title: NMDA receptor antibodies: A rare association in inflammatory demyelinating diseases.
abstract: OBJECTIVE
  To analyze the frequency of NMDA receptor (NMDAR) antibodies in patients with various inflammatory demyelinating diseases of the CNS and to determine their clinical correlates.
  
  
  METHODS
  Retrospective case-control study from 2005 to 2014 with the detection of serum IgG antibodies to NMDAR, aquaporin-4, and myelin oligodendrocyte glycoprotein by recombinant live cell-based immunofluorescence assays. Fifty-one patients with acute disseminated encephalomyelitis, 41 with neuromyelitis optica spectrum disorders, 34 with clinically isolated syndrome, and 89 with multiple sclerosis (MS) were included. Due to a known association of NMDAR antibodies with seizures and behavioral symptoms, patients with those clinical manifestations were preferentially included and are therefore overrepresented in our cohort. Nine patients with NMDAR encephalitis, 94 patients with other neurologic diseases, and 48 healthy individuals were used as controls.
  
  
  RESULTS
  NMDAR antibodies were found in all 9 patients with NMDAR encephalitis but in only 1 of 215 (0.5%) patients with inflammatory demyelination and in none of the controls. This patient had relapsing-remitting MS with NMDAR antibodies present at disease onset, with an increase in NMDAR antibody titer with the onset of psychiatric symptoms and cognitive deficits.
  
  
  CONCLUSIONS
  In demyelinating disorders, NMDAR antibodies are uncommon, even in those with symptoms seen in NMDAR encephalitis.
authors: Clinical Department of Neurology (M. Ramberger, G.B., K.S., A.L., F.D., T.B., M. Reindl) and Department of Pediatrics I (K.R., M.B.), Medical University of Innsbruck, Austria; Institute of Neurology (R.H.), Medical University of Vienna, Austria; Pediatric Neurology (K.R.), Witten/Herdecke University, Children's Hospital Datteln, Datteln, Germany; Department of Neurology (F.A.-D.), Karl Landsteiner Institute for Neuroimmunological and Neurodegenerative Disorders, Sozialmedizinisches Zentrum Ost Donauspital, Vienna, Austria; and Neuroimmunology and Multiple Sclerosis Research (A.L.), Department of Neurology, University Hospital Zurich and University of Zurich, Switzerland.
authors: Melanie
authors: M
authors: Ramberger
authors: Clinical Department of Neurology (M. Ramberger, G.B., K.S., A.L., F.D., T.B., M. Reindl) and Department of Pediatrics I (K.R., M.B.), Medical University of Innsbruck, Austria; Institute of Neurology (R.H.), Medical University of Vienna, Austria; Pediatric Neurology (K.R.), Witten/Herdecke University, Children's Hospital Datteln, Datteln, Germany; Department of Neurology (F.A.-D.), Karl Landsteiner Institute for Neuroimmunological and Neurodegenerative Disorders, Sozialmedizinisches Zentrum Ost Donauspital, Vienna, Austria; and Neuroimmunology and Multiple Sclerosis Research (A.L.), Department of Neurology, University Hospital Zurich and University of Zurich, Switzerland.
authors: Gabriel
authors: G
authors: Bsteh
authors: Clinical Department of Neurology (M. Ramberger, G.B., K.S., A.L., F.D., T.B., M. Reindl) and Department of Pediatrics I (K.R., M.B.), Medical University of Innsbruck, Austria; Institute of Neurology (R.H.), Medical University of Vienna, Austria; Pediatric Neurology (K.R.), Witten/Herdecke University, Children's Hospital Datteln, Datteln, Germany; Department of Neurology (F.A.-D.), Karl Landsteiner Institute for Neuroimmunological and Neurodegenerative Disorders, Sozialmedizinisches Zentrum Ost Donauspital, Vienna, Austria; and Neuroimmunology and Multiple Sclerosis Research (A.L.), Department of Neurology, University Hospital Zurich and University of Zurich, Switzerland.
authors: Kathrin
authors: K
authors: Schanda
authors: Clinical Department of Neurology (M. Ramberger, G.B., K.S., A.L., F.D., T.B., M. Reindl) and Department of Pediatrics I (K.R., M.B.), Medical University of Innsbruck, Austria; Institute of Neurology (R.H.), Medical University of Vienna, Austria; Pediatric Neurology (K.R.), Witten/Herdecke University, Children's Hospital Datteln, Datteln, Germany; Department of Neurology (F.A.-D.), Karl Landsteiner Institute for Neuroimmunological and Neurodegenerative Disorders, Sozialmedizinisches Zentrum Ost Donauspital, Vienna, Austria; and Neuroimmunology and Multiple Sclerosis Research (A.L.), Department of Neurology, University Hospital Zurich and University of Zurich, Switzerland.
authors: Romana
authors: R
authors: Höftberger
authors: Clinical Department of Neurology (M. Ramberger, G.B., K.S., A.L., F.D., T.B., M. Reindl) and Department of Pediatrics I (K.R., M.B.), Medical University of Innsbruck, Austria; Institute of Neurology (R.H.), Medical University of Vienna, Austria; Pediatric Neurology (K.R.), Witten/Herdecke University, Children's Hospital Datteln, Datteln, Germany; Department of Neurology (F.A.-D.), Karl Landsteiner Institute for Neuroimmunological and Neurodegenerative Disorders, Sozialmedizinisches Zentrum Ost Donauspital, Vienna, Austria; and Neuroimmunology and Multiple Sclerosis Research (A.L.), Department of Neurology, University Hospital Zurich and University of Zurich, Switzerland.
authors: Kevin
authors: K
authors: Rostásy
authors: Clinical Department of Neurology (M. Ramberger, G.B., K.S., A.L., F.D., T.B., M. Reindl) and Department of Pediatrics I (K.R., M.B.), Medical University of Innsbruck, Austria; Institute of Neurology (R.H.), Medical University of Vienna, Austria; Pediatric Neurology (K.R.), Witten/Herdecke University, Children's Hospital Datteln, Datteln, Germany; Department of Neurology (F.A.-D.), Karl Landsteiner Institute for Neuroimmunological and Neurodegenerative Disorders, Sozialmedizinisches Zentrum Ost Donauspital, Vienna, Austria; and Neuroimmunology and Multiple Sclerosis Research (A.L.), Department of Neurology, University Hospital Zurich and University of Zurich, Switzerland.
authors: Matthias
authors: M
authors: Baumann
authors: Clinical Department of Neurology (M. Ramberger, G.B., K.S., A.L., F.D., T.B., M. Reindl) and Department of Pediatrics I (K.R., M.B.), Medical University of Innsbruck, Austria; Institute of Neurology (R.H.), Medical University of Vienna, Austria; Pediatric Neurology (K.R.), Witten/Herdecke University, Children's Hospital Datteln, Datteln, Germany; Department of Neurology (F.A.-D.), Karl Landsteiner Institute for Neuroimmunological and Neurodegenerative Disorders, Sozialmedizinisches Zentrum Ost Donauspital, Vienna, Austria; and Neuroimmunology and Multiple Sclerosis Research (A.L.), Department of Neurology, University Hospital Zurich and University of Zurich, Switzerland.
authors: Fahmy
authors: F
authors: Aboulenein-Djamshidian
authors: Clinical Department of Neurology (M. Ramberger, G.B., K.S., A.L., F.D., T.B., M. Reindl) and Department of Pediatrics I (K.R., M.B.), Medical University of Innsbruck, Austria; Institute of Neurology (R.H.), Medical University of Vienna, Austria; Pediatric Neurology (K.R.), Witten/Herdecke University, Children's Hospital Datteln, Datteln, Germany; Department of Neurology (F.A.-D.), Karl Landsteiner Institute for Neuroimmunological and Neurodegenerative Disorders, Sozialmedizinisches Zentrum Ost Donauspital, Vienna, Austria; and Neuroimmunology and Multiple Sclerosis Research (A.L.), Department of Neurology, University Hospital Zurich and University of Zurich, Switzerland.
authors: Andreas
authors: A
authors: Lutterotti
authors: Clinical Department of Neurology (M. Ramberger, G.B., K.S., A.L., F.D., T.B., M. Reindl) and Department of Pediatrics I (K.R., M.B.), Medical University of Innsbruck, Austria; Institute of Neurology (R.H.), Medical University of Vienna, Austria; Pediatric Neurology (K.R.), Witten/Herdecke University, Children's Hospital Datteln, Datteln, Germany; Department of Neurology (F.A.-D.), Karl Landsteiner Institute for Neuroimmunological and Neurodegenerative Disorders, Sozialmedizinisches Zentrum Ost Donauspital, Vienna, Austria; and Neuroimmunology and Multiple Sclerosis Research (A.L.), Department of Neurology, University Hospital Zurich and University of Zurich, Switzerland.
authors: Florian
authors: F
authors: Deisenhammer
authors: Clinical Department of Neurology (M. Ramberger, G.B., K.S., A.L., F.D., T.B., M. Reindl) and Department of Pediatrics I (K.R., M.B.), Medical University of Innsbruck, Austria; Institute of Neurology (R.H.), Medical University of Vienna, Austria; Pediatric Neurology (K.R.), Witten/Herdecke University, Children's Hospital Datteln, Datteln, Germany; Department of Neurology (F.A.-D.), Karl Landsteiner Institute for Neuroimmunological and Neurodegenerative Disorders, Sozialmedizinisches Zentrum Ost Donauspital, Vienna, Austria; and Neuroimmunology and Multiple Sclerosis Research (A.L.), Department of Neurology, University Hospital Zurich and University of Zurich, Switzerland.
authors: Thomas
authors: T
authors: Berger
authors: Clinical Department of Neurology (M. Ramberger, G.B., K.S., A.L., F.D., T.B., M. Reindl) and Department of Pediatrics I (K.R., M.B.), Medical University of Innsbruck, Austria; Institute of Neurology (R.H.), Medical University of Vienna, Austria; Pediatric Neurology (K.R.), Witten/Herdecke University, Children's Hospital Datteln, Datteln, Germany; Department of Neurology (F.A.-D.), Karl Landsteiner Institute for Neuroimmunological and Neurodegenerative Disorders, Sozialmedizinisches Zentrum Ost Donauspital, Vienna, Austria; and Neuroimmunology and Multiple Sclerosis Research (A.L.), Department of Neurology, University Hospital Zurich and University of Zurich, Switzerland.
authors: Markus
authors: M
authors: Reindl