title: Autoimmunity as a prognostic factor in sporadic adult onset cerebellar ataxia.
abstract: Cerebellar adult onset ataxia is a heterogeneous condition. The aim of this study was to ascertain if there is a heightened autoimmune background in patients with sporadic cerebellar ataxia of unknown origin, and if autoimmunity correlates with a more rapid evolution of the ataxia. We selected patients with sporadic progressive adult onset cerebellar ataxia with a follow-up of >5 years. As controls we included 43 patients with genetically demonstrated hereditary ataxia. All patients were tested for a panel of neuronal (onconeuronal, glutamate-decarboxylase [GAD], IgG/IgA transglutaminase 6 antibodies) and systemic non-neuronal antibodies (including IgG/IgA gliadin and transglutaminase 2, thyroperoxidase, thyroglobulin, antinuclear, striational, smooth muscle, mitochondrial, liver kidney microsomal, and parietal gastric cells antibodies). Correlation between the antibodies and disease progression was studied with Cox regression models and Kaplan-Meier plots. Forty-four patients were included. All patients were negative for onconeuronal or GAD antibodies. There were no significant differences between patients and controls in the prevalence of transglutaminase 6, 2, gliadin, or thyroid antibodies. However, when we studied the panel of systemic non-neuronal autoantibodies as a group, antibodies were more frequent in patients with sporadic ataxia (p = 0.018). The presence of one or more systemic non-neuronal antibodies correlated with a faster evolution to stage 2 (loss of independent gait) (p = 0.03) and shorter survival (p = 0.03) in patients with sporadic ataxia. We conclude that there is probably a heightened autoimmune background in some patients with sporadic cerebellar ataxia of unknown origin. The presence of systemic non-neuronal autoantibodies is a prognostic marker.
authors: Department of Neurology, Hospital Universitari I Politècnic La Fe, Boulevar Sur, s/n, 46026, Valencia, Spain.
authors: R
authors: R
authors: Sivera
authors: N
authors: N
authors: Martín
authors: I
authors: I
authors: Boscá
authors: T
authors: T
authors: Sevilla
authors: N
authors: N
authors: Muelas
authors: I
authors: I
authors: Azorín
authors: J J
authors: JJ
authors: Vílchez
authors: M
authors: M
authors: Bolonio
authors: E
authors: E
authors: Donat
authors: C
authors: C
authors: Ribes-Koninckx
authors: L
authors: L
authors: Bataller
mesh_terms: D000368:Aged; D001323:Autoantibodies / Q000276:immunology; D015551:Autoimmunity / Q000502:physiology*; D002524:Cerebellar Ataxia / Q000175:diagnosis* / Q000276:immunology*; D018450:Disease Progression; D005260:Female; D019204:GTP-Binding Proteins / Q000276:immunology; D005903:Gliadin / Q000276:immunology; D005968:Glutamate Decarboxylase / Q000276:immunology; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009419:Nerve Tissue Proteins / Q000276:immunology; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D011503:Transglutaminases / Q000276:immunology
chemical_list: D001323:Autoantibodies; D009419:Nerve Tissue Proteins; D005903:Gliadin; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins; D005968:Glutamate Decarboxylase