Abstract

BackgroundThe detection of neural autoantibodies in patients with cognitive decline is an increasingly frequent phenomenon in memory clinics, and demanding as it does a specific diagnostic approach and therapeutic management, it deserves greater attention. It is this review’s aim to present the latest nosology of neural autoantibody-associated dementia.MethodsA specific literature research via PubMed was conducted to describe the nosology of neural autoantibody-associated dementia.ResultsAn autoimmune dementia comprises with an early onset, atypical clinical presentation and rapid progression in conjunction with neural antibodies, signs of inflammation in the cerebrospinal fluid, and a non-neurodegenerative pattern in neuroimaging. An autoimmune dementia is probably present if the patient responds to immunotherapy. Atypical dementia involving neural autoantibodies with mostly N-methyl-D-aspartate receptor antibodies might not fulfill all the autoimmune-dementia criteria, thus it may constitute an independent disease entity. Finally, a neurodegenerative dementia such as the frontotemporal type also coincides with neural autoantibodies such as the subunit ionotropic glutamate receptors 3 of amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor antibodies, dementia with Lewy bodies with myelin oligodendrocytic protein, myelin basic protein antibodies, or Creutzfeldt-Jakob disease with Zic4 or voltage gated potassium channel antibodies. These dementia entities may well overlap in their clinical features and biomarkers, i.e., their neural autoantibodies or neuroimaging patterns.ConclusionThere are three main forms of neural autoantibody-associated dementia we can distinguish that might also share certain features in their clinical and laboratory presentation. More research is urgently necessary to improve the diagnosis and therapy of these patients, as the progression of their dementia might thus be improved or even reversed.

Highlights

  • Dementia is a serious socioeconomic and medical challenge increasing worldwide

  • The purpose of this review is to provide an overview of the dementia subtypes associated with neural autoantibodies, and how these subtypes might be classified to present a nosology of neural autoantibodyassociated dementia

  • I relied on a PubMed search to identify appropriate articles using the terms “autoimmune dementia,” “dementia and neural autoantibody,” “cognitive impairment and neural autoantibody,” “dementia with Lewy bodies (DLB) and neural autoantibody,” “frontotemporal dementia (FTD) and neural autoantibody,” “Alzheimer’s disease (AD) and neural autoantibody,” “Creutzfeldt-Jakob disease (CJD) and neural autoantibody,” “dementia and autoantibody,” “cognitive impairment and autoantibody,” “DLB and autoantibody,” “FTD and autoantibody,” “AD and autoantibody,” “CJD and autoantibody” in May 2021

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Summary

Introduction

Dementia is a serious socioeconomic and medical challenge increasing worldwide. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5 R , fifth edition; American Psychiatric Association, 2013) dementia is defined as an impaired memory function coinciding with other malfunctioning higher cortical functions accompanied by consecutive functional social and occupational impairments. Current Concept of Autoimmune Dementia autoantibodies are often associated with cognitive impairment ranging from mild cognitive impairment to dementia (Flanagan et al, 2010; Doss et al, 2014; Gibson et al, 2020; Banks et al, 2021; Hansen et al, 2021a; Timäus et al, 2021) These neural autoantibodies can be classified as autoantibodies against intracellular and membrane-surface antigens. The detection of neural autoantibodies in patients with cognitive decline is an increasingly frequent phenomenon in memory clinics, and demanding as it does a specific diagnostic approach and therapeutic management, it deserves greater attention. It is this review’s aim to present the latest nosology of neural autoantibodyassociated dementia

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