Alternative TitleAnti-ganglionic acetylcholine receptor antibodies in Functional Neurological Symptom Disorder/Conversion Disorderr
Degree Type博士(医学)
Doctor of Philosophy in Medical Science
Note (General)博士論文全文, 博士論文要旨, 最終試験結果の要旨, 論文審査の要旨
Objective: Autoimmune autonomic ganglionopathy (AAG) is a rare disorder characterized by autonomic failure associated with the presence of anti-ganglionic acetylcholine receptor (gAChR) antibodies; however, several studies have reported that individuals with anti-gAChR antibodies present with central nervous system (CNS) symptoms such as impaired consciousness and seizures. In the present study, we investigated whether the presence of serum anti-gAChR antibodies correlated with autonomic symptoms in patients with functional neurological symptom disorder/conversion disorder (FNSD/CD).Methods: Clinical data were collected for 59 patients presenting with neurologically unexplained motor and sensory symptoms at the Department of Neurology and Geriatrics between January 2013 and October 2017 and who were ultimately diagnosed with FNSD/CD according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. Correlations between serum anti-gAChR antibodies and clinical symptoms and laboratory data were analyzed. Data analysis was conducted in 2021.Results: Of the 59 patients with FNSD/CD, 52 (88.1%) exhibited autonomic disturbances and 16 (27.1%) were positive for serum anti-gAChR antibodies. Cardiovascular autonomic dysfunction, including orthostatic hypotension, was significantly more prevalent (75.0 vs. 34.9%, P = 0.008), whereas involuntary movements were significantly less prevalent (31.3 vs. 69.8%, P = 0.007), among anti-gAChR antibody-positive compared with -negative patients. Anti-gAChR antibody serostatus did not correlate significantly with the frequency of other autonomic, sensory, or motor symptoms analyzed.Conclusions: An autoimmune mechanism mediated by anti-gAChR antibodies may be involved in disease etiology in a subgroup of FNSD/CD patients.
Ryusei Nagata, Eiji Matsuura, Satoshi Nozuma, Mika Dozono, Yutaka Noguchi, Masahiro Ando, Yu Hiramatsu, Daisuke Kodama, Masakazu Tanaka, Ryuji Kubota, Munekazu Yamakuchi, Yujiro Higuchi, Yusuke Sakiyama, Hitoshi Arata, Keiko Higashi, Teruto Hashiguchi, Shunya Nakane and Hiroshi TakashimaAnti-ganglionic acetylcholine receptor antibodies in functional neurological symptom disorder/conversion disorderFrontiers in Neurology 14:1137958.https://doi.org/10.3389/fneur.2023.1137958
Collection (particular)国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文
Date Accepted (W3CDTF)2024-08-02T22:09:14+09:00
Data Provider (Database)国立国会図書館 : 国立国会図書館デジタルコレクション