Anti-NMDA-receptor antibody in initial diagnosis of mood disorder

Hiroki Kawai, Manabu Takaki, Shinji Sakamoto, Takashi Shibata, Ayaka Tsuchida, Bunta Yoshimura, Yuji Yada, Namiko Matsumoto, Kota Sato, Koji Abe, Yuko Okahisa, Yoshiki Kishi, Soshi Takao, Ko Tsutsui, Takashi Kanbayashi, Keiko Tanaka, Norihito Yamada

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Anti-NMDAR encephalitis is increasingly recognized as one etiology of psychiatric symptoms, but there is not enough evidence on patients with mood disorder. We assayed anti-NR1/NR2B IgG antibodies in serum and/or cerebrospinal fluid of 62 patients initially diagnosed with mood disorder by a cell-based assay. We also investigated the specific patient characteristics and psychotic symptoms. At first admission, the patients showed only psychiatric symptoms without typical neurological signs or abnormal examination findings. Four of the 62 patients had anti-NR1/NR2B IgG antibodies. The anti-NR1/NR2B IgG antibody-positive patients showed more super- or abnormal sensitivity (P = 0.00088), catatonia (P = 0.049), and more conceptual disorganization (P < 0.0001), hostility (P = 0.0010), suspiciousness (P < 0.0001), and less emotional withdrawal (P < 0.0001) and motor retardation (P < 0.0001) on the Brief Psychiatric Rating Scale than the antibody-negative patients. During the clinical course, anti-NR1/NR2B IgG antibody-positive patients showed more catatonia (P = 0.0042) and met Graus's criteria for diagnosis of anti-NMDAR encephalitis, but negative patients did not. Immunotherapy was effective for anti-NR1/NR2B IgG antibody-positive patients, and there was the weak relationship (R² = 0.318) between the anti-NR1/NR2B IgG antibody titer in the cerebrospinal fluid and the Brief Psychiatric Rating Scale score.

Original languageEnglish
Pages (from-to)1041-1050
Number of pages10
JournalEuropean Neuropsychopharmacology
Volume29
Issue number9
DOIs
Publication statusPublished - Sep 2019

Keywords

  • Anti-NR1/NR2B IgG antibodies
  • Brief Psychiatric Rating Scale
  • Catatonia
  • Cell-based assay
  • Mood disorder
  • Super- or abnormal sensitivity

ASJC Scopus subject areas

  • Pharmacology
  • Neurology
  • Clinical Neurology
  • Psychiatry and Mental health
  • Biological Psychiatry
  • Pharmacology (medical)

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  • Cite this

    Kawai, H., Takaki, M., Sakamoto, S., Shibata, T., Tsuchida, A., Yoshimura, B., Yada, Y., Matsumoto, N., Sato, K., Abe, K., Okahisa, Y., Kishi, Y., Takao, S., Tsutsui, K., Kanbayashi, T., Tanaka, K., & Yamada, N. (2019). Anti-NMDA-receptor antibody in initial diagnosis of mood disorder. European Neuropsychopharmacology, 29(9), 1041-1050. https://doi.org/10.1016/j.euroneuro.2019.07.137