Bartels F, Wandrey MM, Aigner A, et al. - In this prospective, cross-sectional study, neuronal autoantibodies were found to be related to cognitive impairment in more than one-third of lung cancer patients. Such autoantibodies may indicate a potential therapeutic pathway of immune-mediated cognitive impairment in lung cancer patients.

• Among 167 lung cancer patients (median age, 66.0 years [interquartile range, 59.0-72.0 years]; 105 men [62.9%]), 127 had non–small cell lung cancer (NSCLC), and 40 had small cell lung cancer (SCLC).

• Brain-directed autoantibodies were found in 61 of 167 patients (36.5%), with 33 patients (19.8%) having known autoantibodies and 28 patients (16.8%) having autoantibodies against currently unknown antigens discovered through immunohistochemical analysis.

• In 65 of 97 patients (67.0%), cognitive impairment was discovered.

• Patients with SCLC who had any autoantibodies had an 11-fold higher risk of cognitive impairment than those who did not have any autoantibodies, and the elevated risk was irrespective of age, gender, and neurological deficit.

• Among NSCLC patients, individuals with immunoglobin A autoantibodies targeting the N-methyl-d-aspartate receptor had a significantly higher risk of verbal memory deficits.

• Autoantibodies against currently unknown antigens were also linked to increased risk of cognitive impairment.