Anti-ganglionic acetylcholine receptor antibodies in functional neurological symptom disorder/conversion disorder
ObjectiveAutoimmune autonomic ganglionopathy (AAG) is a rare disorder characterized by autonomic failure associated with the presence of anti-ganglionic acetylcholine receptor (gAChR) antibodies; however, several studies have reported that individuals with anti-gAChR antibodies present with central...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-02-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1137958/full |
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| author | Ryusei Nagata Eiji Matsuura Satoshi Nozuma Mika Dozono Yutaka Noguchi Masahiro Ando Yu Hiramatsu Daisuke Kodama Masakazu Tanaka Ryuji Kubota Munekazu Yamakuchi Yujiro Higuchi Yusuke Sakiyama Hitoshi Arata Keiko Higashi Teruto Hashiguchi Shunya Nakane Hiroshi Takashima |
| author_facet | Ryusei Nagata Eiji Matsuura Satoshi Nozuma Mika Dozono Yutaka Noguchi Masahiro Ando Yu Hiramatsu Daisuke Kodama Masakazu Tanaka Ryuji Kubota Munekazu Yamakuchi Yujiro Higuchi Yusuke Sakiyama Hitoshi Arata Keiko Higashi Teruto Hashiguchi Shunya Nakane Hiroshi Takashima |
| author_sort | Ryusei Nagata |
| collection | DOAJ |
| description | ObjectiveAutoimmune autonomic ganglionopathy (AAG) is a rare disorder characterized by autonomic failure associated with the presence of anti-ganglionic acetylcholine receptor (gAChR) antibodies; however, several studies have reported that individuals with anti-gAChR antibodies present with central nervous system (CNS) symptoms such as impaired consciousness and seizures. In the present study, we investigated whether the presence of serum anti-gAChR antibodies correlated with autonomic symptoms in patients with functional neurological symptom disorder/conversion disorder (FNSD/CD).MethodsClinical data were collected for 59 patients presenting with neurologically unexplained motor and sensory symptoms at the Department of Neurology and Geriatrics between January 2013 and October 2017 and who were ultimately diagnosed with FNSD/CD according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. Correlations between serum anti-gAChR antibodies and clinical symptoms and laboratory data were analyzed. Data analysis was conducted in 2021.ResultsOf the 59 patients with FNSD/CD, 52 (88.1%) exhibited autonomic disturbances and 16 (27.1%) were positive for serum anti-gAChR antibodies. Cardiovascular autonomic dysfunction, including orthostatic hypotension, was significantly more prevalent (75.0 vs. 34.9%, P = 0.008), whereas involuntary movements were significantly less prevalent (31.3 vs. 69.8%, P = 0.007), among anti-gAChR antibody-positive compared with -negative patients. Anti-gAChR antibody serostatus did not correlate significantly with the frequency of other autonomic, sensory, or motor symptoms analyzed.ConclusionsAn autoimmune mechanism mediated by anti-gAChR antibodies may be involved in disease etiology in a subgroup of FNSD/CD patients. |
| first_indexed | 2024-04-10T15:36:26Z |
| format | Article |
| id | doaj.art-399277845a9f4c39bab17fb72b5506a5 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-10T15:36:26Z |
| publishDate | 2023-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-399277845a9f4c39bab17fb72b5506a52023-02-13T04:44:02ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-02-011410.3389/fneur.2023.11379581137958Anti-ganglionic acetylcholine receptor antibodies in functional neurological symptom disorder/conversion disorderRyusei Nagata0Eiji Matsuura1Satoshi Nozuma2Mika Dozono3Yutaka Noguchi4Masahiro Ando5Yu Hiramatsu6Daisuke Kodama7Masakazu Tanaka8Ryuji Kubota9Munekazu Yamakuchi10Yujiro Higuchi11Yusuke Sakiyama12Hitoshi Arata13Keiko Higashi14Teruto Hashiguchi15Shunya Nakane16Hiroshi Takashima17Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, JapanDepartment of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, JapanDepartment of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, JapanDepartment of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, JapanDepartment of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, JapanDepartment of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, JapanDepartment of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, JapanDivision of Neuroimmunology, Joint Research Center for Human Retrovirus Infection, Kagoshima University, Kagoshima, JapanDivision of Neuroimmunology, Joint Research Center for Human Retrovirus Infection, Kagoshima University, Kagoshima, JapanDivision of Neuroimmunology, Joint Research Center for Human Retrovirus Infection, Kagoshima University, Kagoshima, JapanDepartment of Laboratory and Vascular Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, JapanDepartment of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, JapanDepartment of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, JapanDepartment of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, JapanDepartment of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, JapanDepartment of Laboratory and Vascular Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, JapanDepartment of Neurology, Graduate School of Medicine, Nippon Medical School, Tokyo, JapanDepartment of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, JapanObjectiveAutoimmune autonomic ganglionopathy (AAG) is a rare disorder characterized by autonomic failure associated with the presence of anti-ganglionic acetylcholine receptor (gAChR) antibodies; however, several studies have reported that individuals with anti-gAChR antibodies present with central nervous system (CNS) symptoms such as impaired consciousness and seizures. In the present study, we investigated whether the presence of serum anti-gAChR antibodies correlated with autonomic symptoms in patients with functional neurological symptom disorder/conversion disorder (FNSD/CD).MethodsClinical data were collected for 59 patients presenting with neurologically unexplained motor and sensory symptoms at the Department of Neurology and Geriatrics between January 2013 and October 2017 and who were ultimately diagnosed with FNSD/CD according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. Correlations between serum anti-gAChR antibodies and clinical symptoms and laboratory data were analyzed. Data analysis was conducted in 2021.ResultsOf the 59 patients with FNSD/CD, 52 (88.1%) exhibited autonomic disturbances and 16 (27.1%) were positive for serum anti-gAChR antibodies. Cardiovascular autonomic dysfunction, including orthostatic hypotension, was significantly more prevalent (75.0 vs. 34.9%, P = 0.008), whereas involuntary movements were significantly less prevalent (31.3 vs. 69.8%, P = 0.007), among anti-gAChR antibody-positive compared with -negative patients. Anti-gAChR antibody serostatus did not correlate significantly with the frequency of other autonomic, sensory, or motor symptoms analyzed.ConclusionsAn autoimmune mechanism mediated by anti-gAChR antibodies may be involved in disease etiology in a subgroup of FNSD/CD patients.https://www.frontiersin.org/articles/10.3389/fneur.2023.1137958/fullautonomic symptomsfunctional neurological symptom disorderconversion disorderganglionic acetylcholine receptorantibodyLIPS |
| spellingShingle | Ryusei Nagata Eiji Matsuura Satoshi Nozuma Mika Dozono Yutaka Noguchi Masahiro Ando Yu Hiramatsu Daisuke Kodama Masakazu Tanaka Ryuji Kubota Munekazu Yamakuchi Yujiro Higuchi Yusuke Sakiyama Hitoshi Arata Keiko Higashi Teruto Hashiguchi Shunya Nakane Hiroshi Takashima Anti-ganglionic acetylcholine receptor antibodies in functional neurological symptom disorder/conversion disorder Frontiers in Neurology autonomic symptoms functional neurological symptom disorder conversion disorder ganglionic acetylcholine receptor antibody LIPS |
| title | Anti-ganglionic acetylcholine receptor antibodies in functional neurological symptom disorder/conversion disorder |
| title_full | Anti-ganglionic acetylcholine receptor antibodies in functional neurological symptom disorder/conversion disorder |
| title_fullStr | Anti-ganglionic acetylcholine receptor antibodies in functional neurological symptom disorder/conversion disorder |
| title_full_unstemmed | Anti-ganglionic acetylcholine receptor antibodies in functional neurological symptom disorder/conversion disorder |
| title_short | Anti-ganglionic acetylcholine receptor antibodies in functional neurological symptom disorder/conversion disorder |
| title_sort | anti ganglionic acetylcholine receptor antibodies in functional neurological symptom disorder conversion disorder |
| topic | autonomic symptoms functional neurological symptom disorder conversion disorder ganglionic acetylcholine receptor antibody LIPS |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1137958/full |
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