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Absence of autoantibodies against neuronal surface antigens in sera of patients with psychotic disorders

JAMA Psychiatry Dec 11, 2019

Hoffmann C, Zong S, Mané-Damas M, et al. - Given that autoimmune encephalitis with characteristic neurological and psychiatric symptoms typically develop among patients with antibodies against neuronal surface antigens (NSAbs), including the N-methyl-d-aspartate receptor (NMDAR), researchers performed this analysis focussing on other common NSAbs known to cause encephalitis, with the aim to expand the clinical spectrum of psychosis potentially caused by autoantibodies. Psychotic episodes without simultaneous neurological involvement occur in 4% of individuals with NMDAR encephalitis raising the question that whether NSAbs are underdiagnosed in patients with psychotic disorders. However, contradictory results were reported in studies testing this, possibly because of differences in the methods of antibody detection. In the previous report in a cohort of 475 patients with schizophrenia, combined immunohistochemistry tests and cell-based assays across laboratories identified no one with NMDAR antibodies after excluding 2 false-positive results.
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