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首页> 外文期刊>The British journal of psychiatry : >Anti-basal ganglia antibodies in primary obsessive-compulsive disorder: systematic review and meta-analysis
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Anti-basal ganglia antibodies in primary obsessive-compulsive disorder: systematic review and meta-analysis

机译：原发性强迫症中的抗基底神经节抗体：系统评价和荟萃分析

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Background Autoimmune-mediated basal ganglia dysfunction is implicated in the pathophysiology of neuropsychiatric disorders commonly manifesting with obsessive-compulsive features (e.g. Sydenham chorea). The relationship between autoimmunity and primary obsessive-compulsive disorder (OCD), however, is less clear. Aims To pool data on serum and cerebrospinal fluid (CSF) anti-basal ganglia antibody (ABGA) positivity in primary OCD (without neurological or autoimmune comorbidity) relative to controls or neuropsychiatric disorders previously associated with increased odds of ABGA positivity. Method We performed electronic database and hand-searches for studies meeting pre-specified eligibility criteria from which we extracted data using a standardised form. We calculated pooled estimates of ABGA positivity using a random-effects model. Results Seven case-control studies totalling 844 participants met the eligibility criteria. Meta-analysis showed that a significantly greater proportion of those with primary OCD were ABGA seropositive compared with various controls (odds ratio (OR) = 4.97, 95% CI 2.88-8.55, P 0.00001). This effect was not associated with heterogeneity or publication bias, and remained significant after stratifying the analysis by age, gender, disease severity, illness duration, immunostaining methodology, study quality, publication type, kind of control group, and sample size. There were no significant differences in ABGA seropositivity for comparisons between primary OCD and Tourette syndrome, attention-deficit hyperactivity disorder or paediatric acute-onset neuropsychiatric syndrome. Results of one study testing CSF samples showed that a significantly greater proportion of participants with primary OCD were ABGA CSF-positive compared with healthy controls (OR = 5.60, 95% CI 1.04-30.20, P = 0.045). Conclusions Odds of ABGA seropositivity are increased fivefold in primary OCD compared with controls, but are comparable to those associated with disorders previously associated with ABGA, providing circumstantial evidence of autoimmunity in a subset of those with primary OCD. Further experimental studies are needed to ascertain whether this relationship is causal.
机译：背景自身免疫介导的基底神经节功能异常与神经精神疾病的病理生理有关，通常表现为强迫症（例如Sydenham chorea）。然而，自身免疫与原发性强迫症（OCD）之间的关系尚不清楚。目的收集有关原发性强迫症（无神经系统疾病或自身免疫性合并症）的血清和脑脊液（CSF）抗基底神经节抗体（ABGA）阳性的数据，该数据与先前与ABGA阳性几率增加相关的对照或神经精神疾病有关。方法我们执行了电子数据库并手动搜索满足预定资格标准的研究，然后使用标准化表格从中提取数据。我们使用随机效应模型计算了ABGA阳性的合并估计。结果共有844名参与者进行了7项病例对照研究，符合入选标准。荟萃分析显示，与各种对照相比，原发性强迫症患者的ABGA血清阳性比例更高（优势比（OR）= 4.97，95％CI 2.88-8.55，P <0.00001）。该效应与异质性或发表偏倚无关，在按年龄，性别，疾病严重性，疾病持续时间，免疫染色方法，研究质量，发表类型，对照组种类和样本量进行分层分析后，仍然显着。比较原发性强迫症和图雷特综合症，注意力缺陷多动障碍或小儿急性发作神经精神病综合症之间的ABGA血清阳性率没有显着差异。一项测试CSF样本的研究结果表明，与健康对照组相比，患有原发性OCD的参与者ABGA CSF阳性比例更高（OR = 5.60，95％CI 1.04-30.20，P = 0.045）。结论与对照组相比，原发性强迫症患者的ABGA血清阳性阳性率增加了五倍，但与先前与ABGA相关的疾病相关的可比性可比，提供了部分原发性强迫症患者自身免疫的间接证据。需要进一步的实验研究以确定这种关系是否是因果关系。

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