Nav: Home

Responses to treatment, outcomes of autoimmune cerebellar ataxia

September 28, 2015

While autoimmune cerebellar ataxia (a loss of muscle coordination) can lead to severe disability with some patients becoming wheelchair-bound, there are factors that may help to predict better immunotherapy response and neurological outcomes, according to an article published online by JAMA Neurology.

Autoimmune cerebellar ataxia in adults, which usually comes on rapidly and progresses quickly, can be divided into disorders that are paraneoplastic (triggered by cancer in the body) or nonparaneoplastic (non-cancer-related autoimmune disorders of the central nervous system). The disabling neurological effects can include speech that is not clearly articulated, gait and balance disorders, and loss of muscle control in the limbs. Little has been published regarding treatment responses and neurologic outcomes among patients with autoimmune cerebellar ataxia. However, at least 17 autoantibodies have been reported as causally linked to autoimmune cerebellar ataxia.

Andrew McKeon, M.D., of the Mayo Clinic, Rochester, Minn., and coauthors reviewed medical records at the Mayo Clinic to examine treatment responses and outcomes in 118 adults with autoimmune cerebellar ataxia who were seropositive for at least one neural autoantibody, had received at least one immunotherapy or cancer therapy, and had neurologist-reported outcomes from 1989 through 2013.

Results indicate the median (midpoint) age at onset of neurologic symptoms was 58, nearly three-quarters of the patients were women, and the median duration from symptom onset to last follow-up was 25 months. Among the patients, 63 had paraneoplastic ataxic disorders and 55 patients had nonparaneoplastic ataxic disorders. Also, 81 patients were seropositive for NNC [neuronal nuclear and/or cytoplasmic] antibodies; 22 patients for neural PMP [plasma membrane protein] receptor or ion channel antibodies; and 15 patients for antibodies from both categories.

Overall, 54 patients (45.8 percent) had physician-reported neurologic improvement with immunotherapy (n=51) or cancer therapy (n=3), according to the study results. Analyses suggest factors that may predict better immunotherapy response and neurologic outcomes include a nonparaneoplastic disorder, the detection of at least one or more PMP antibodies or the detection of GAD 65 [glutamic acid decarboxylase 65-kDa isoform] antibodies.

Regardless of the response to immunotherapy, the final ambulatory outcomes regarding the use of gait aids to get around were 56 patients used a wheelchair, 26 patients had walkers and seven patients used canes. Among the remaining 29 patients, 25 of them required no gait aid but had an abnormal gait and four patients had normal gait, the study reports.

"Although autoimmune ataxia is usually severe, treatment responses can be gratifying, particularly in patients with nonparaneoplastic disorders and in those harboring autoantibodies directed against GAD65 or neural PMPs," the study concludes.
-end-
(JAMA Neurol. Published online September 28, 2015. doi:10.1001/jamaneurol.2015.2378. Available pre-embargo to the media at http://media.jamanetwork.com.)

Editor's Note: An author made a conflict of interest disclosure. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Media Advisory: To contact corresponding author Andrew McKeon, M.D., call Dusanka Anastasijevic at 507-284-5005 or email Anastasijevic.Duska@mayo.edu.

To place an electronic embedded link in your story: Links will be live at the embargo time: http://archneur.jamanetwork.com/article.aspx?doi=10.1001/jamaneurol.2015.1843

The JAMA Network Journals

Related Cancer Articles:

Radiotherapy for invasive breast cancer increases the risk of second primary lung cancer
East Asian female breast cancer patients receiving radiotherapy have a higher risk of developing second primary lung cancer.
Cancer genomics continued: Triple negative breast cancer and cancer immunotherapy
Continuing PLOS Medicine's special issue on cancer genomics, Christos Hatzis of Yale University, New Haven, Conn., USA and colleagues describe a new subtype of triple negative breast cancer that may be more amenable to treatment than other cases of this difficult-to-treat disease.
Metabolite that promotes cancer cell transformation and colorectal cancer spread identified
Osaka University researchers revealed that the metabolite D-2-hydroxyglurate (D-2HG) promotes epithelial-mesenchymal transition of colorectal cancer cells, leading them to develop features of lower adherence to neighboring cells, increased invasiveness, and greater likelihood of metastatic spread.
UH Cancer Center researcher finds new driver of an aggressive form of brain cancer
University of Hawai'i Cancer Center researchers have identified an essential driver of tumor cell invasion in glioblastoma, the most aggressive form of brain cancer that can occur at any age.
UH Cancer Center researchers develop algorithm to find precise cancer treatments
University of Hawai'i Cancer Center researchers developed a computational algorithm to analyze 'Big Data' obtained from tumor samples to better understand and treat cancer.
New analytical technology to quantify anti-cancer drugs inside cancer cells
University of Oklahoma researchers will apply a new analytical technology that could ultimately provide a powerful tool for improved treatment of cancer patients in Oklahoma and beyond.
Radiotherapy for lung cancer patients is linked to increased risk of non-cancer deaths
Researchers have found that treating patients who have early stage non-small cell lung cancer with a type of radiotherapy called stereotactic body radiation therapy is associated with a small but increased risk of death from causes other than cancer.
Cancer expert says public health and prevention measures are key to defeating cancer
Is investment in research to develop new treatments the best approach to controlling cancer?
UI Cancer Center, Governors State to address cancer disparities in south suburbs
The University of Illinois Cancer Center and Governors State University have received a joint four-year, $1.5 million grant from the National Cancer Institute to help both institutions conduct community-based research to reduce cancer-related health disparities in Chicago's south suburbs.
Leading cancer research organizations to host international cancer immunotherapy conference
The Cancer Research Institute, the Association for Cancer Immunotherapy, the European Academy of Tumor Immunology, and the American Association for Cancer Research will join forces to sponsor the first International Cancer Immunotherapy Conference at the Sheraton New York Times Square Hotel in New York, Sept.

Related Cancer Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Jumpstarting Creativity
Our greatest breakthroughs and triumphs have one thing in common: creativity. But how do you ignite it? And how do you rekindle it? This hour, TED speakers explore ideas on jumpstarting creativity. Guests include economist Tim Harford, producer Helen Marriage, artificial intelligence researcher Steve Engels, and behavioral scientist Marily Oppezzo.
Now Playing: Science for the People

#524 The Human Network
What does a network of humans look like and how does it work? How does information spread? How do decisions and opinions spread? What gets distorted as it moves through the network and why? This week we dig into the ins and outs of human networks with Matthew Jackson, Professor of Economics at Stanford University and author of the book "The Human Network: How Your Social Position Determines Your Power, Beliefs, and Behaviours".