Can Neuronal Autoantibodies Influence Cognitive Impairment in Patients With Lung Cancer?
Posted: Thursday, October 14, 2021
Carsten Finke, MD, of Charité–Universitätsmedizin Berlin, Germany, and colleagues conducted a cross-sectional study to identify the association between neuronal autoantibodies and the impairment of cognitive function in patients with lung cancer. These researchers found that 36.5% of individuals in this trial who experienced cognitive impairment harbored these neuronal autoantibodies, suggesting these autoantibodies may be a potential therapeutic target of immune-mediated cognitive impairment. Their results were published in JAMA Oncology.
A total of 167 patients—127 with non–small cell lung cancer (NSCLC) and 40 with small cell lung cancer (SCLC)—were recruited for this study. Additionally, a carefully selected subgroup of 97 participants underwent neurologic examinations and neurophysiologic testing. Cognitive impairment was defined as a test score two standard deviations below the test-specific reference cohort on at least one test, according to International Cognition and Cancer Task Force criteria.
Known autoantibodies were identified in 33 patients, whereas autoantibodies against currently undiscovered antigens were found in 28 patients. Approximately 45.0% and 33.9% of participants with SCLC and NSCLC appeared to have neuronal antibodies, respectively. Autoantibodies against intracellular antibodies were identified in 20% of patients with SCLC; however, autoantibodies against neuronal surface antigens seemed to occur at similar rates among both SCLC and NSCLC groups (10.0% vs. 11.0%).
Cognitive impairment was identified in two-thirds (67.0%) of participants, and the most common types were in executive function (45.8%) and attention (43.4%). A similar prevalence of cognitive impairment was observed in both groups, as well as among males (69.6%) and females (63.4%). Patients with SCLC and neuronal autoantibodies were 11 times more likely to experience cognitive impairment than those who were autoantibody-negative, and those with NSCLC and immunoglobulin-A autoantibodies had a 182.8 odds ratio for verbal memory deficit. Furthermore, the odds ratio for cognitive impairment of individuals with autoantibodies against unknown antigens was 2.8.
Disclosure: For full disclosures of the study authors, visit jamanetwork.com.