Published in:
Open Access
22-02-2024 | Neuropathic Pain | Original Communication
Different pain phenotypes are associated with anti-Caspr2 autoantibodies
Authors:
Patrik Greguletz, Maria Plötz, Carolin Baade-Büttner, Christian G. Bien, Katharina Eisenhut, Christian Geis, Robert Handreka, Jaqueline Klausewitz, Peter Körtvelyessy, Stjepana Kovac, Andrea Kraft, Jan Lewerenz, Michael Malter, Michael Nagel, Felix von Podewils, Harald Prüß, Anna Rada, Johanna Rau, Sebastian Rauer, Rosa Rößling, Thomas Seifert-Held, Kai Siebenbrodt, Kurt-Wolfram Sühs, Simone C. Tauber, Franziska Thaler, Judith Wagner, Jonathan Wickel, Frank Leypoldt, Heike L. Rittner, Claudia Sommer, Carmen Villmann, Kathrin Doppler, the GENERATE study group
Published in:
Journal of Neurology
|
Issue 5/2024
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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.