May 02, 2017; 88 (18) Article
Clinical manifestations of the anti-IgLON5 disease
Carles Gaig, Francesc Graus, Yarko Compta, Birgit Högl, Luis Bataller, Norbert Brüggemann, Caroline Giordana, Anna Heidbreder, Katya Kotschet, Jan Lewerenz, Stefan Macher, Maria J. Martí, Teresa Montojo, Jesus Pérez-Pérez, Inmaculada Puertas, Caspar Seitz, Mateus Simabukuro, Nieves Téllez, Klaus-Peter Wandinger, Alex Iranzo, Guadalupe Ercilla, Lidia Sabater, Joan Santamaría, Josep Dalmau
First published April 5, 2017, DOI: https://doi.org/10.1212/WNL.0000000000003887
Carles Gaig
From the Neuroimmunology Program (C. Gaig, F.G., A.I., L.S., J.S., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Department of Neurology (C. Gaig, F.G., Y.C., M.J.M., A.I., J.S.), Multidisciplinary Sleep Disorders Unit (C. Gaig, A.I., J.S.), Parkinson's Disease & Movement Disorders Unit (Y.C., M.J.M.), and Department of Immunology (G.E.), Hospital Clinic, Barcelona, Spain; Department of Neurology (B.H.), Medical University of Innsbruck, Austria; Department of Neurology (L.B.), Hospital Universitari i Politècnic La Fe; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (L.B., L.S., J.D.), Valencia, Spain; Department of Neurology and Institute of Neurogenetics (N.P., K.-P.W.), University of Lübeck, Germany; Department of Movement Disorders and Neurology (C. Giordana), Centre Hospitalier Universitaire Nice, France; Department of Neurology (A.H.), Division of Sleep Medicine and Neuromuscular Disorders, University Hospital Muenster, Germany; Clinical Neurosciences (K.K.), St Vincent's Hospital, Melbourne, Australia; Department of Neurology (J.L.), Ulm University, Germany; Department of Neurology (S.M.), Medical University of Vienna, Austria; Department of Neurology (T.M.), Centre Hospitalier de Luxembourg; Department of Neurology (J.P.-P.), Hospital de la Santa Creu i Sant Pau, Barcelona; Department of Neurology (I.P.), Hospital La Paz, Madrid, Spain; Department of Neurology (C.S.), University Medical Center of the Johannes Gutenberg University Mainz, Germany; Neurology Division (M.S.), Hospital das Clínicas, São Paulo University, Brazil; Department of Neurology (N.T.), Hospital Clínico Universitario, Valladolid, Spain; Institute of Clinical Chemistry (K.-P.W.), University Hospital Schleswig-Holstein, Lübeck, Germany; Department of Neurology (J.D.), University of Pennsylvania, Philadelphia; and Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain.
Francesc Graus
From the Neuroimmunology Program (C. Gaig, F.G., A.I., L.S., J.S., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Department of Neurology (C. Gaig, F.G., Y.C., M.J.M., A.I., J.S.), Multidisciplinary Sleep Disorders Unit (C. Gaig, A.I., J.S.), Parkinson's Disease & Movement Disorders Unit (Y.C., M.J.M.), and Department of Immunology (G.E.), Hospital Clinic, Barcelona, Spain; Department of Neurology (B.H.), Medical University of Innsbruck, Austria; Department of Neurology (L.B.), Hospital Universitari i Politècnic La Fe; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (L.B., L.S., J.D.), Valencia, Spain; Department of Neurology and Institute of Neurogenetics (N.P., K.-P.W.), University of Lübeck, Germany; Department of Movement Disorders and Neurology (C. Giordana), Centre Hospitalier Universitaire Nice, France; Department of Neurology (A.H.), Division of Sleep Medicine and Neuromuscular Disorders, University Hospital Muenster, Germany; Clinical Neurosciences (K.K.), St Vincent's Hospital, Melbourne, Australia; Department of Neurology (J.L.), Ulm University, Germany; Department of Neurology (S.M.), Medical University of Vienna, Austria; Department of Neurology (T.M.), Centre Hospitalier de Luxembourg; Department of Neurology (J.P.-P.), Hospital de la Santa Creu i Sant Pau, Barcelona; Department of Neurology (I.P.), Hospital La Paz, Madrid, Spain; Department of Neurology (C.S.), University Medical Center of the Johannes Gutenberg University Mainz, Germany; Neurology Division (M.S.), Hospital das Clínicas, São Paulo University, Brazil; Department of Neurology (N.T.), Hospital Clínico Universitario, Valladolid, Spain; Institute of Clinical Chemistry (K.-P.W.), University Hospital Schleswig-Holstein, Lübeck, Germany; Department of Neurology (J.D.), University of Pennsylvania, Philadelphia; and Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain.
Yarko Compta
From the Neuroimmunology Program (C. Gaig, F.G., A.I., L.S., J.S., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Department of Neurology (C. Gaig, F.G., Y.C., M.J.M., A.I., J.S.), Multidisciplinary Sleep Disorders Unit (C. Gaig, A.I., J.S.), Parkinson's Disease & Movement Disorders Unit (Y.C., M.J.M.), and Department of Immunology (G.E.), Hospital Clinic, Barcelona, Spain; Department of Neurology (B.H.), Medical University of Innsbruck, Austria; Department of Neurology (L.B.), Hospital Universitari i Politècnic La Fe; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (L.B., L.S., J.D.), Valencia, Spain; Department of Neurology and Institute of Neurogenetics (N.P., K.-P.W.), University of Lübeck, Germany; Department of Movement Disorders and Neurology (C. Giordana), Centre Hospitalier Universitaire Nice, France; Department of Neurology (A.H.), Division of Sleep Medicine and Neuromuscular Disorders, University Hospital Muenster, Germany; Clinical Neurosciences (K.K.), St Vincent's Hospital, Melbourne, Australia; Department of Neurology (J.L.), Ulm University, Germany; Department of Neurology (S.M.), Medical University of Vienna, Austria; Department of Neurology (T.M.), Centre Hospitalier de Luxembourg; Department of Neurology (J.P.-P.), Hospital de la Santa Creu i Sant Pau, Barcelona; Department of Neurology (I.P.), Hospital La Paz, Madrid, Spain; Department of Neurology (C.S.), University Medical Center of the Johannes Gutenberg University Mainz, Germany; Neurology Division (M.S.), Hospital das Clínicas, São Paulo University, Brazil; Department of Neurology (N.T.), Hospital Clínico Universitario, Valladolid, Spain; Institute of Clinical Chemistry (K.-P.W.), University Hospital Schleswig-Holstein, Lübeck, Germany; Department of Neurology (J.D.), University of Pennsylvania, Philadelphia; and Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain.
Birgit Högl
From the Neuroimmunology Program (C. Gaig, F.G., A.I., L.S., J.S., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Department of Neurology (C. Gaig, F.G., Y.C., M.J.M., A.I., J.S.), Multidisciplinary Sleep Disorders Unit (C. Gaig, A.I., J.S.), Parkinson's Disease & Movement Disorders Unit (Y.C., M.J.M.), and Department of Immunology (G.E.), Hospital Clinic, Barcelona, Spain; Department of Neurology (B.H.), Medical University of Innsbruck, Austria; Department of Neurology (L.B.), Hospital Universitari i Politècnic La Fe; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (L.B., L.S., J.D.), Valencia, Spain; Department of Neurology and Institute of Neurogenetics (N.P., K.-P.W.), University of Lübeck, Germany; Department of Movement Disorders and Neurology (C. Giordana), Centre Hospitalier Universitaire Nice, France; Department of Neurology (A.H.), Division of Sleep Medicine and Neuromuscular Disorders, University Hospital Muenster, Germany; Clinical Neurosciences (K.K.), St Vincent's Hospital, Melbourne, Australia; Department of Neurology (J.L.), Ulm University, Germany; Department of Neurology (S.M.), Medical University of Vienna, Austria; Department of Neurology (T.M.), Centre Hospitalier de Luxembourg; Department of Neurology (J.P.-P.), Hospital de la Santa Creu i Sant Pau, Barcelona; Department of Neurology (I.P.), Hospital La Paz, Madrid, Spain; Department of Neurology (C.S.), University Medical Center of the Johannes Gutenberg University Mainz, Germany; Neurology Division (M.S.), Hospital das Clínicas, São Paulo University, Brazil; Department of Neurology (N.T.), Hospital Clínico Universitario, Valladolid, Spain; Institute of Clinical Chemistry (K.-P.W.), University Hospital Schleswig-Holstein, Lübeck, Germany; Department of Neurology (J.D.), University of Pennsylvania, Philadelphia; and Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain.
Luis Bataller
From the Neuroimmunology Program (C. Gaig, F.G., A.I., L.S., J.S., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Department of Neurology (C. Gaig, F.G., Y.C., M.J.M., A.I., J.S.), Multidisciplinary Sleep Disorders Unit (C. Gaig, A.I., J.S.), Parkinson's Disease & Movement Disorders Unit (Y.C., M.J.M.), and Department of Immunology (G.E.), Hospital Clinic, Barcelona, Spain; Department of Neurology (B.H.), Medical University of Innsbruck, Austria; Department of Neurology (L.B.), Hospital Universitari i Politècnic La Fe; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (L.B., L.S., J.D.), Valencia, Spain; Department of Neurology and Institute of Neurogenetics (N.P., K.-P.W.), University of Lübeck, Germany; Department of Movement Disorders and Neurology (C. Giordana), Centre Hospitalier Universitaire Nice, France; Department of Neurology (A.H.), Division of Sleep Medicine and Neuromuscular Disorders, University Hospital Muenster, Germany; Clinical Neurosciences (K.K.), St Vincent's Hospital, Melbourne, Australia; Department of Neurology (J.L.), Ulm University, Germany; Department of Neurology (S.M.), Medical University of Vienna, Austria; Department of Neurology (T.M.), Centre Hospitalier de Luxembourg; Department of Neurology (J.P.-P.), Hospital de la Santa Creu i Sant Pau, Barcelona; Department of Neurology (I.P.), Hospital La Paz, Madrid, Spain; Department of Neurology (C.S.), University Medical Center of the Johannes Gutenberg University Mainz, Germany; Neurology Division (M.S.), Hospital das Clínicas, São Paulo University, Brazil; Department of Neurology (N.T.), Hospital Clínico Universitario, Valladolid, Spain; Institute of Clinical Chemistry (K.-P.W.), University Hospital Schleswig-Holstein, Lübeck, Germany; Department of Neurology (J.D.), University of Pennsylvania, Philadelphia; and Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain.
Norbert Brüggemann
From the Neuroimmunology Program (C. Gaig, F.G., A.I., L.S., J.S., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Department of Neurology (C. Gaig, F.G., Y.C., M.J.M., A.I., J.S.), Multidisciplinary Sleep Disorders Unit (C. Gaig, A.I., J.S.), Parkinson's Disease & Movement Disorders Unit (Y.C., M.J.M.), and Department of Immunology (G.E.), Hospital Clinic, Barcelona, Spain; Department of Neurology (B.H.), Medical University of Innsbruck, Austria; Department of Neurology (L.B.), Hospital Universitari i Politècnic La Fe; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (L.B., L.S., J.D.), Valencia, Spain; Department of Neurology and Institute of Neurogenetics (N.P., K.-P.W.), University of Lübeck, Germany; Department of Movement Disorders and Neurology (C. Giordana), Centre Hospitalier Universitaire Nice, France; Department of Neurology (A.H.), Division of Sleep Medicine and Neuromuscular Disorders, University Hospital Muenster, Germany; Clinical Neurosciences (K.K.), St Vincent's Hospital, Melbourne, Australia; Department of Neurology (J.L.), Ulm University, Germany; Department of Neurology (S.M.), Medical University of Vienna, Austria; Department of Neurology (T.M.), Centre Hospitalier de Luxembourg; Department of Neurology (J.P.-P.), Hospital de la Santa Creu i Sant Pau, Barcelona; Department of Neurology (I.P.), Hospital La Paz, Madrid, Spain; Department of Neurology (C.S.), University Medical Center of the Johannes Gutenberg University Mainz, Germany; Neurology Division (M.S.), Hospital das Clínicas, São Paulo University, Brazil; Department of Neurology (N.T.), Hospital Clínico Universitario, Valladolid, Spain; Institute of Clinical Chemistry (K.-P.W.), University Hospital Schleswig-Holstein, Lübeck, Germany; Department of Neurology (J.D.), University of Pennsylvania, Philadelphia; and Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain.
Caroline Giordana
From the Neuroimmunology Program (C. Gaig, F.G., A.I., L.S., J.S., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Department of Neurology (C. Gaig, F.G., Y.C., M.J.M., A.I., J.S.), Multidisciplinary Sleep Disorders Unit (C. Gaig, A.I., J.S.), Parkinson's Disease & Movement Disorders Unit (Y.C., M.J.M.), and Department of Immunology (G.E.), Hospital Clinic, Barcelona, Spain; Department of Neurology (B.H.), Medical University of Innsbruck, Austria; Department of Neurology (L.B.), Hospital Universitari i Politècnic La Fe; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (L.B., L.S., J.D.), Valencia, Spain; Department of Neurology and Institute of Neurogenetics (N.P., K.-P.W.), University of Lübeck, Germany; Department of Movement Disorders and Neurology (C. Giordana), Centre Hospitalier Universitaire Nice, France; Department of Neurology (A.H.), Division of Sleep Medicine and Neuromuscular Disorders, University Hospital Muenster, Germany; Clinical Neurosciences (K.K.), St Vincent's Hospital, Melbourne, Australia; Department of Neurology (J.L.), Ulm University, Germany; Department of Neurology (S.M.), Medical University of Vienna, Austria; Department of Neurology (T.M.), Centre Hospitalier de Luxembourg; Department of Neurology (J.P.-P.), Hospital de la Santa Creu i Sant Pau, Barcelona; Department of Neurology (I.P.), Hospital La Paz, Madrid, Spain; Department of Neurology (C.S.), University Medical Center of the Johannes Gutenberg University Mainz, Germany; Neurology Division (M.S.), Hospital das Clínicas, São Paulo University, Brazil; Department of Neurology (N.T.), Hospital Clínico Universitario, Valladolid, Spain; Institute of Clinical Chemistry (K.-P.W.), University Hospital Schleswig-Holstein, Lübeck, Germany; Department of Neurology (J.D.), University of Pennsylvania, Philadelphia; and Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain.
Anna Heidbreder
From the Neuroimmunology Program (C. Gaig, F.G., A.I., L.S., J.S., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Department of Neurology (C. Gaig, F.G., Y.C., M.J.M., A.I., J.S.), Multidisciplinary Sleep Disorders Unit (C. Gaig, A.I., J.S.), Parkinson's Disease & Movement Disorders Unit (Y.C., M.J.M.), and Department of Immunology (G.E.), Hospital Clinic, Barcelona, Spain; Department of Neurology (B.H.), Medical University of Innsbruck, Austria; Department of Neurology (L.B.), Hospital Universitari i Politècnic La Fe; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (L.B., L.S., J.D.), Valencia, Spain; Department of Neurology and Institute of Neurogenetics (N.P., K.-P.W.), University of Lübeck, Germany; Department of Movement Disorders and Neurology (C. Giordana), Centre Hospitalier Universitaire Nice, France; Department of Neurology (A.H.), Division of Sleep Medicine and Neuromuscular Disorders, University Hospital Muenster, Germany; Clinical Neurosciences (K.K.), St Vincent's Hospital, Melbourne, Australia; Department of Neurology (J.L.), Ulm University, Germany; Department of Neurology (S.M.), Medical University of Vienna, Austria; Department of Neurology (T.M.), Centre Hospitalier de Luxembourg; Department of Neurology (J.P.-P.), Hospital de la Santa Creu i Sant Pau, Barcelona; Department of Neurology (I.P.), Hospital La Paz, Madrid, Spain; Department of Neurology (C.S.), University Medical Center of the Johannes Gutenberg University Mainz, Germany; Neurology Division (M.S.), Hospital das Clínicas, São Paulo University, Brazil; Department of Neurology (N.T.), Hospital Clínico Universitario, Valladolid, Spain; Institute of Clinical Chemistry (K.-P.W.), University Hospital Schleswig-Holstein, Lübeck, Germany; Department of Neurology (J.D.), University of Pennsylvania, Philadelphia; and Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain.
Katya Kotschet
From the Neuroimmunology Program (C. Gaig, F.G., A.I., L.S., J.S., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Department of Neurology (C. Gaig, F.G., Y.C., M.J.M., A.I., J.S.), Multidisciplinary Sleep Disorders Unit (C. Gaig, A.I., J.S.), Parkinson's Disease & Movement Disorders Unit (Y.C., M.J.M.), and Department of Immunology (G.E.), Hospital Clinic, Barcelona, Spain; Department of Neurology (B.H.), Medical University of Innsbruck, Austria; Department of Neurology (L.B.), Hospital Universitari i Politècnic La Fe; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (L.B., L.S., J.D.), Valencia, Spain; Department of Neurology and Institute of Neurogenetics (N.P., K.-P.W.), University of Lübeck, Germany; Department of Movement Disorders and Neurology (C. Giordana), Centre Hospitalier Universitaire Nice, France; Department of Neurology (A.H.), Division of Sleep Medicine and Neuromuscular Disorders, University Hospital Muenster, Germany; Clinical Neurosciences (K.K.), St Vincent's Hospital, Melbourne, Australia; Department of Neurology (J.L.), Ulm University, Germany; Department of Neurology (S.M.), Medical University of Vienna, Austria; Department of Neurology (T.M.), Centre Hospitalier de Luxembourg; Department of Neurology (J.P.-P.), Hospital de la Santa Creu i Sant Pau, Barcelona; Department of Neurology (I.P.), Hospital La Paz, Madrid, Spain; Department of Neurology (C.S.), University Medical Center of the Johannes Gutenberg University Mainz, Germany; Neurology Division (M.S.), Hospital das Clínicas, São Paulo University, Brazil; Department of Neurology (N.T.), Hospital Clínico Universitario, Valladolid, Spain; Institute of Clinical Chemistry (K.-P.W.), University Hospital Schleswig-Holstein, Lübeck, Germany; Department of Neurology (J.D.), University of Pennsylvania, Philadelphia; and Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain.
Jan Lewerenz
From the Neuroimmunology Program (C. Gaig, F.G., A.I., L.S., J.S., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Department of Neurology (C. Gaig, F.G., Y.C., M.J.M., A.I., J.S.), Multidisciplinary Sleep Disorders Unit (C. Gaig, A.I., J.S.), Parkinson's Disease & Movement Disorders Unit (Y.C., M.J.M.), and Department of Immunology (G.E.), Hospital Clinic, Barcelona, Spain; Department of Neurology (B.H.), Medical University of Innsbruck, Austria; Department of Neurology (L.B.), Hospital Universitari i Politècnic La Fe; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (L.B., L.S., J.D.), Valencia, Spain; Department of Neurology and Institute of Neurogenetics (N.P., K.-P.W.), University of Lübeck, Germany; Department of Movement Disorders and Neurology (C. Giordana), Centre Hospitalier Universitaire Nice, France; Department of Neurology (A.H.), Division of Sleep Medicine and Neuromuscular Disorders, University Hospital Muenster, Germany; Clinical Neurosciences (K.K.), St Vincent's Hospital, Melbourne, Australia; Department of Neurology (J.L.), Ulm University, Germany; Department of Neurology (S.M.), Medical University of Vienna, Austria; Department of Neurology (T.M.), Centre Hospitalier de Luxembourg; Department of Neurology (J.P.-P.), Hospital de la Santa Creu i Sant Pau, Barcelona; Department of Neurology (I.P.), Hospital La Paz, Madrid, Spain; Department of Neurology (C.S.), University Medical Center of the Johannes Gutenberg University Mainz, Germany; Neurology Division (M.S.), Hospital das Clínicas, São Paulo University, Brazil; Department of Neurology (N.T.), Hospital Clínico Universitario, Valladolid, Spain; Institute of Clinical Chemistry (K.-P.W.), University Hospital Schleswig-Holstein, Lübeck, Germany; Department of Neurology (J.D.), University of Pennsylvania, Philadelphia; and Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain.
Stefan Macher
From the Neuroimmunology Program (C. Gaig, F.G., A.I., L.S., J.S., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Department of Neurology (C. Gaig, F.G., Y.C., M.J.M., A.I., J.S.), Multidisciplinary Sleep Disorders Unit (C. Gaig, A.I., J.S.), Parkinson's Disease & Movement Disorders Unit (Y.C., M.J.M.), and Department of Immunology (G.E.), Hospital Clinic, Barcelona, Spain; Department of Neurology (B.H.), Medical University of Innsbruck, Austria; Department of Neurology (L.B.), Hospital Universitari i Politècnic La Fe; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (L.B., L.S., J.D.), Valencia, Spain; Department of Neurology and Institute of Neurogenetics (N.P., K.-P.W.), University of Lübeck, Germany; Department of Movement Disorders and Neurology (C. Giordana), Centre Hospitalier Universitaire Nice, France; Department of Neurology (A.H.), Division of Sleep Medicine and Neuromuscular Disorders, University Hospital Muenster, Germany; Clinical Neurosciences (K.K.), St Vincent's Hospital, Melbourne, Australia; Department of Neurology (J.L.), Ulm University, Germany; Department of Neurology (S.M.), Medical University of Vienna, Austria; Department of Neurology (T.M.), Centre Hospitalier de Luxembourg; Department of Neurology (J.P.-P.), Hospital de la Santa Creu i Sant Pau, Barcelona; Department of Neurology (I.P.), Hospital La Paz, Madrid, Spain; Department of Neurology (C.S.), University Medical Center of the Johannes Gutenberg University Mainz, Germany; Neurology Division (M.S.), Hospital das Clínicas, São Paulo University, Brazil; Department of Neurology (N.T.), Hospital Clínico Universitario, Valladolid, Spain; Institute of Clinical Chemistry (K.-P.W.), University Hospital Schleswig-Holstein, Lübeck, Germany; Department of Neurology (J.D.), University of Pennsylvania, Philadelphia; and Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain.
Maria J. Martí
From the Neuroimmunology Program (C. Gaig, F.G., A.I., L.S., J.S., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Department of Neurology (C. Gaig, F.G., Y.C., M.J.M., A.I., J.S.), Multidisciplinary Sleep Disorders Unit (C. Gaig, A.I., J.S.), Parkinson's Disease & Movement Disorders Unit (Y.C., M.J.M.), and Department of Immunology (G.E.), Hospital Clinic, Barcelona, Spain; Department of Neurology (B.H.), Medical University of Innsbruck, Austria; Department of Neurology (L.B.), Hospital Universitari i Politècnic La Fe; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (L.B., L.S., J.D.), Valencia, Spain; Department of Neurology and Institute of Neurogenetics (N.P., K.-P.W.), University of Lübeck, Germany; Department of Movement Disorders and Neurology (C. Giordana), Centre Hospitalier Universitaire Nice, France; Department of Neurology (A.H.), Division of Sleep Medicine and Neuromuscular Disorders, University Hospital Muenster, Germany; Clinical Neurosciences (K.K.), St Vincent's Hospital, Melbourne, Australia; Department of Neurology (J.L.), Ulm University, Germany; Department of Neurology (S.M.), Medical University of Vienna, Austria; Department of Neurology (T.M.), Centre Hospitalier de Luxembourg; Department of Neurology (J.P.-P.), Hospital de la Santa Creu i Sant Pau, Barcelona; Department of Neurology (I.P.), Hospital La Paz, Madrid, Spain; Department of Neurology (C.S.), University Medical Center of the Johannes Gutenberg University Mainz, Germany; Neurology Division (M.S.), Hospital das Clínicas, São Paulo University, Brazil; Department of Neurology (N.T.), Hospital Clínico Universitario, Valladolid, Spain; Institute of Clinical Chemistry (K.-P.W.), University Hospital Schleswig-Holstein, Lübeck, Germany; Department of Neurology (J.D.), University of Pennsylvania, Philadelphia; and Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain.
Teresa Montojo
From the Neuroimmunology Program (C. Gaig, F.G., A.I., L.S., J.S., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Department of Neurology (C. Gaig, F.G., Y.C., M.J.M., A.I., J.S.), Multidisciplinary Sleep Disorders Unit (C. Gaig, A.I., J.S.), Parkinson's Disease & Movement Disorders Unit (Y.C., M.J.M.), and Department of Immunology (G.E.), Hospital Clinic, Barcelona, Spain; Department of Neurology (B.H.), Medical University of Innsbruck, Austria; Department of Neurology (L.B.), Hospital Universitari i Politècnic La Fe; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (L.B., L.S., J.D.), Valencia, Spain; Department of Neurology and Institute of Neurogenetics (N.P., K.-P.W.), University of Lübeck, Germany; Department of Movement Disorders and Neurology (C. Giordana), Centre Hospitalier Universitaire Nice, France; Department of Neurology (A.H.), Division of Sleep Medicine and Neuromuscular Disorders, University Hospital Muenster, Germany; Clinical Neurosciences (K.K.), St Vincent's Hospital, Melbourne, Australia; Department of Neurology (J.L.), Ulm University, Germany; Department of Neurology (S.M.), Medical University of Vienna, Austria; Department of Neurology (T.M.), Centre Hospitalier de Luxembourg; Department of Neurology (J.P.-P.), Hospital de la Santa Creu i Sant Pau, Barcelona; Department of Neurology (I.P.), Hospital La Paz, Madrid, Spain; Department of Neurology (C.S.), University Medical Center of the Johannes Gutenberg University Mainz, Germany; Neurology Division (M.S.), Hospital das Clínicas, São Paulo University, Brazil; Department of Neurology (N.T.), Hospital Clínico Universitario, Valladolid, Spain; Institute of Clinical Chemistry (K.-P.W.), University Hospital Schleswig-Holstein, Lübeck, Germany; Department of Neurology (J.D.), University of Pennsylvania, Philadelphia; and Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain.
Jesus Pérez-Pérez
From the Neuroimmunology Program (C. Gaig, F.G., A.I., L.S., J.S., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Department of Neurology (C. Gaig, F.G., Y.C., M.J.M., A.I., J.S.), Multidisciplinary Sleep Disorders Unit (C. Gaig, A.I., J.S.), Parkinson's Disease & Movement Disorders Unit (Y.C., M.J.M.), and Department of Immunology (G.E.), Hospital Clinic, Barcelona, Spain; Department of Neurology (B.H.), Medical University of Innsbruck, Austria; Department of Neurology (L.B.), Hospital Universitari i Politècnic La Fe; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (L.B., L.S., J.D.), Valencia, Spain; Department of Neurology and Institute of Neurogenetics (N.P., K.-P.W.), University of Lübeck, Germany; Department of Movement Disorders and Neurology (C. Giordana), Centre Hospitalier Universitaire Nice, France; Department of Neurology (A.H.), Division of Sleep Medicine and Neuromuscular Disorders, University Hospital Muenster, Germany; Clinical Neurosciences (K.K.), St Vincent's Hospital, Melbourne, Australia; Department of Neurology (J.L.), Ulm University, Germany; Department of Neurology (S.M.), Medical University of Vienna, Austria; Department of Neurology (T.M.), Centre Hospitalier de Luxembourg; Department of Neurology (J.P.-P.), Hospital de la Santa Creu i Sant Pau, Barcelona; Department of Neurology (I.P.), Hospital La Paz, Madrid, Spain; Department of Neurology (C.S.), University Medical Center of the Johannes Gutenberg University Mainz, Germany; Neurology Division (M.S.), Hospital das Clínicas, São Paulo University, Brazil; Department of Neurology (N.T.), Hospital Clínico Universitario, Valladolid, Spain; Institute of Clinical Chemistry (K.-P.W.), University Hospital Schleswig-Holstein, Lübeck, Germany; Department of Neurology (J.D.), University of Pennsylvania, Philadelphia; and Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain.
Inmaculada Puertas
From the Neuroimmunology Program (C. Gaig, F.G., A.I., L.S., J.S., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Department of Neurology (C. Gaig, F.G., Y.C., M.J.M., A.I., J.S.), Multidisciplinary Sleep Disorders Unit (C. Gaig, A.I., J.S.), Parkinson's Disease & Movement Disorders Unit (Y.C., M.J.M.), and Department of Immunology (G.E.), Hospital Clinic, Barcelona, Spain; Department of Neurology (B.H.), Medical University of Innsbruck, Austria; Department of Neurology (L.B.), Hospital Universitari i Politècnic La Fe; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (L.B., L.S., J.D.), Valencia, Spain; Department of Neurology and Institute of Neurogenetics (N.P., K.-P.W.), University of Lübeck, Germany; Department of Movement Disorders and Neurology (C. Giordana), Centre Hospitalier Universitaire Nice, France; Department of Neurology (A.H.), Division of Sleep Medicine and Neuromuscular Disorders, University Hospital Muenster, Germany; Clinical Neurosciences (K.K.), St Vincent's Hospital, Melbourne, Australia; Department of Neurology (J.L.), Ulm University, Germany; Department of Neurology (S.M.), Medical University of Vienna, Austria; Department of Neurology (T.M.), Centre Hospitalier de Luxembourg; Department of Neurology (J.P.-P.), Hospital de la Santa Creu i Sant Pau, Barcelona; Department of Neurology (I.P.), Hospital La Paz, Madrid, Spain; Department of Neurology (C.S.), University Medical Center of the Johannes Gutenberg University Mainz, Germany; Neurology Division (M.S.), Hospital das Clínicas, São Paulo University, Brazil; Department of Neurology (N.T.), Hospital Clínico Universitario, Valladolid, Spain; Institute of Clinical Chemistry (K.-P.W.), University Hospital Schleswig-Holstein, Lübeck, Germany; Department of Neurology (J.D.), University of Pennsylvania, Philadelphia; and Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain.
Caspar Seitz
From the Neuroimmunology Program (C. Gaig, F.G., A.I., L.S., J.S., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Department of Neurology (C. Gaig, F.G., Y.C., M.J.M., A.I., J.S.), Multidisciplinary Sleep Disorders Unit (C. Gaig, A.I., J.S.), Parkinson's Disease & Movement Disorders Unit (Y.C., M.J.M.), and Department of Immunology (G.E.), Hospital Clinic, Barcelona, Spain; Department of Neurology (B.H.), Medical University of Innsbruck, Austria; Department of Neurology (L.B.), Hospital Universitari i Politècnic La Fe; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (L.B., L.S., J.D.), Valencia, Spain; Department of Neurology and Institute of Neurogenetics (N.P., K.-P.W.), University of Lübeck, Germany; Department of Movement Disorders and Neurology (C. Giordana), Centre Hospitalier Universitaire Nice, France; Department of Neurology (A.H.), Division of Sleep Medicine and Neuromuscular Disorders, University Hospital Muenster, Germany; Clinical Neurosciences (K.K.), St Vincent's Hospital, Melbourne, Australia; Department of Neurology (J.L.), Ulm University, Germany; Department of Neurology (S.M.), Medical University of Vienna, Austria; Department of Neurology (T.M.), Centre Hospitalier de Luxembourg; Department of Neurology (J.P.-P.), Hospital de la Santa Creu i Sant Pau, Barcelona; Department of Neurology (I.P.), Hospital La Paz, Madrid, Spain; Department of Neurology (C.S.), University Medical Center of the Johannes Gutenberg University Mainz, Germany; Neurology Division (M.S.), Hospital das Clínicas, São Paulo University, Brazil; Department of Neurology (N.T.), Hospital Clínico Universitario, Valladolid, Spain; Institute of Clinical Chemistry (K.-P.W.), University Hospital Schleswig-Holstein, Lübeck, Germany; Department of Neurology (J.D.), University of Pennsylvania, Philadelphia; and Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain.
Mateus Simabukuro
From the Neuroimmunology Program (C. Gaig, F.G., A.I., L.S., J.S., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Department of Neurology (C. Gaig, F.G., Y.C., M.J.M., A.I., J.S.), Multidisciplinary Sleep Disorders Unit (C. Gaig, A.I., J.S.), Parkinson's Disease & Movement Disorders Unit (Y.C., M.J.M.), and Department of Immunology (G.E.), Hospital Clinic, Barcelona, Spain; Department of Neurology (B.H.), Medical University of Innsbruck, Austria; Department of Neurology (L.B.), Hospital Universitari i Politècnic La Fe; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (L.B., L.S., J.D.), Valencia, Spain; Department of Neurology and Institute of Neurogenetics (N.P., K.-P.W.), University of Lübeck, Germany; Department of Movement Disorders and Neurology (C. Giordana), Centre Hospitalier Universitaire Nice, France; Department of Neurology (A.H.), Division of Sleep Medicine and Neuromuscular Disorders, University Hospital Muenster, Germany; Clinical Neurosciences (K.K.), St Vincent's Hospital, Melbourne, Australia; Department of Neurology (J.L.), Ulm University, Germany; Department of Neurology (S.M.), Medical University of Vienna, Austria; Department of Neurology (T.M.), Centre Hospitalier de Luxembourg; Department of Neurology (J.P.-P.), Hospital de la Santa Creu i Sant Pau, Barcelona; Department of Neurology (I.P.), Hospital La Paz, Madrid, Spain; Department of Neurology (C.S.), University Medical Center of the Johannes Gutenberg University Mainz, Germany; Neurology Division (M.S.), Hospital das Clínicas, São Paulo University, Brazil; Department of Neurology (N.T.), Hospital Clínico Universitario, Valladolid, Spain; Institute of Clinical Chemistry (K.-P.W.), University Hospital Schleswig-Holstein, Lübeck, Germany; Department of Neurology (J.D.), University of Pennsylvania, Philadelphia; and Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain.
Nieves Téllez
From the Neuroimmunology Program (C. Gaig, F.G., A.I., L.S., J.S., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Department of Neurology (C. Gaig, F.G., Y.C., M.J.M., A.I., J.S.), Multidisciplinary Sleep Disorders Unit (C. Gaig, A.I., J.S.), Parkinson's Disease & Movement Disorders Unit (Y.C., M.J.M.), and Department of Immunology (G.E.), Hospital Clinic, Barcelona, Spain; Department of Neurology (B.H.), Medical University of Innsbruck, Austria; Department of Neurology (L.B.), Hospital Universitari i Politècnic La Fe; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (L.B., L.S., J.D.), Valencia, Spain; Department of Neurology and Institute of Neurogenetics (N.P., K.-P.W.), University of Lübeck, Germany; Department of Movement Disorders and Neurology (C. Giordana), Centre Hospitalier Universitaire Nice, France; Department of Neurology (A.H.), Division of Sleep Medicine and Neuromuscular Disorders, University Hospital Muenster, Germany; Clinical Neurosciences (K.K.), St Vincent's Hospital, Melbourne, Australia; Department of Neurology (J.L.), Ulm University, Germany; Department of Neurology (S.M.), Medical University of Vienna, Austria; Department of Neurology (T.M.), Centre Hospitalier de Luxembourg; Department of Neurology (J.P.-P.), Hospital de la Santa Creu i Sant Pau, Barcelona; Department of Neurology (I.P.), Hospital La Paz, Madrid, Spain; Department of Neurology (C.S.), University Medical Center of the Johannes Gutenberg University Mainz, Germany; Neurology Division (M.S.), Hospital das Clínicas, São Paulo University, Brazil; Department of Neurology (N.T.), Hospital Clínico Universitario, Valladolid, Spain; Institute of Clinical Chemistry (K.-P.W.), University Hospital Schleswig-Holstein, Lübeck, Germany; Department of Neurology (J.D.), University of Pennsylvania, Philadelphia; and Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain.
Klaus-Peter Wandinger
From the Neuroimmunology Program (C. Gaig, F.G., A.I., L.S., J.S., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Department of Neurology (C. Gaig, F.G., Y.C., M.J.M., A.I., J.S.), Multidisciplinary Sleep Disorders Unit (C. Gaig, A.I., J.S.), Parkinson's Disease & Movement Disorders Unit (Y.C., M.J.M.), and Department of Immunology (G.E.), Hospital Clinic, Barcelona, Spain; Department of Neurology (B.H.), Medical University of Innsbruck, Austria; Department of Neurology (L.B.), Hospital Universitari i Politècnic La Fe; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (L.B., L.S., J.D.), Valencia, Spain; Department of Neurology and Institute of Neurogenetics (N.P., K.-P.W.), University of Lübeck, Germany; Department of Movement Disorders and Neurology (C. Giordana), Centre Hospitalier Universitaire Nice, France; Department of Neurology (A.H.), Division of Sleep Medicine and Neuromuscular Disorders, University Hospital Muenster, Germany; Clinical Neurosciences (K.K.), St Vincent's Hospital, Melbourne, Australia; Department of Neurology (J.L.), Ulm University, Germany; Department of Neurology (S.M.), Medical University of Vienna, Austria; Department of Neurology (T.M.), Centre Hospitalier de Luxembourg; Department of Neurology (J.P.-P.), Hospital de la Santa Creu i Sant Pau, Barcelona; Department of Neurology (I.P.), Hospital La Paz, Madrid, Spain; Department of Neurology (C.S.), University Medical Center of the Johannes Gutenberg University Mainz, Germany; Neurology Division (M.S.), Hospital das Clínicas, São Paulo University, Brazil; Department of Neurology (N.T.), Hospital Clínico Universitario, Valladolid, Spain; Institute of Clinical Chemistry (K.-P.W.), University Hospital Schleswig-Holstein, Lübeck, Germany; Department of Neurology (J.D.), University of Pennsylvania, Philadelphia; and Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain.
Alex Iranzo
From the Neuroimmunology Program (C. Gaig, F.G., A.I., L.S., J.S., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Department of Neurology (C. Gaig, F.G., Y.C., M.J.M., A.I., J.S.), Multidisciplinary Sleep Disorders Unit (C. Gaig, A.I., J.S.), Parkinson's Disease & Movement Disorders Unit (Y.C., M.J.M.), and Department of Immunology (G.E.), Hospital Clinic, Barcelona, Spain; Department of Neurology (B.H.), Medical University of Innsbruck, Austria; Department of Neurology (L.B.), Hospital Universitari i Politècnic La Fe; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (L.B., L.S., J.D.), Valencia, Spain; Department of Neurology and Institute of Neurogenetics (N.P., K.-P.W.), University of Lübeck, Germany; Department of Movement Disorders and Neurology (C. Giordana), Centre Hospitalier Universitaire Nice, France; Department of Neurology (A.H.), Division of Sleep Medicine and Neuromuscular Disorders, University Hospital Muenster, Germany; Clinical Neurosciences (K.K.), St Vincent's Hospital, Melbourne, Australia; Department of Neurology (J.L.), Ulm University, Germany; Department of Neurology (S.M.), Medical University of Vienna, Austria; Department of Neurology (T.M.), Centre Hospitalier de Luxembourg; Department of Neurology (J.P.-P.), Hospital de la Santa Creu i Sant Pau, Barcelona; Department of Neurology (I.P.), Hospital La Paz, Madrid, Spain; Department of Neurology (C.S.), University Medical Center of the Johannes Gutenberg University Mainz, Germany; Neurology Division (M.S.), Hospital das Clínicas, São Paulo University, Brazil; Department of Neurology (N.T.), Hospital Clínico Universitario, Valladolid, Spain; Institute of Clinical Chemistry (K.-P.W.), University Hospital Schleswig-Holstein, Lübeck, Germany; Department of Neurology (J.D.), University of Pennsylvania, Philadelphia; and Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain.
Guadalupe Ercilla
From the Neuroimmunology Program (C. Gaig, F.G., A.I., L.S., J.S., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Department of Neurology (C. Gaig, F.G., Y.C., M.J.M., A.I., J.S.), Multidisciplinary Sleep Disorders Unit (C. Gaig, A.I., J.S.), Parkinson's Disease & Movement Disorders Unit (Y.C., M.J.M.), and Department of Immunology (G.E.), Hospital Clinic, Barcelona, Spain; Department of Neurology (B.H.), Medical University of Innsbruck, Austria; Department of Neurology (L.B.), Hospital Universitari i Politècnic La Fe; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (L.B., L.S., J.D.), Valencia, Spain; Department of Neurology and Institute of Neurogenetics (N.P., K.-P.W.), University of Lübeck, Germany; Department of Movement Disorders and Neurology (C. Giordana), Centre Hospitalier Universitaire Nice, France; Department of Neurology (A.H.), Division of Sleep Medicine and Neuromuscular Disorders, University Hospital Muenster, Germany; Clinical Neurosciences (K.K.), St Vincent's Hospital, Melbourne, Australia; Department of Neurology (J.L.), Ulm University, Germany; Department of Neurology (S.M.), Medical University of Vienna, Austria; Department of Neurology (T.M.), Centre Hospitalier de Luxembourg; Department of Neurology (J.P.-P.), Hospital de la Santa Creu i Sant Pau, Barcelona; Department of Neurology (I.P.), Hospital La Paz, Madrid, Spain; Department of Neurology (C.S.), University Medical Center of the Johannes Gutenberg University Mainz, Germany; Neurology Division (M.S.), Hospital das Clínicas, São Paulo University, Brazil; Department of Neurology (N.T.), Hospital Clínico Universitario, Valladolid, Spain; Institute of Clinical Chemistry (K.-P.W.), University Hospital Schleswig-Holstein, Lübeck, Germany; Department of Neurology (J.D.), University of Pennsylvania, Philadelphia; and Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain.
Lidia Sabater
From the Neuroimmunology Program (C. Gaig, F.G., A.I., L.S., J.S., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Department of Neurology (C. Gaig, F.G., Y.C., M.J.M., A.I., J.S.), Multidisciplinary Sleep Disorders Unit (C. Gaig, A.I., J.S.), Parkinson's Disease & Movement Disorders Unit (Y.C., M.J.M.), and Department of Immunology (G.E.), Hospital Clinic, Barcelona, Spain; Department of Neurology (B.H.), Medical University of Innsbruck, Austria; Department of Neurology (L.B.), Hospital Universitari i Politècnic La Fe; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (L.B., L.S., J.D.), Valencia, Spain; Department of Neurology and Institute of Neurogenetics (N.P., K.-P.W.), University of Lübeck, Germany; Department of Movement Disorders and Neurology (C. Giordana), Centre Hospitalier Universitaire Nice, France; Department of Neurology (A.H.), Division of Sleep Medicine and Neuromuscular Disorders, University Hospital Muenster, Germany; Clinical Neurosciences (K.K.), St Vincent's Hospital, Melbourne, Australia; Department of Neurology (J.L.), Ulm University, Germany; Department of Neurology (S.M.), Medical University of Vienna, Austria; Department of Neurology (T.M.), Centre Hospitalier de Luxembourg; Department of Neurology (J.P.-P.), Hospital de la Santa Creu i Sant Pau, Barcelona; Department of Neurology (I.P.), Hospital La Paz, Madrid, Spain; Department of Neurology (C.S.), University Medical Center of the Johannes Gutenberg University Mainz, Germany; Neurology Division (M.S.), Hospital das Clínicas, São Paulo University, Brazil; Department of Neurology (N.T.), Hospital Clínico Universitario, Valladolid, Spain; Institute of Clinical Chemistry (K.-P.W.), University Hospital Schleswig-Holstein, Lübeck, Germany; Department of Neurology (J.D.), University of Pennsylvania, Philadelphia; and Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain.
Joan Santamaría
From the Neuroimmunology Program (C. Gaig, F.G., A.I., L.S., J.S., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Department of Neurology (C. Gaig, F.G., Y.C., M.J.M., A.I., J.S.), Multidisciplinary Sleep Disorders Unit (C. Gaig, A.I., J.S.), Parkinson's Disease & Movement Disorders Unit (Y.C., M.J.M.), and Department of Immunology (G.E.), Hospital Clinic, Barcelona, Spain; Department of Neurology (B.H.), Medical University of Innsbruck, Austria; Department of Neurology (L.B.), Hospital Universitari i Politècnic La Fe; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (L.B., L.S., J.D.), Valencia, Spain; Department of Neurology and Institute of Neurogenetics (N.P., K.-P.W.), University of Lübeck, Germany; Department of Movement Disorders and Neurology (C. Giordana), Centre Hospitalier Universitaire Nice, France; Department of Neurology (A.H.), Division of Sleep Medicine and Neuromuscular Disorders, University Hospital Muenster, Germany; Clinical Neurosciences (K.K.), St Vincent's Hospital, Melbourne, Australia; Department of Neurology (J.L.), Ulm University, Germany; Department of Neurology (S.M.), Medical University of Vienna, Austria; Department of Neurology (T.M.), Centre Hospitalier de Luxembourg; Department of Neurology (J.P.-P.), Hospital de la Santa Creu i Sant Pau, Barcelona; Department of Neurology (I.P.), Hospital La Paz, Madrid, Spain; Department of Neurology (C.S.), University Medical Center of the Johannes Gutenberg University Mainz, Germany; Neurology Division (M.S.), Hospital das Clínicas, São Paulo University, Brazil; Department of Neurology (N.T.), Hospital Clínico Universitario, Valladolid, Spain; Institute of Clinical Chemistry (K.-P.W.), University Hospital Schleswig-Holstein, Lübeck, Germany; Department of Neurology (J.D.), University of Pennsylvania, Philadelphia; and Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain.
Josep Dalmau
From the Neuroimmunology Program (C. Gaig, F.G., A.I., L.S., J.S., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Department of Neurology (C. Gaig, F.G., Y.C., M.J.M., A.I., J.S.), Multidisciplinary Sleep Disorders Unit (C. Gaig, A.I., J.S.), Parkinson's Disease & Movement Disorders Unit (Y.C., M.J.M.), and Department of Immunology (G.E.), Hospital Clinic, Barcelona, Spain; Department of Neurology (B.H.), Medical University of Innsbruck, Austria; Department of Neurology (L.B.), Hospital Universitari i Politècnic La Fe; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) (L.B., L.S., J.D.), Valencia, Spain; Department of Neurology and Institute of Neurogenetics (N.P., K.-P.W.), University of Lübeck, Germany; Department of Movement Disorders and Neurology (C. Giordana), Centre Hospitalier Universitaire Nice, France; Department of Neurology (A.H.), Division of Sleep Medicine and Neuromuscular Disorders, University Hospital Muenster, Germany; Clinical Neurosciences (K.K.), St Vincent's Hospital, Melbourne, Australia; Department of Neurology (J.L.), Ulm University, Germany; Department of Neurology (S.M.), Medical University of Vienna, Austria; Department of Neurology (T.M.), Centre Hospitalier de Luxembourg; Department of Neurology (J.P.-P.), Hospital de la Santa Creu i Sant Pau, Barcelona; Department of Neurology (I.P.), Hospital La Paz, Madrid, Spain; Department of Neurology (C.S.), University Medical Center of the Johannes Gutenberg University Mainz, Germany; Neurology Division (M.S.), Hospital das Clínicas, São Paulo University, Brazil; Department of Neurology (N.T.), Hospital Clínico Universitario, Valladolid, Spain; Institute of Clinical Chemistry (K.-P.W.), University Hospital Schleswig-Holstein, Lübeck, Germany; Department of Neurology (J.D.), University of Pennsylvania, Philadelphia; and Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain.
Clinical manifestations of the anti-IgLON5 disease
Carles Gaig, Francesc Graus, Yarko Compta, Birgit Högl, Luis Bataller, Norbert Brüggemann, Caroline Giordana, Anna Heidbreder, Katya Kotschet, Jan Lewerenz, Stefan Macher, Maria J. Martí, Teresa Montojo, Jesus Pérez-Pérez, Inmaculada Puertas, Caspar Seitz, Mateus Simabukuro, Nieves Téllez, Klaus-Peter Wandinger, Alex Iranzo, Guadalupe Ercilla, Lidia Sabater, Joan Santamaría, Josep Dalmau
Neurology May 2017, 88 (18) 1736-1743; DOI: 10.1212/WNL.0000000000003887
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Abstract
Objective: To report the presentation, main syndromes, human leukocyte antigen (HLA) association, and immunoglobulin G (IgG) subclass in the anti-IgLON5 disease: a disorder with parasomnias, sleep apnea, and IgLON5 antibodies.
Methods: This was a retrospective clinical analysis of 22 patients. The IgG subclass was determined using reported techniques.
Results: Patients' median age was 64 years (range 46–83). Symptoms that led to initial consultation included sleep problems (8 patients; 36%), gait abnormalities (8; 36%), bulbar dysfunction (3; 14%), chorea (2; 9%), and cognitive decline (1; 5%). By the time of diagnosis of the disorder, 4 syndromes were identified: (1) a sleep disorder with parasomnia and sleep breathing difficulty in 8 (36%) patients; (2) a bulbar syndrome including dysphagia, sialorrhea, stridor, or acute respiratory insufficiency in 6 (27%); (3) a syndrome resembling progressive supranuclear palsy (PSP-like) in 5 (23%); and (4) cognitive decline with or without chorea in 3 (14%). All patients eventually developed parasomnia, sleep apnea, insomnia, or excessive daytime sleepiness. HLA-DRB1*10:01 and HLA-DQB1*05:01 were positive in 13/15 (87%) patients; the DRB1*10:01 allele was 36 times more prevalent than in the general population. Among 16 patients with paired serum and CSF samples, 14 had IgLON5 antibodies in both, and 2 only in serum (both had a PSP-like syndrome). Twenty of 21 patients had IgG1 and IgG4 antibodies; the latter predominated in 16.
Conclusions: Patients with IgLON5 antibodies develop a characteristic sleep disorder preceded or accompanied by bulbar symptoms, gait abnormalities, oculomotor problems, and, less frequently, cognitive decline. IgG4 subclass antibodies predominate over IgG1; we confirm a strong association with the HLA-DRB1*10:01 allele.
GLOSSARY
- CBA=
- cell-based assay;
- CI=
- confidence interval;
- HLA=
- human leukocyte antigen;
- IgG=
- immunoglobulin G;
- MSA=
- multiple system atrophy;
- NREM=
- non-REM;
- OSA=
- obstructive sleep apnea;
- PSG=
- polysomnography;
- PSP=
- progressive supranuclear palsy
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Supplemental data at Neurology.org
Editorial, page 1688
- Received August 12, 2016.
- Accepted in final form January 17, 2017.
- © 2017 American Academy of Neurology
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