ArticleJournal of neurology, neurosurgery, and psychiatry2021
Clinical spectrum of high-titre GAD65 antibodies.
Article in Journal of neurology, neurosurgery, and psychiatry, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 89 papers.
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Who cites it
89 citing papers in PubMed, 163 citations in OpenAlex.
- Anti-CD320 Autoantibodies and Central Nervous System Vitamin B12 Deficiency in Idiopathic Myelopathy.JAMA neurology · 2026Article
- Neuroimmunology of Epilepsy: Mechanisms, Treatments, and Clinical Insights.Epilepsy currents · 2026Article
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- Clinical Spectrum and Outcomes of SOX1 Antibody-Associated Paraneoplastic Neurological Syndromes: A Chinese Cohort Study.Annals of clinical and translational neurology · 2026Article
- Timing, Composition, and Clinical Correlates of Immunotherapy Response in GAD65 Antibody-Associated Epilepsy: A Literature-Derived Patient-Level Analysis of 375 Published Cases.Neurology international · 2026Article
- Oculomotor phenotypes and longitudinal video-oculography dynamics in anti-GAD65 antibody-associated neurological syndromes: a case series and literature review.BMC neurology · 2026Review
- Stiff-Person Syndrome: A Comprehensive Review of a Rare Disease with Emphasis on Pathophysiology, Clinical Features, Diagnostic Challenges and Therapeutic Advances.The Yale journal of biology and medicine · 2026Review
- Current and Future Biomarkers in the Diagnosis of Autoimmune Encephalitis: A Review of Biomarker Detection Techniques and Their Performance.Medicina (Kaunas, Lithuania) · 2026Review
- Long-Term Outcomes in Stiff Person Spectrum Disorder.European journal of neurology · 2026Article
- A rare case of crescent-shaped peridentate hyperintensity preceding cerebellar atrophy in GAD65 antibody-associated ataxia.Neuroradiology · 2026Article
- Anti-gad autoimmune encephalitis: a case report.BMC neurology · 2026Article
- Article
- Testing for neural antibodies in autoimmune encephalitis: who, what, where, when, why, and how.Therapeutic advances in neurological disorders · 2026Review
- Successful fresh formulation CD19 CAR-T cell therapy for GAD65 antibody-mediated cerebellar ataxia. A Case Report.Frontiers in immunology · 2026Article
- Effective Treatment of Anti-GAD65 Limbic Encephalitis-Associated Epilepsy Despite Delayed Immunotherapy: A Brief Report.Case reports in neurological medicine · 2026Article
- Clinical heterogeneity and immunotherapy outcomes in anti-GAD65 antibody-associated autoimmune encephalitis: a retrospective study.Therapeutic advances in neurological disorders · 2026Article
- A Case Report of Anti-GAD65 Antibody-Positive Autoimmune Encephalitis Associated with Diabetes.Endocrine, metabolic & immune disorders drug targets · 2026Article
- Treatment of anti-GAD65 antibody-positive epilepsy and cerebellar ataxia with efgartigimod: a case report and literature review.Frontiers in immunology · 2026Review
- Diagnostic challenge of GAD65-associated autoimmune encephalitis mimicking post-traumatic complications in an older adult: a case report.Frontiers in medicine · 2026Article
- Neuroglial markers of damage in autoimmune neurology.Therapeutic advances in neurological disorders · 2026Review
29 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
11 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine clinical manifestations, immunotherapy responsiveness and outcomes of glutamic acid decarboxylase-65 (GAD65) neurological autoimmunity.
methodsWe identified 323 Mayo Clinic patients with high-titre (>20 nmol/L in serum) GAD65 antibodies out of 380 514 submitted anti-GAD65 samples (2003-2018). Patients classified as having GAD65 neurological autoimmunity after chart review were analysed to determine disease manifestations, immunotherapy responsiveness and predictors of poor outcome (modified Rankin score >2).
resultsOn review, 108 patients were classified as not having GAD65 neurological autoimmunity and 3 patients had no more likely alternative diagnoses but atypical presentations (hyperkinetic movement disorders). Of remaining 212 patients with GAD65 neurological autoimmunity, median age at symptom onset was 46 years (range: 5-83 years); 163/212 (77%) were female. Stiff-person spectrum disorders (SPSD) (N=71), cerebellar ataxia (N=55), epilepsy (N=35) and limbic encephalitis (N=7) could occur either in isolation or as part of an overlap syndrome (N=44), and were designated core manifestations. Cognitive impairment (N=38), myelopathy (N=23) and brainstem dysfunction (N=22) were only reported as co-occurring phenomena, and were designated secondary manifestations. Sustained response to immunotherapy ranged from 5/20 (25%) in epilepsy to 32/44 (73%) in SPSD (p=0.002). Complete immunotherapy response occurred in 2/142 (1%). Cerebellar ataxia and serum GAD65 antibody titre >500 nmol/L predicted poor outcome.
interpretationHigh-titre GAD65 antibodies were suggestive of, but not pathognomonic for GAD65 neurological autoimmunity, which has discrete core and secondary manifestations. SPSD was most likely to respond to immunotherapy, while epilepsy was least immunotherapy responsive. Complete immunotherapy response was rare. Serum GAD65 antibody titre >500 nmol/L and cerebellar ataxia predicted poor outcome.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.