ArticleJournal of neurology2026
Screening 1021 Swedish memory clinic visitors for autoantibody-mediated encephalitis.
Article in Journal of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionA treatable differential diagnosis to neurodegenerative dementia is autoimmune encephalitis (AE). In Sweden, the prevalence of AE varies considerably between regions, suggesting underdiagnosis. We hypothesized that some undetected AE patients would attend Swedish memory clinics.
methodsWe retrospectively screened 1021 individuals attending the Karolinska University Hospital memory clinics for AE autoantibodies. Serum screening was performed with live cell-based assays (CBAs) for antibodies to contactin-associated protein-like 2 (CASPR2), gamma-aminobutyric acid receptor B (GABA
resultsEleven patients were antibody-positive in two or more independent tests. When investigating clinical information, three patients had phenotypes suggesting paraneoplastic (PE) or autoimmune encephalitis. These patients had antibodies to either CASPR2 or NMDA-R in serum and CSF and either had CSF-specific electrophoresis IgG-bands or increased Kappa free light-chain-intrathecal fraction. In four patients, available clinical information was insufficient to clarify if the antibodies were related to an ongoing or past encephalitis or lacked relevance, with a further three considered false positive. The final individual had previously been diagnosed with LGI1-AE. When the STAM3mP score, a tool for identifying treatment-responsive rapidly progressive dementia, was used on the seven previously undiagnosed patients with antibodies of possible relevance, six got one point, indicating potential treatment response.
conclusionAE is a rare differential diagnosis in our study of memory clinic visitors. Given the low prevalence, we conclude that AE autoantibody testing is not suitable for unselective screening in this setting. Instead, a rigorous clinical evaluation, potentially supported by tools like the STAM3mP score, might acceptably limit the number of missed AE cases among patients suffering from memory impairment, but further studies on pre-screening biomarkers are warranted.
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