Cerebrospinal Fluid GAD65-Antibody Levels Accurately Identify Relevant Neurological Diseases.
5 affiliations
- 1Department of Neurology, Mayo Clinic, Jacksonville, Florida, USA.
- 2Department of Neurosciences, Mayo Clinic, Jacksonville, Florida, USA.
- 3Department of Neurology, St. Luke's University Health Network, Bethlehem, Pennsylvania, USA.
- 4Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA.
- 5Oxford Autoimmune Neurology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
Abstract
Retrospective cohort study to investigate which factors most reliably distinguish incidental GAD65-antibodies (iGAD65) from true GAD65-antibody neurological disease (tGAD65). 167 adults with positive serum and CSF GAD65-antibodies (> 0.02 nmol/L by radioimmunoassay) were classified as tGAD65 or iGAD65, with diagnostic performance of paraclinical parameters compared in discovery and validation cohorts. CSF GAD65-antibody titers ≥ 1 nmol/L performed best in discovery (AUC 0.956) and validation (AUC 0.949; p = 0.814), with 89.7% sensitivity and 94% specificity for identifying tGAD65. Serum titers > 20 nmol/L and indices of intrathecal synthesis showed lower discriminative ability. Our finding aims to reduce misdiagnosis and identify potential immunotherapy-responsive diseases.
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BibTeX
@article{herman2026cerebrospinal,
title = {{Cerebrospinal Fluid GAD65-Antibody Levels Accurately Identify Relevant Neurological Diseases.}},
author = {Max Charles Herman and Maya Marzello and Zoaib Habib Tharwani and Snigdha Kotaru and Yoav D Piura and Eric Newman and Gregory S Day and Andrew McKeon and A Sebastian Lopez-Chiriboga and Sarosh R Irani},
journal = {Annals of clinical and translational neurology},
year = {2026},
month = nov,
doi = {10.1002/acn3.70578},
url = {https://europepmc.org/article/MED/42974934},
note = {CC BY},
}
RIS
TY - JOUR
TI - Cerebrospinal Fluid GAD65-Antibody Levels Accurately Identify Relevant Neurological Diseases.
AU - Max Charles Herman
AU - Maya Marzello
AU - Zoaib Habib Tharwani
AU - Snigdha Kotaru
AU - Yoav D Piura
AU - Eric Newman
AU - Gregory S Day
AU - Andrew McKeon
AU - A Sebastian Lopez-Chiriboga
AU - Sarosh R Irani
PY - 2026
DA - 2026/11/03
JO - Annals of clinical and translational neurology
DO - 10.1002/acn3.70578
UR - https://europepmc.org/article/MED/42974934
AB - Retrospective cohort study to investigate which factors most reliably distinguish incidental GAD65-antibodies (iGAD65) from true GAD65-antibody neurological disease (tGAD65). 167 adults with positive serum and CSF GAD65-antibodies (> 0.02 nmol/L by radioimmunoassay) were classified as tGAD65 or iGAD65, with diagnostic performance of paraclinical parameters compared in discovery and validation cohorts. CSF GAD65-antibody titers ≥ 1 nmol/L performed best in discovery (AUC 0.956) and validation (AUC 0.949; p = 0.814), with 89.7% sensitivity and 94% specificity for identifying tGAD65. Serum titers > 20 nmol/L and indices of intrathecal synthesis showed lower discriminative ability. Our finding aims to reduce misdiagnosis and identify potential immunotherapy-responsive diseases.
SN - 2328-9503
ER -