AUTHOR=Hansen Niels , Teegen Bianca , Hirschel Sina , Wiltfang Jens , Schott Björn H. , Bartels Claudia , Bouter Caroline 

TITLE=Case report: Mixed dementia associated with autoantibodies targeting the vesicular glutamate transporter 2

JOURNAL=Frontiers in Psychiatry

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2023.1227824

DOI=10.3389/fpsyt.2023.1227824

ISSN=1664-0640

ABSTRACT=Background: Autoantibodies against the vesicular glutamate transporter type 2 (VGlut2) can trigger impaired synaptic signaling and are described here for the first time in association with mixed dementia.We report on a 71-year-old female patient with a dementing syndrome who underwent a thorough dementia diagnosis including neuropsychological testing, magnetic resonance imaging (MRI), 18 F-fluorodesoxyglucose positron emission tomography (FDG-PET), and a neural tap to search for neural autoantibodies.Results: Our patient exhibited a mixed dementia. Her CSF revealed elevated ptau 181 protein and a reduced Aß42/40 ratio indicating Alzheimer's disease (AD) pathology. In addition, neuropsychological testing showed a profile consistent with AD with impaired memory, reduced semantic word fluency, and naming disorder, and impaired visuoconstructive skills.Nevertheless, in-depth neuropsychological testing also revealed marked psychomotor slowing and visuospatial perceptual impairments that are more indicative of the presence of DLB.Overall, therefore, her dementia is of more likely of mixed pathology. In addition, we repeatedly detected VGlut2 autoantibodies in her serum.To the best of our knowledge, this report of ours is the first to describe mixed dementia associated with VGlut2 autoantibodies.