Anti-MOG autoantibody–associated schizophreniform psychosis

Abstract Objective: Autoimmune mechanisms are related to disease development in a subgroup of patients with psychosis. The contribution of immunoglobulin G (IgG) antibodies against myelin oligodendrocyte glycoprotein (MOG) is mainly unclear in this context. Methods: Therefore, two patients with psychosis and anti-MOG antibodies—detected in fixed cell-based and live cell-based assays—are presented. Results: Patient 1 suffered from late-onset psychosis with singular white matter lesions in MRI and intermittent EEG slowing. Patient 2 suffered from a chronic paranoid-hallucinatory disorder with intermittent confusional states, non-specific white matter alterations on MRI, a disorganized alpha rhythm on EEG and elevated cerebrospinal-fluid protein. Both patients had anti-MOG antibody titers of 1:320 in serum (reference<1:20). Conclusion: The arguments for and against a causal role for anti-MOG antibodies are discussed. The antibodies could be relevant, but due to moderate titers, they may have caused a rather “subtle clinical picture” consisting of psychosis instead of “classical” MOG encephalomyelitis.

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Two cases of late-onset neuromyelitis optica spectrum disorder initially presenting with isolated cerebral white matter lesions

eNeurologicalSci ◽

10.1016/j.ensci.2018.11.008 ◽

2018 ◽

Vol 13 ◽

pp. 35-37 ◽

Cited By ~ 1

Author(s):

Tai Otani ◽

Takashi Irioka ◽

Yuko K Takahashi ◽

Kazumasa Soga ◽

Susumu Igarashi ◽

...

Keyword(s):

White Matter ◽

Neuromyelitis Optica ◽

Late Onset ◽

White Matter Lesions ◽

Spectrum Disorder ◽

Cerebral White Matter ◽

Neuromyelitis Optica Spectrum Disorder ◽

Cerebral White Matter Lesions

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Late-onset major depression is associated with age-related white matter lesions in the brainstem

International Journal of Geriatric Psychiatry ◽

10.1002/gps.4487 ◽

2016 ◽

Vol 32 (4) ◽

pp. 446-454 ◽

Cited By ~ 5

Author(s):

Johannes Schwichtenberg ◽

Mansour Al-Zghloul ◽

Hans U. Kerl ◽

Holger Wenz ◽

Lucrezia Hausner ◽

...

Keyword(s):

White Matter ◽

Major Depression ◽

Late Onset ◽

White Matter Lesions ◽

Age Related

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Treatment response in late-onset depression: relationship to neuropsychological, neuroradiological and vascular risk factors

Psychological Medicine ◽

10.1017/s0033291703008870 ◽

2004 ◽

Vol 34 (1) ◽

pp. 125-136 ◽

Cited By ~ 79

Author(s):

R. BALDWIN ◽

S. JEFFRIES ◽

A. JACKSON ◽

C. SUTCLIFFE ◽

N. THACKER ◽

...

Keyword(s):

Risk Factors ◽

Executive Function ◽

White Matter ◽

Depressive Disorder ◽

Late Onset ◽

White Matter Lesions ◽

Vascular Risk Factors ◽

Group Differences ◽

Vascular Risk ◽

Control Subjects

Background. Late-onset depressive disorder is associated with white matter lesions and neuropsychological deficits that in some studies are linked to a poorer outcome for depression. Some white matter lesions may be vascular in origin. This study investigated the relationship between response or non-response to antidepressant monotherapy and neuropsychological function, structural brain measures and vascular factors.Method. This was a case–control study. Fifty patients with late-onset major depressive disorder (29 who were responders to antidepressant monotherapy and 21 who were not) were compared with 35 non-depressed control subjects. Measures included assessment of vascular risk factors, neuropsychological testing and a magnetic resonance imaging (MRI) scan.Results. After adjustment for depressed mood and medication at evaluation, both patient groups had significantly more impairment compared to control subjects on verbal learning tasks involving immediate or delayed recall. Patients who did not respond to antidepressant monotherapy had significantly poorer performance than controls on tests involving visuospatial ability, language, word recognition and tests of executive function, whereas there were no differences between control subjects and responders. On two tests of executive function (verbal fluency and the Stroop test) non-responders scored significantly worse than responders. There were no significant group differences on MRI measures of atrophy or of white matter lesions apart from a higher periventricular hyperintensity score in non-responders compared to controls. There were no group differences on measures of vascular disease.Conclusion. The results lend support to the emerging evidence that resistance to treatment in late-onset depression may be associated with impaired executive function. Subtle cerebrovascular mechanisms may be involved.

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Late-Onset Depression With White Matter Lesions

Psychosomatics ◽

10.1016/s0033-3182(93)71872-1 ◽

1993 ◽

Vol 34 (4) ◽

pp. 364-367 ◽

Cited By ~ 21

Author(s):

Ira M. Lesser ◽

Elizabeth Hill-Gutierrez ◽

Bruce L. Miller ◽

Kyle B. Boone

Keyword(s):

White Matter ◽

Late Onset ◽

White Matter Lesions

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IC-102-05: Differential effects of white matter lesions on medial temporal lobe atrophy in early versus late onset Alzheimer's disease

Alzheimer s & Dementia ◽

10.1016/j.jalz.2006.05.2194 ◽

2006 ◽

Vol 2 ◽

pp. S652-S652

Author(s):

Frank-Erik De Leeuw ◽

Wiesje van der Flier ◽

Esther Korf ◽

Frederik Barkhof ◽

Philip Scheltens

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

White Matter ◽

Temporal Lobe ◽

Medial Temporal Lobe ◽

Late Onset ◽

White Matter Lesions ◽

Medial Temporal Lobe Atrophy ◽

Differential Effects ◽

Lobe Atrophy

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Localization of white-matter lesions and effect of vascular risk factors in late-onset major depression

Psychological Medicine ◽

10.1017/s0033291709991656 ◽

2009 ◽

Vol 40 (8) ◽

pp. 1389-1399 ◽

Cited By ~ 50

Author(s):

R. B. Dalby ◽

M. M. Chakravarty ◽

J. Ahdidan ◽

L. Sørensen ◽

J. Frandsen ◽

...

Keyword(s):

Risk Factors ◽

White Matter ◽

Major Depression ◽

Late Onset ◽

Brain Magnetic Resonance Imaging ◽

White Matter Lesions ◽

Vascular Risk Factors ◽

Vascular Risk ◽

Lesion Load ◽

Significant Difference

BackgroundSeveral studies suggest that patients with late-onset major depression (MD) have an increased load of cerebral white-matter lesions (WMLs) compared with age-matched controls. Vascular risk factors such as hypertension and smoking may confound such findings. Our aim was to investigate the association between the localization and load of WMLs in late-onset MD with respect to vascular risk factors.MethodWe examined 22 consecutive patients with late-onset first-episode MD and 22 age- and gender-matched controls using whole-brain magnetic resonance imaging (MRI). The localization, number and volume of WMLs were compared between patients and controls, while testing the effect of vascular risk factors.ResultsAmong subjects with one or more WMLs, patients displayed a significantly higher WML density in two white-matter tracts: the left superior longitudinal fasciculus and the right frontal projections of the corpus callosum. These tracts are part of circuitries essential for cognitive and emotional functions. Analyses revealed no significant difference in the total number and volume of WMLs between groups. Patients and controls showed no difference in vascular risk factors, except for smoking. Lesion load was highly correlated with smoking.ConclusionsOur results indicate that lesion localization rather than lesion load differs between patients with late-onset MD and controls. Increased lesion density in regions associated with cognitive and emotional functions may be crucial in late-onset MD, and vascular risk factors such as smoking may play an important role in the pathophysiology of late-onset MD, consistent with the vascular depression hypothesis.

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