Different pain phenotypes are associated with anti-Caspr2 autoantibodies.

Greguletz P, Plötz M, Baade-Büttner C, Bien CG, Eisenhut K, Geis C, Handreka R, Klausewitz J, Körtvelyessy P, Kovac S, Kraft A, Lewerenz J, Malter M, Nagel M, von Podewils F, Prüß H, Rada A, Rau J, Rauer S, Rößling R, Seifert-Held T, Siebenbrodt K, Sühs KW, Tauber SC, Thaler F, Wagner J, Wickel J, Leypoldt F, Rittner HL, Sommer C, Villmann C, Doppler K (2024)

Publication Type: Journal article

Publication year: 2024

Journal

Book Volume: 271

Pages Range: 2736-2744

Journal Issue: 5

DOI: 10.1007/s00415-024-12224-4

Abstract

Autoantibodies against contactin-associated protein 2 (Caspr2) not only induce limbic autoimmune encephalitis but are also associated with pain conditions. Here, we analyzed clinical data on pain in a large cohort of patients included into the German Network for Research in Autoimmune Encephalitis. Out of 102 patients in our cohort, pain was a frequent symptom (36% of all patients), often severe (63.6% of the patients with pain) and/or even the major symptom (55.6% of the patients with pain). Pain phenotypes differed between patients. Cluster analysis revealed two major phenotypes including mostly distal-symmetric burning pain and widespread pain with myalgia and cramps. Almost all patients had IgG4 autoantibodies and some additional IgG1, 2, and/or 3 autoantibodies, but IgG subclasses, titers, and presence or absence of intrathecal synthesis were not associated with the occurrence of pain. However, certain pre-existing risk factors for chronic pain like diabetes mellitus, peripheral neuropathy, or preexisting chronic back pain tended to occur more frequently in patients with anti-Caspr2 autoantibodies and pain. Our data show that pain is a relevant symptom in patients with anti-Caspr2 autoantibodies and support the idea of decreased algesic thresholds leading to pain. Testing for anti-Caspr2 autoantibodies needs to be considered in patients with various pain phenotypes.

Involved external institutions

Universitätsmedizin Greifswald / Universitätsklinikum Greifswald Germany (DE) Universitätsklinikum Würzburg Germany (DE) Universitätsklinikum Jena Germany (DE) Universität Bielefeld Germany (DE) Klinikum der Universität München Germany (DE) Carl-Thiem-Klinikum Germany (DE) Katholisches Klinikum Bochum (St. Josef- und St. Elisabeth-Hospital gGmbH) Germany (DE) Universitätsklinikum Magdeburg A.ö.R. Germany (DE) Universitätsklinikum Münster Germany (DE) Krankenhaus Martha-Maria Halle-Dölau Germany (DE) Universität Ulm Germany (DE) Klinikum Osnabrück Germany (DE) Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE) Germany (DE) Albert-Ludwigs-Universität Freiburg Germany (DE) Medizinische Universität Graz Austria (AT) Universitätsklinikum Frankfurt am Main (KGU) Germany (DE) Medizinische Hochschule Hannover (MHH) / Hannover Medical School Germany (DE) Universitätsklinikum Aachen (UKA) Germany (DE) Kepler Universitätsklinikum (KUK) Austria (AT) Christian-Albrechts-Universität zu Kiel Germany (DE)

How to cite

APA:

Greguletz, P., Plötz, M., Baade-Büttner, C., Bien, C.G., Eisenhut, K., Geis, C.,... Doppler, K. (2024). Different pain phenotypes are associated with anti-Caspr2 autoantibodies. Journal of Neurology, 271(5), 2736-2744. https://doi.org/10.1007/s00415-024-12224-4

MLA:

Greguletz, Patrik, et al. "Different pain phenotypes are associated with anti-Caspr2 autoantibodies." Journal of Neurology 271.5 (2024): 2736-2744.

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