title: In vitro neuronal network activity in NMDA receptor encephalitis.
abstract: BACKGROUND
  Anti-NMDA-encephalitis is caused by antibodies against the N-methyl-D-aspartate receptor (NMDAR) and characterized by a severe encephalopathy with psychosis, epileptic seizures and autonomic disturbances. It predominantly occurs in young women and is associated in 59% with an ovarian teratoma.
  
  
  RESULTS
  We describe effects of cerebrospinal fluid (CSF) from an anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis patient on in vitro neuronal network activity (ivNNA). In vitro NNA of dissociated primary rat cortical populations was recorded by the microelectrode array (MEA) system.The 23-year old patient was severely affected but showed an excellent recovery following multimodal immunomodulatory therapy and removal of an ovarian teratoma. Patient CSF (pCSF) taken during the initial weeks after disease onset suppressed global spike- and burst rates of ivNNA in contrast to pCSF sampled after clinical recovery and decrease of NMDAR antibody titers. The synchrony of pCSF-affected ivNNA remained unaltered during the course of the disease.
  
  
  CONCLUSIONS
  Patient CSF directly suppresses global activity of neuronal networks recorded by the MEA system. In contrast, pCSF did not regulate the synchrony of ivNNA suggesting that NMDAR antibodies selectively regulate distinct parameters of ivNNA while sparing their functional connectivity. Thus, assessing ivNNA could represent a new technique to evaluate functional consequences of autoimmune encephalitis-related CSF changes.
authors: Department of Neurology, LVR-Klinikum Duesseldorf, Bergische Landstrasse 2, 40629, Duesseldorf, Germany. sabine.jantzen@uk-koeln.de
authors: Sabine U
authors: SU
authors: Jantzen
authors: Stefano
authors: S
authors: Ferrea
authors: Claudia
authors: C
authors: Wach
authors: Kim
authors: K
authors: Quasthoff
authors: Sebastian
authors: S
authors: Illes
authors: Dag
authors: D
authors: Scherfeld
authors: Hans-Peter
authors: HP
authors: Hartung
authors: Rüdiger J
authors: RJ
authors: Seitz
authors: Marcel
authors: M
authors: Dihné
mesh_terms: D000818:Animals; D000906:Antibodies / Q000134:cerebrospinal fluid*; D002478:Cells, Cultured; D002540:Cerebral Cortex / Q000166:cytology; D004622:Embryo, Mammalian; D004660:Encephalitis / Q000134:cerebrospinal fluid*; D005260:Female; D006801:Humans; D009474:Neurons / Q000187:drug effects / Q000378:metabolism; D051381:Rats; D017208:Rats, Wistar; D016194:Receptors, N-Methyl-D-Aspartate / Q000276:immunology*; D013997:Time Factors; D014162:Transfection; D055815:Young Adult
chemical_list: D000906:Antibodies; D016194:Receptors, N-Methyl-D-Aspartate
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