N-Methyl-D-aspartate receptor antibody could be a cause of catatonic symptoms in psychiatric patients: case reports and methods for detection.
N-Methyl-D-aspartate receptor antibody could be a cause of catatonic symptoms in psychiatric patients: case reports and methods for detection.
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DOI：
10.2147/ndt.s125800
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发表时间：
2017
影响因子：
3.2
通讯作者：
Shimizu T
中科院分区：
文献类型：
--
作者：
Tsutsui K;Kanbayashi T;Takaki M;Omori Y;Imai Y;Nishino S;Tanaka K;Shimizu T
据报道，紧张症的症状与抗N-甲基-D-天冬氨酸受体（NMDAR）脑炎的初始症状相似。随后，这种自身免疫性边缘系统脑炎引起了许多精神科医生的注意。对于紧张症的鉴别诊断，检测抗NMDAR脑炎是重要的。通过早期发现和治疗，这种脑炎有望得到缓解。对于精神分裂症的紧张性症状我们应该更加谨慎。当患者怀疑患有脑炎时，我们应该使用基于细胞的测定来筛查脑脊液样本中的抗NMDAR抗体。本文结合病例报告，介绍了NMDAR抗体检测方法及该脑炎的病因。报告了两例具有代表性的紧张症和非紧张症（短暂精神障碍）病例。精神分裂症是一种广泛的、异质的、复杂的疾病，其病理生理机制尚不清楚。有一个确定的证据表明NMDAR功能减退，这是中央组件的功能断开;这是精神分裂症最公认的模型之一。此外，据说至少在精神分裂症患者的亚组中，自身免疫机制已经参与其中。进一步研究抗NMDAR抗体与脑炎的关系，将为精神分裂症、紧张症和不典型精神病的研究提供重要线索。
The symptoms of catatonia have been reported to be similar to the initial symptoms of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. Subsequently, this autoimmune limbic encephalitis has been noticed by many psychiatrists. For a differential diagnosis of catatonic state, it is important to detect anti-NMDAR encephalitis. This encephalitis is expected to be in remission by early detection and treatment. We should be more cautious about catatonic symptoms of schizophrenia. When a patient is suspected of having encephalitis, we should screen for anti-NMDAR antibodies in cerebrospinal fluid samples using a cell-based assay. We describe the methods of NMDAR antibody detection and the etiology of this encephalitis with case reports. Two representative cases with catatonia and non-catatonia (brief psychotic disorder) were reported. Schizophrenia is a general, heterogeneous, and complicated disorder, and its pathophysiology is unknown. There is an established evidence of NMDAR hypofunction, which is the functional disconnection of the central component; this is one of the most recognized models for schizophrenia. Furthermore, it is said that autoimmune mechanisms have been involved, at least in subgroups of schizophrenia patients. Further study of anti-NMDAR antibody and its related encephalitis would give essential clues for the research of schizophrenia, catatonia, and atypical psychosis.