyric acid B receptor (GABA-B-R), anti-alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid 1 and 2 receptors (AMPA-1-R and AMPA-2-R), and enzyme-linked immunosorbent assay for detection of anti-glutamic acid decarboxylase 65 (GAD65). Mean age of patients and controls was 41.2 vs 42 years, and 55% vs 56% were female. Mean duration of epilepsy was 27.2 years. No neuronal autoantibodies were found in either group, except for anti-GAD65 in 3 patients and 2 controls. This study adds to the mounting evidence that, in Brazilian patients, MTLE-HS without signs and symptoms of autoimmune encephalitis may be infrequently associated with these autoantibodies. Differences regarding accuracy of used methodologies for autoantibody detection and genetic and environmental characteristics are discussed. Further works with different methodologies tested simultaneously in different populations may help clarify the incongruent study results about autoantibodies in MTLE-HS.

KW - autoantibodies

KW - hippocampal sclerosis

KW - temporal lobe epilepsy

KW - Autoantibodies/blood

KW - Hippocampus/pathology

KW - Nerve Tissue Proteins/immunology

KW - Sclerosis/blood

KW - Humans

KW - Middle Aged

KW - Male

KW - Receptors, Ionotropic Glutamate/immunology

KW - Case-Control Studies

KW - Membrane Proteins/immunology

KW - Young Adult

KW - Glutamate Decarboxylase/immunology

KW - Adolescent

KW - Adult

KW - Female

KW - Aged

KW - Epilepsy, Temporal Lobe/blood

U2 - 10.1111/epi.14534

DO - 10.1111/epi.14534

M3 - Letter

C2 - 30146688

AN - SCOPUS:85052449480

VL - 59

SP - e152-e156

JO - Epilepsia

JF - Epilepsia

SN - 0013-9580

IS - 9

ER -

Nóbrega-Jr AW, Gregory CP, Schlindwein-Zanini R, Neves FDS, Wolf P, Walz R et al. Mesial temporal lobe epilepsy with hippocampal sclerosis is infrequently associated with neuronal autoantibodies. Epilepsia. 2018 Sep;59(9):e152-e156. https://doi.org/10.1111/epi.14534