Imaging features of anti-glutamic acid decarboxylase 65 antibody-associated neurological syndromes
10.19845/j.cnki.zfysjjbzz.2025.0065
- VernacularTitle:谷氨酸脱羧酶65抗体相关神经综合征的影像特征
- Author:
Lixia ZHOU
1
;
Lijing JIA
2
Author Information
1. 河北医科大学第二医院医学影像科，河北 石家庄 050000
2. 河北医科大学第二医院神经内科，河北省神经病学重点实验室，临床神经病学教育部重点实验室，河北 石家庄 050000
- Publication Type:Journal Article
- Keywords:
Glutamic acid decarboxylase 65;
Magnetic resonance imaging;
Autoimmune neurological syndromes;
Immunotherapy
- From:
Journal of Apoplexy and Nervous Diseases
2025;42(4):328-334
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the dynamic imaging features of a group of patients with anti-glutamic acid decarboxylase 65 （GAD65） antibody-associated neurological syndromes. Methods A retrospective analysis was performed for related data of the patients who were diagnosed with anti-GAD65 antibody-associated autoimmune neurological syndromes in The Second Hospital of Hebei Medical University from January 2018 to December 2021，including clinical features，treatment outcomes，and cranial magnetic resonance imaging （MRI） features at baseline and during follow-up. Results A total of 15 patients were enrolled，among whom there were 8 female patients and 7 male patients，with an age of onset of 28-72 years. The clinical syndromes included limbic encephalitis in 2 patients，temporal lobe epilepsy in 3 patients，and seizures in 7 patients，accounting for 80%，as well as stiff-person syndrome in 1 patient （6.67%） and cerebellar ataxia in 2 patients （13.3%）. Imaging findings showed that of all 15 patients，14 （93.3%） had brain atrophy at initial diagnosis，and only 1 young patient had no brain atrophy； 10 patients （67%） had abnormal signals in the bilateral or unilateral hippocampus，and 3 patients （20%） had abnormal signals in the cortex/subcortical regions. All 15 patients received first-line immunotherapy，and dynamic MRI follow-up was performed for 8 patients，with a follow-up time of half a year to 4 years. Follow-up results showed that based on clinical and imaging findings，the patients with abnormal signals in the cortex/subcortical regions had good response to immunotherapy，while those with abnormal signals in the bilateral or unilateral hippocampus had poor response to immunotherapy. Progressive brain atrophy was observed in all 8 patients receiving MRI follow-up.Conclusion The common imaging findings of anti-GAD65 antibody-associated autoimmune neurological syndromes include abnormal signals in the bilateral or unilateral hippocampus and abnormal signals in the cortex/subcortical regions，and there are differences in clinical manifestations and response to immunotherapy between these two types. Cranial MRI features have an important value in the diagnosis of anti-GAD65 antibody-associated syndromes. MRI examination may be used as an important method for monitoring disease progression and treatment outcome.
