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Clinical and Electrophysiological Effects of D-Serine in a Schizophrenia Patient Positive for Anti-N-Methyl-D-Aspartate Receptor Antibodies

Published:September 13, 2014DOI:https://doi.org/10.1016/j.biopsych.2014.08.023
      The term anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis refers to an autoimmune disorder in which immunoglobulin G antibodies (ABs) against the NR1 subunit of NMDAR cause receptor internalization and decreased NMDAR-mediated neurotransmission. NMDAR encephalitis predominantly affects women, children, and young adults; occurs with or without tumor association; and is characterized by a predictable set of symptoms including psychosis as a common early feature, disorganized behavior, motor (e.g., catatonia and dyskinesia) manifestations, and seizures. NMDAR encephalitis is responsive to immunotherapy but refractory to antipsychotic medication and is associated with the long-term persistence of behavioral and cognitive deficits. Patients’ ABs decrease the surface density of NMDAR clusters via antibody-mediated capping and internalization resulting in decreased NMDAR-mediated synaptic currents (
      • Dalmau J.
      • Lancaster E.
      • Martinez-Hernandez E.
      • Rosenfeld M.R.
      • Balice-Gordon R.
      Clinical experience and laboratory investigations in patients with anti-NMDAR encephalitis.
      ,
      • Hughes E.G.
      • Peng X.
      • Gleichman A.J.
      • Lai M.
      • Zhou L.
      • Tsou R.
      • et al.
      Cellular and synaptic mechanisms of anti-NMDAR encephalitis.
      ). This relative NMDAR function loss may underlie the deficits in behavior and cognition that are hallmarks of NMDAR encephalitis.
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      References

        • Dalmau J.
        • Lancaster E.
        • Martinez-Hernandez E.
        • Rosenfeld M.R.
        • Balice-Gordon R.
        Clinical experience and laboratory investigations in patients with anti-NMDAR encephalitis.
        Lancet Neurol. 2011; 10: 63-74
        • Hughes E.G.
        • Peng X.
        • Gleichman A.J.
        • Lai M.
        • Zhou L.
        • Tsou R.
        • et al.
        Cellular and synaptic mechanisms of anti-NMDAR encephalitis.
        J Neurosci. 2010; 30: 5866-5875
        • Rosenthal-Simons A.
        • Durrant A.R.
        • Heresco-Levy U.
        Autoimmune-induced glutamatergic receptor dysfunctions: Conceptual and psychiatric practice implications.
        Eur Neuropsychopharmacol. 2013; 23: 1659-1671
        • Hammer C.
        • Stepniak B.
        • Schneider A.
        • Papiol S.
        • Tantra M.
        • Begemann M.
        • et al.
        Neuropsychiatric disease relevance of circulating anti-NMDAR autoantibodies depends on blood-brain barrier integrity.
        Mol Psychiatry. 2014; 19: 1143-1149
        • Takano S.
        • Takahashi Y.
        • Kishi H.
        • Taguchi Y.
        • Takashima S.
        • Tanaka K.
        • et al.
        Detection of autoantibody against extracellular epitopes of NMDAR by cell-based assay.
        Neurosci Res. 2011; 71: 294-302
        • Schmitt S.E.
        • Pargeon K.
        • Frechette E.S.
        • Hirsch L.J.
        • Dalmau J.
        • Friedman D.
        Extreme delta brush: A unique EEG pattern in adults with anti-NMDA receptor encephalitis.
        Neurology. 2012; 79: 1094-1100
        • Wilkinson G.
        • Hesdon B.
        • Wild D.
        • Cookson R.
        • Farina C.
        • Sharma V.
        • et al.
        Self-report quality of life measure for people with schizophrenia: The SQLS.
        Br J Psychiatry. 2000; 177: 42-46
        • Durrant A.R.
        • Heresco-Levy U.
        D-Serine in neuropsychiatric disorders: New advances.
        Advances in Psychiatry. 2014; (Available at: http://dx.doi.org/10.1155/2014/859735)