A Growing and Rapidly Evolving Field
- Improving recognition of autoimmune disorders is driving higher patient diagnosis levels, however, therapy options remain limited for many conditions.
- There are abundant opportunities for clinical, translational, and basic science research to improve patient outcomes and quality of life.
Autoimmune Disorders Affecting the Nervous System
- Autoimmune disorders affecting the nervous system can cause a range of symptoms, including neurologic and psychiatric.
- This subspecialty is driven by recent discoveries of multiple autoantibodies that target proteins expressed in the central, peripheral, and autonomic nervous system.
Diagnosis and Treatment
- Patients typically present with highly complex medical histories and symptoms and can be challenging to effectively diagnose.
- Effective diagnosis and treatment of these disorders requires specialized expertise in Autoimmune Neurology
- Treatment options include immunomodulatory therapies tailored to patient presentations.
- Multidisciplinary care is often necessary as Autoimmune Neurology intersects with many other subspecialties in neurology including epilepsy, movement, cognitive, neuromuscular and other medical specialties such as rheumatology, oncology, gastroenterology, and psychiatry.
Director, Autoimmune Neurology Program
Céline Dion Foundation Endowed Chair in Autoimmune Neurology
Professor of Neurology
Landscape of neuronal autoantibody discovery
The concept of immune-mediated neurological syndromes linked to cancer dates back to the 19th century. In 1965, Dr. Josep Wilkinson's team first discovered neuronal antibodies in small-cell lung cancer patients with sensory neuronopathy. The identification of disease-specific neuronal antibodies accelerated in the 1980s, with notable discoveries including Purkinje cell antibodies in ovarian cancer (Greenlee & Brashear, 1983) and expanded descriptions of paraneoplastic syndromes (Posner et al., 1985). In 2004, Dr. Vanda Lennon characterized neuromyelitis optica (NMO) through aquaporin-4 antibodies (AQP4). The field grew rapidly after Professor Dalmau’s group described N-methyl-D-aspartate (NMDA) receptor encephalitis (NMDARE) in 2007, initially in young women with ovarian teratomas but later in a broader population, including men, women, and children. Beyond just NMDARE, other antibodies against cell-surface and synaptic antigens have been identified with increasing frequency (identified in red). The discovery of these cell-surface antibodies has shaped the landscape of Autoimmune Neurology, as it is now recognized that many of these antibody syndromes can be readily treatable with immunomodulatory therapy.