Review
Neurosciences
Igor Gusmao Campana, Guilherme Diogo Silva
Summary: Rapidly progressive cerebellar ataxia associated with anti-Tr/DNER antibodies mainly affects middle-aged males. Isolated cerebellar ataxia is the most common presentation, with a high rate of tumor association. Abnormal neuroimaging patterns include cerebellar atrophy and hyperintensity, while cerebrospinal fluid analysis often shows signs of inflammation. Oncological response is favorable, but neurological prognosis is poor.
Article
Neurosciences
Fabrice Faure, Lidia Yshii, Toufic Renno, Isabelle Coste, Bastien Joubert, Virginie Desestret, Roland Liblau, Jerome Honnorat
Summary: This pilot study aimed to model paraneoplastic cerebellar degeneration with Yo autoantibodies in mice. The mice were implanted with ovarian carcinoma cells expressing the antigens recognized by anti-Yo antibodies and were immunized with antigens and immune checkpoint inhibitors. The results showed the presence of anti-Yo antibodies in the brain and serum of mice, but did not find significant cell death or motor impairments.
Article
Neurosciences
John E. Greenlee, H. Robert Brashear
Summary: Prior to 1982, the cause of cerebellar injury in patients with ovarian and certain other cancers was unknown. However, studies revealed that these patients had high titers of antibodies directed against cytoplasmic antigens of Purkinje cells and deep cerebellar nuclei, which was not found in ovarian cancer patients without neurological symptoms. This discovery of the anti-Yo antibody provides a marker for rapidly progressive cerebellar ataxia associated with gynecological and breast malignancies.
Article
Clinical Neurology
Kjell Inge Erikstad, Ida Herdlevaer, Elise Peter, Mette Haugen, Cecilie Totland, Christian Vedeler
Summary: To increase the accuracy of Yo-PCD diagnosis, using a CDR2L cell-based assay (CBA) as an additional screening technique can be helpful.
EUROPEAN JOURNAL OF NEUROLOGY
(2023)
Article
Clinical Neurology
Satyan Nanda, Rahul Handa, Atul Prasad, Rajiv Anand, Dhruv Zutshi, Sujata K. Dass, Prabhjeet Kaur Bedi, Aarti Pahuja, Pankaj Kumar Shah, Bipan Sharma, Nalin Malhotra
Summary: Neurological manifestations are common in COVID-19 patients, with encephalitis being a relatively rare but serious complication. It is crucial to differentiate between herpes encephalitis and COVID-19-associated encephalitis due to differences in treatment and prognosis. Physicians should maintain a high level of suspicion for COVID-19 infection in patients with encephalitis symptoms and respiratory complaints.
NEUROLOGICAL SCIENCES
(2021)
Editorial Material
Radiology, Nuclear Medicine & Medical Imaging
Federico Massa, Laura Filippi, Luana Benedetti, Silvia Morbelli, Flavio Nobili
Summary: This study describes a case of seronegative PCD associated with small cell lung cancer, in which F-18-FDG PET semiquantitative analysis accurately revealed the longitudinal pathological changes in brain metabolism during acute and posttreatment remission stages, correlating with clinical impairment and response to treatment.
CLINICAL NUCLEAR MEDICINE
(2021)
Article
Immunology
Ramona Miske, Madeleine Scharf, Kathrin Borowski, Nicole Rieckhoff, Bianca Teegen, Yvonne Denno, Christian Probst, Kersten Guthke, Ieva Didrihsone, Brigitte Wildemann, Klemens Ruprecht, Lars Komorowski, Sven Jarius
Summary: This study identifies autoantibodies against septin-3 in patients with paraneoplastic cerebellar ataxia and proposes a strategy for anti-septin autoantibody determination.
JOURNAL OF NEUROINFLAMMATION
(2023)
Review
Neurosciences
Natalia Trombini Mendes, Nathalia Rossoni Ronchi, Guilherme Diogo Silva
Summary: This study summarizes the clinical features of anti-Yo/PCA1 antibody-associated cerebellar ataxia, with a focus on atypical presentations and knowledge gaps. The majority of patients were female with gynecologic cancer, while male patients had associated tumors mainly of gastrointestinal origin. Pancerebellar ataxia was the main clinical feature, but extracerebellar findings were also common. Neuroimaging usually showed normal or cerebellar atrophy, but inflammatory changes could also be present. More than half of the patients reported improvement after immunotherapy, but the majority of survivors were still unable to walk unassisted on follow-up.
Article
Clinical Neurology
Akihiko Kudo, Hiroaki Yaguchi, Keiko Tanaka, Akio Kimura, Ichiro Yabe
Summary: A retrospective study was conducted in a Japanese hospital to investigate the clinical features of autoimmune cerebellar ataxia (ACA) and differentiate it from neurodegenerative CA. Among the 243 CA patients enrolled, 13 were diagnosed with ACA. ACA showed less cerebellar atrophy compared to CA but had a higher frequency of CSF pleocytosis. Further studies are needed to identify additional clinical features and accurate diagnostic biomarkers for ACA.
JOURNAL OF NEUROLOGY
(2023)
Article
Oncology
Zeynep Ozozen Ayas, Gulgun Uncu
Summary: This article presents a rare case of a patient with paraneoplastic cerebellar degeneration (PCD) and papillary thyroid carcinoma (PTC), highlighting the importance for clinicians to be alert to this rare comorbidity.
Review
Neurosciences
Philipp Alexander Loehrer, Lara Zieger, Ole J. Simon
Summary: Paraneoplastic cerebellar degeneration (PCD) is characterized by rapidly progressive cerebellar syndrome and is associated with specific antibodies. Early recognition of clinical symptoms and antibodies is crucial for detecting underlying malignancies, and the 2021 updated diagnostic criteria play a key role in this process. Continuous surveillance of patients with specific symptoms and antibodies is recommended as clinical symptoms can precede tumor diagnosis by years.
Correction
Clinical Neurology
Satyan Nanda, Rahul Handa, Atul Prasad, Rajiv Anand, Dhruv Zutshi, Sujata K. Dass, Prabhjeet Kaur Bedi, Aarti Pahuja, Pankaj Kumar Shah, Bipan Sharma, Nalin Malhotra
Summary: Paraneoplastic cerebellar degeneration is a classic paraneoplastic syndrome with a low association with lymphomas. Early diagnosis and aggressive treatment are crucial for improving survival and reducing morbidity.
NEUROLOGICAL SCIENCES
(2021)
Article
Oncology
Michael J. Lehner, Jinesh S. Gheeya, Bilal A. Siddiqui, Sudhakar Tummala
Summary: PCA-1 associated PCD is a rare neurological disorder linked to breast and ovarian cancers, characterized by autoimmunity against cerebellar antigens. Prompt diagnosis and treatment are crucial, with immunosuppression being the primary treatment modality.
JOURNAL OF NEURO-ONCOLOGY
(2021)
Review
Clinical Neurology
Sophie L. Duong, Harald Pruess
Summary: The introduction of immune checkpoint inhibitors (ICIs) has revolutionized cancer treatment by increasing overall survival in patients with various tumors. However, ICIs can also lead to neurological immune-related adverse events (irAEs) known as paraneoplastic neurological syndromes (PNSs). ICI-induced PNSs are rare but can have severe and life-threatening manifestations. Timely diagnosis and intervention are crucial for favorable outcomes. This review focuses on the pathogenesis, clinical manifestations, and management of PNSs, as well as potential therapeutic monoclonal antibodies for their treatment.
Article
Immunology
Margrethe Raspotnig, Torbjorn Krakenes, Ida Herdlevaer, Mette Haugen, Christian Vedeler
Summary: The study revealed distinct distribution patterns of CDR2L and CDR2 antigens in the rat and human brain, with CDR2L primarily localized in Purkinje cells and large neurons, and CDR2 detected in vascular smooth muscle cells and the ventricle system. This suggests that CDR2L may be the main target of anti-Yo antibodies, as CDR2 and CDR2L are expressed by different cell subtypes.
JOURNAL OF NEUROIMMUNOLOGY
(2022)