中风与神经疾病杂志2025，Vol.42Issue(4)：328-334,7.DOI:10.19845/j.cnki.zfysjjbzz.2025.0065
谷氨酸脱羧酶65抗体相关神经综合征的影像特征
Imaging features of anti-glutamic acid decarboxylase 65 antibody-associated neurological syndromes
摘要
Abstract
Objective To investigate the dynamic imaging features of a group of patients with anti-glutamic acid decarbox-ylase 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 en-rolled,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 pa-tients receiving MRI follow-up.Conclusion The common imaging findings of anti-GAD65 antibody-associated autoimmune neu-rological syndromes include abnormal signals in the bilateral or unilateral hippocampus and abnormal signals in the cortex/subcorti-cal 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.关键词
谷氨酸脱羧酶65/磁共振成像/自身免疫性神经系统综合征/免疫疗法Key words
Glutamic acid decarboxylase 65/Magnetic resonance imaging/Autoimmune neurological syndromes/Immunotherapy分类
临床医学引用本文复制引用
周立霞,高境谦,吕飞燕,张文琳,王亮,曲珍珍,司沛沛,毛卓锋,贾丽景..谷氨酸脱羧酶65抗体相关神经综合征的影像特征[J].中风与神经疾病杂志,2025,42(4):328-334,7.基金项目
河北省重点研发计划卫生健康创新专项(22377710D) （22377710D）
