N-Methyl- d -aspartate (NMDA) receptor antibody in relation to autism spectrum disorder (ASD): presence and association with symptom profile

Heba Hamed Elshahawi, Ghada Refaat Amin Taha,Hanan Mohamed Ezzeldin Azzam,Reem H. El Ghamry,Ahmed Adel Mohammad Abdelgawad, Mohammad Abdullah Ahmad Abdullah Elshiekh

MIDDLE EAST CURRENT PSYCHIATRY-MECPSYCH(2021)

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Abstract
Background Several studies pointed to immune dysregulation abnormalities linked to autism spectrum disorders (ASD). Of those, several autoantibodies had been identified. Recent findings of N-methyl d -aspartate (NMDA) antibodies in autoimmune encephalitis suggested that it caused symptoms like autistic regression. Thus, the purpose of the study was to test for the presence of anti-NMDAR antibodies in the ASD disorder population and to correlate this with the clinical findings. Results Eighty-seven autistic children, 4–12 years old, were enrolled in the study and were matched with sixty typically developing children used as controls. The diagnosis of cases was confirmed by ADOS-2 and clinical evaluation. None of the control children had positive anti-NMDAR antibodies, while 26.4% (23 children) of the patients’ group were positive for serum anti-NMDA receptor antibodies (> 200 pg/ml, p = 0.0157). The positive anti-NMDAR antibody was statistically correlated with better speech stage ( p = 0.017), more severe stereotyped behavior ( p ≤ 0.001), and abnormal EEG findings ( p = 0.025). Conclusions There is a possibility of the presence of anti-NMDAR antibodies in the autism spectrum disorder population with certain characteristics, especially the severity of the stereotyped behaviors.
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Key words
Autism, Autoimmune, Autoantibodies, NMDA receptor
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