Janet L. Cunningham

Although it is well established that psychiatric symptoms often occur secondary to SLE, only one of the eleven patients with comorbid SLE in this cohort met the current criteria for even a possible autoimmune psychiatric disorder. CSF-NfL appears to be a more sensitive tool.

Preselection based on suspected immunologica or autoimmune psychiatric disease identifies a population with a high prevalence of CSF alterations suggesting CNS pathology. nature.com/articles/s4139…

Severely ill patients are an underrepresented group in clinical studies, increases the clinical relevance of the results. Clinical features such as catatonia, infectious prodrome and comorbid autoimmunity are linked to CSF findings and motivate CSF investigations.

The investigations led to a diagnosis of definite NMDAR encephalitis (n = 3), neuropsychiatric SLE (n = 3), multiple sclerosis (n = 1), neuroborreliosis (n = 2), frontotemporal dementia (n = 1) and Wernicke-Korsakoff syndrome (n = 1).

Elevated CNS damage markers were associated with different red flags: NfL with comorbid autoimmunity and affective dysregulation, t-Tau with catatonia and higher ratings of agitation/hyperactivity. GFAP with acute onset and infectious prodrome.

Our understanding of the mechanisms for NMDAR encephalitis deepens! "..dysfunction is extrasynaptic, and that the synaptic effects are secondary.... ... imply that clinical manifestations may be secondary to the disruption of other NMDAR-co-localizing proteins."

@epikrisa Samma i Uppsala! Vad det kommer att kosta att göra om finns sällan med i beräkningen.

We are pleased to share the recorded presentations from @TheAlexManfullFund symposium, which includes those by #expandSMAB members @Doc_Cunningham on adult clinical immunopsychiatry, & Prof. Herb Lachman & Prof. Peter van der Spek on PANS Candidate Genes. thealexmanfullfund.org/2022-tamf-symp…

Despite decades of promises, health research still overlooks women | Medical research | The Guardian theguardian.com/science/2023/n…

Do you know differences between catalepsy versus waxy flexibility which may occur together as signs of catatonia? Two of the coolest and most mysterious signs which may be associated with catatonia. Catalepsy think muscular rigidity and fixity of posture; you may give external stimulation and it may not matter; they may be surprisingly not responsive to pain. Now when the rigidity spills into a situation where the extremity when moved by an examiner ends up staying in the same position folks sometimes refer to that as waxy flexibility. The tendency is to remain in an immobile posture.  Folks have referred to it as repositioning an arm or leg as like a warm candle that can be shaped. Typically there is resistance to movement. youtube.com/watch?v=zAEJ-J…

Can you name all the features associated with catatonia and the current diagnostic criteria. I bet you that most of you cannot and will need to read the new review in @NEJM which rightly points out that catatonia has been 'well described but is poorly understood and that many physicians incorrectly believe that catatonia is a rare form of schizophrenia, with bizarre abnormalities of motor behavior.' Catatonia may 'linger in the shadow of delirium.' Key points: - Diagnosis is often missed. - Frequently a person with catatonia may be inappropriately treated. - DSM-5 removed catatonia as a subtype of schizophrenia. - In emergency department presents as failure to respond to questioning (mutism) and very little spontaneous movement (stupor). - Look for underlying causes and medical as well as psychiatric conditions. - Anti–N-methyl-d-aspartate (NMDA) receptor encephalitis may cause acute catatonia before progressing to encephalopathy or seizures. - Look for metabolic disorders and focal cerebral lesions. - Medications prescribed or illicit may be the cause and could present during withdrawal. - The less severe forms of catatonia have been described such as elective mutism (refusal to speak) or ambitendency (indecisive, hesitant movements due to conflicting goals). - Depression, bipolar disorder, schizophrenia, or autism spectrum disorder may present with staring, mutism, immobility, or stereotypies. nejm.org/doi/full/10.10…

Autoantigen-bearing CAR T for depletion of autoantigen specific B cells. Amazing work from the Pruss lab. doi.org/10.1016/j.cell…

At #ECNP2023, experts in the field are now presenting novel findings that highlight the immune system as a pivotal player in innovative strategies for #PsychiatricDisorders @Doc_Cunningham @brenda_penninx #immunesystem

From brain-centered to brain-body-environment inclusive approach to understand mental illness! Today join our session ‘Translating the brain-immune crosstalk into therapeutical interventions’ at #ECNP2023 with @LCapuron @brenda_penninx @ProfBaune @Doc_Cunningham @ECNPtweets

Last but not least, @Doc_Cunningham switches gears and focuses on the autoimmune side of brain-immune crosstalk. How to spot, diagnose & treat autoimmune disorders in treatment resistant psychiatric patients? Great selection of speakers for this session at #ECNP2023 @ECNPtweets

Excellent talk from @Doc_Cunningham at @ECNPtweets #ECNP23 on clinical immunopsychiatry!

Join the 36th ECNP Congress in Barcelona and participate to our session on ‘Translating the brain-immune crosstalk into therapeutical interventions’ with @LCapuron, @brenda_penninx, @ProfBaune and @Doc_Cunningham See programme at ecnp.eu/programme2023 #ECNP2023 @ECNPtweets

I was just going to quickly check patient derived CSF IgG staining patterns against this atlas and emerged 5 hours later with several ideas - such a great tool! I only wish the colours in the images were clickable.

@ScienceYael @caromenard666 I am a so happy you felt it was meaningful! 🤓

neuroimmunology at #cvb2023, best session yet! Incredibly inspiring talks by @caromenard666 on BBB role in chronic stress & depression 🐭, and by @Doc_Cunningham on autoimmune underpinnings of some psychiatric disorders 🧫. Super important work, glad it’s getting a spotlight.