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Serum anti-NMDA receptor antibodies are linked to memory impairment 12 months after stroke

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Item Type:Article
Title:Serum anti-NMDA receptor antibodies are linked to memory impairment 12 months after stroke
Creators: Arlt, F.A. ORCID logoORCID: https://orcid.org/0000-0002-0112-8685, Sperber, P.S. ORCID logoORCID: https://orcid.org/0000-0002-9534-2374, von Rennenberg, R., Gebert, P., Teegen, B., Georgakis, M.K. ORCID logoORCID: https://orcid.org/0000-0003-3507-3659, Fang, R. ORCID logoORCID: https://orcid.org/0000-0002-5663-9407, Dewenter, A. ORCID logoORCID: https://orcid.org/0000-0002-5636-196X, Görtler, M., Petzold, G.C., Wunderlich, S., Zerr, I. ORCID logoORCID: https://orcid.org/0000-0002-6722-2463, Dichgans, M. ORCID logoORCID: https://orcid.org/0000-0002-0654-387X, Prüss, H. ORCID logoORCID: https://orcid.org/0000-0002-8283-7976 and Endres, M. ORCID logoORCID: https://orcid.org/0000-0001-6520-3720
Abstract:Patients suffering from strokes are at increased risk of developing post-stroke dementia. Serum anti-NMDA receptor autoantibodies (NMDAR1-abs) have been associated with unfavorable post-stroke outcomes. However, their effect on specific cognitive domains remains unclear. We used data from the prospective multicenter DZNE—mechanisms after stroke (DEMDAS) cohort, and measured NMDAR1-abs in serum at baseline. Cognitive function was assessed with a comprehensive neuropsychological test battery at 6- and 12-months follow-up. We employed crude and stepwise confounder adjusted linear and logistic regression models as well as generalized estimating equation models (GEE) to determine the relevance of NMDAR1-abs seropositivity on cognitive function after stroke. 10.2% (58/569) DEMDAS patients were NMDAR1-abs seropositive (IgM:n = 44/IgA:n = 21/IgG:n = 2). Seropositivity was not associated with global cognitive impairment after stroke. However, NMDAR1-abs seropositive patients performed lower in the memory domain (β(adjusted) = −0.11; 95%CI = −0.57 to −0.03) and were at increased risk for memory impairment (OR(adjusted) = 3.8; 95%CI = 1.33–10.82) compared to seronegative patients, 12 months after stroke. Further, NMDAR1-abs were linked to memory impairment over time in GEE from 6- to 12-months follow-up (OR(adjusted) = 2.41; 95%CI = 1.05–5.49). Our data suggests that NMDAR1-abs contribute to memory dysfunction 1 year after stroke while not affecting other cognitive subdomains. Hence, antineuronal autoimmunity may be involved in distinct mechanisms of post-stroke memory impairment. Clinical trial name and registration number: The Determinants of Dementia After Stroke (DEMDAS; study identifier on clinical trials.gov: NCT01334749).
Keywords:Autoantibodies, Cognition, Cognitive Dysfunction, Dementia, Follow-Up Studies, Memory Disorders, N-Methyl-D-Aspartate Receptors, Neuropsychological Tests, Prospective Studies, Stroke
Source:Molecular Psychiatry
ISSN:1359-4184
Publisher:Springer Nature
Volume:30
Number:4
Page Range:1359-1368
Date:April 2025
Official Publication:https://doi.org/10.1038/s41380-024-02744-w
PubMed:View item in PubMed

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