Prevalence of Neural Autoantibodies in Paired Serum and Cerebrospinal Fluid in Adult Patients with Drug-Resistant Temporal Lobe Epilepsy of Unknown Etiology

In order to determine the prevalence of neural autoantibodies in adult patients with drug-resistant temporal lobe epilepsy (DRTLE) of unknown etiology, we compared the characteristics of patients with and without autoantibodies and applied antibody predictive scores to the patients. Patients aged ≥1...

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Autores principales:	Pablo Cabezudo-García, Nicolás L. Ciano-Petersen, Natalia Mena-Vázquez, Jesús Ortega-Pinazo, María J. Postigo-Pozo, Guillermina García-Martín, Helena Antolí-Martínez, Violeta Sánchez-Sánchez, Pablo Quiroga-Subirana, Pedro J. Serrano-Castro, Guillermo Estivill-Torrús
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	autoimmune epilepsy autoimmune-associated epilepsy drug-resistant epilepsy temporal lobe epilepsy neural autoantibodies prevalence Medicine R
Acceso en línea:	https://doaj.org/article/06679057732242eb8f2c7f94cb98ebd8
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spelling	oai:doaj.org-article:06679057732242eb8f2c7f94cb98ebd82021-11-11T17:30:39ZPrevalence of Neural Autoantibodies in Paired Serum and Cerebrospinal Fluid in Adult Patients with Drug-Resistant Temporal Lobe Epilepsy of Unknown Etiology10.3390/jcm102148432077-0383https://doaj.org/article/06679057732242eb8f2c7f94cb98ebd82021-10-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/4843https://doaj.org/toc/2077-0383In order to determine the prevalence of neural autoantibodies in adult patients with drug-resistant temporal lobe epilepsy (DRTLE) of unknown etiology, we compared the characteristics of patients with and without autoantibodies and applied antibody predictive scores to the patients. Patients aged ≥18 years with DRTLE of unknown etiology and ≥12 months of evolution were prospectively recruited. Neural autoantibodies in serum and CSF were systematically determined in all patients. We created the ARTE (antibody in drug-resistant temporal lobe epilepsy) score based on the variables associated with the presence of neural autoantibodies. Twenty-seven patients were included. The mean (SD) age in years at the index date was 52 (±14.2) and at epilepsy onset was 32 (±17.1). The mean epilepsy duration was 19 (±12.5) years. Neural autoantibodies were detected in 51.85% (14/27) of patients. The presence of bitemporal, independent, interictal epileptiform discharges (BIIED) had a higher frequency in patients with neural autoantibodies (57.1% vs. 15.4%; <i>p</i> = 0.025) as well as those patients with a previous history of status epilepticus (49.2% vs. 0.0%; <i>p</i> = 0.007). The ARTE score showed an area under the curve (AUC) of 0.854. Using a cut-off point of ≥1, the sensitivity was 100% and the specificity was 46.1%, whereas when using a cut-off point of ≥3, the results were 35.7% and 100%, respectively. We found a high prevalence of neural autoantibodies in patients with DRTLE of unknown etiology, indicating an autoimmune mechanism. The presence of BIIED and a history of SE in DRTLE of unknown etiology are possible markers for autoimmune-associated epilepsy. The proposed ARTE score requires future validation in larger independent cohorts.Pablo Cabezudo-GarcíaNicolás L. Ciano-PetersenNatalia Mena-VázquezJesús Ortega-PinazoMaría J. Postigo-PozoGuillermina García-MartínHelena Antolí-MartínezVioleta Sánchez-SánchezPablo Quiroga-SubiranaPedro J. Serrano-CastroGuillermo Estivill-TorrúsMDPI AGarticleautoimmune epilepsyautoimmune-associated epilepsydrug-resistant epilepsytemporal lobe epilepsyneural autoantibodiesprevalenceMedicineRENJournal of Clinical Medicine, Vol 10, Iss 4843, p 4843 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	autoimmune epilepsy autoimmune-associated epilepsy drug-resistant epilepsy temporal lobe epilepsy neural autoantibodies prevalence Medicine R
spellingShingle	autoimmune epilepsy autoimmune-associated epilepsy drug-resistant epilepsy temporal lobe epilepsy neural autoantibodies prevalence Medicine R Pablo Cabezudo-García Nicolás L. Ciano-Petersen Natalia Mena-Vázquez Jesús Ortega-Pinazo María J. Postigo-Pozo Guillermina García-Martín Helena Antolí-Martínez Violeta Sánchez-Sánchez Pablo Quiroga-Subirana Pedro J. Serrano-Castro Guillermo Estivill-Torrús Prevalence of Neural Autoantibodies in Paired Serum and Cerebrospinal Fluid in Adult Patients with Drug-Resistant Temporal Lobe Epilepsy of Unknown Etiology
description	In order to determine the prevalence of neural autoantibodies in adult patients with drug-resistant temporal lobe epilepsy (DRTLE) of unknown etiology, we compared the characteristics of patients with and without autoantibodies and applied antibody predictive scores to the patients. Patients aged ≥18 years with DRTLE of unknown etiology and ≥12 months of evolution were prospectively recruited. Neural autoantibodies in serum and CSF were systematically determined in all patients. We created the ARTE (antibody in drug-resistant temporal lobe epilepsy) score based on the variables associated with the presence of neural autoantibodies. Twenty-seven patients were included. The mean (SD) age in years at the index date was 52 (±14.2) and at epilepsy onset was 32 (±17.1). The mean epilepsy duration was 19 (±12.5) years. Neural autoantibodies were detected in 51.85% (14/27) of patients. The presence of bitemporal, independent, interictal epileptiform discharges (BIIED) had a higher frequency in patients with neural autoantibodies (57.1% vs. 15.4%; <i>p</i> = 0.025) as well as those patients with a previous history of status epilepticus (49.2% vs. 0.0%; <i>p</i> = 0.007). The ARTE score showed an area under the curve (AUC) of 0.854. Using a cut-off point of ≥1, the sensitivity was 100% and the specificity was 46.1%, whereas when using a cut-off point of ≥3, the results were 35.7% and 100%, respectively. We found a high prevalence of neural autoantibodies in patients with DRTLE of unknown etiology, indicating an autoimmune mechanism. The presence of BIIED and a history of SE in DRTLE of unknown etiology are possible markers for autoimmune-associated epilepsy. The proposed ARTE score requires future validation in larger independent cohorts.
format	article
author	Pablo Cabezudo-García Nicolás L. Ciano-Petersen Natalia Mena-Vázquez Jesús Ortega-Pinazo María J. Postigo-Pozo Guillermina García-Martín Helena Antolí-Martínez Violeta Sánchez-Sánchez Pablo Quiroga-Subirana Pedro J. Serrano-Castro Guillermo Estivill-Torrús
author_facet	Pablo Cabezudo-García Nicolás L. Ciano-Petersen Natalia Mena-Vázquez Jesús Ortega-Pinazo María J. Postigo-Pozo Guillermina García-Martín Helena Antolí-Martínez Violeta Sánchez-Sánchez Pablo Quiroga-Subirana Pedro J. Serrano-Castro Guillermo Estivill-Torrús
author_sort	Pablo Cabezudo-García
title	Prevalence of Neural Autoantibodies in Paired Serum and Cerebrospinal Fluid in Adult Patients with Drug-Resistant Temporal Lobe Epilepsy of Unknown Etiology
title_short	Prevalence of Neural Autoantibodies in Paired Serum and Cerebrospinal Fluid in Adult Patients with Drug-Resistant Temporal Lobe Epilepsy of Unknown Etiology
title_full	Prevalence of Neural Autoantibodies in Paired Serum and Cerebrospinal Fluid in Adult Patients with Drug-Resistant Temporal Lobe Epilepsy of Unknown Etiology
title_fullStr	Prevalence of Neural Autoantibodies in Paired Serum and Cerebrospinal Fluid in Adult Patients with Drug-Resistant Temporal Lobe Epilepsy of Unknown Etiology
title_full_unstemmed	Prevalence of Neural Autoantibodies in Paired Serum and Cerebrospinal Fluid in Adult Patients with Drug-Resistant Temporal Lobe Epilepsy of Unknown Etiology
title_sort	prevalence of neural autoantibodies in paired serum and cerebrospinal fluid in adult patients with drug-resistant temporal lobe epilepsy of unknown etiology
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/06679057732242eb8f2c7f94cb98ebd8
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Prevalence of Neural Autoantibodies in Paired Serum and Cerebrospinal Fluid in Adult Patients with Drug-Resistant Temporal Lobe Epilepsy of Unknown Etiology

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