{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T09:07:47Z","timestamp":1790327267161,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1 TR002377"],"award-info":[{"award-number":["UL1 TR002377"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>High\u2010titer glutamic acid decarboxylase 65 (GAD65) antibodies (&gt;20\u2009nmol\/L) are linked to chronic focal epilepsy, usually of temporal regional onset. Identification of these antibodies has treatment and prognostic implications. We compared patients with drug\u2010resistant epilepsy and high\u2010titer GAD65 antibodies to an age\u2010 and sex\u2010matched control group with drug\u2010resistant GAD65 antibody\u2013negative temporal lobe epilepsy. From 1432 patients presented at a single\u2010center surgical epilepsy conference (2007\u20132024), we identified 15 patients (1% from surgical epilepsy conference: 13 female, 86.7%) with high\u2010titer serum GAD65 antibodies (median serum titer\u2009=\u2009960\u2009nmol\/L; range 34\u20134678). The median age at epilepsy onset was 25\u2009years (range 4\u201344). All had temporal regional\u2010onset epilepsy; 53% had bitemporal seizures. Three patients had limbic encephalitis, and three developed mesial temporal sclerosis. Those with GAD65 antibody\u2013associated epilepsy were more likely to have depression and\/or anxiety and less likely to undergo resection after evaluation than those in the control group. Although seizure types, electroencephalography (EEG), imaging, and autoimmune history were not statistically significantly different from the control group, we found that musicogenic seizures, limbic encephalitis, and type 1 diabetes occurred only in GAD65\u2010positive patients. These features, when present, may suggest an autoimmune etiology and warrant antibody testing. Identifying patients with GAD65 antibody\u2013associated epilepsy is important due to its drug resistance, lower rate of satisfactory surgical outcomes, and potential responsiveness to immunotherapy. Further research is needed to define the optimal treatment and distinguish this subgroup from other causes of drug\u2010resistant epilepsy.<\/jats:p>","DOI":"10.1002\/epi.70068","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T14:44:00Z","timestamp":1767192240000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Drug\u2010resistant glutamic acid decarboxylase 65\u2013associated epilepsy: Pre\u2010surgical evaluation and comparison to temporal lobe epilepsy of other etiology"],"prefix":"10.1002","volume":"67","author":[{"given":"Anna N.","family":"Thomsen","sequence":"first","affiliation":[{"name":"Department of Neurology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1936-0861","authenticated-orcid":false,"given":"Gloria","family":"Ortiz\u2010Guerrero","sequence":"additional","affiliation":[{"name":"Department of Neurology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6865-9045","authenticated-orcid":false,"given":"Divyanshu","family":"Dubey","sequence":"additional","affiliation":[{"name":"Department of Neurology Mayo Clinic  Rochester Minnesota USA"},{"name":"Laboratory Medicine and Pathology Mayo Clinic College of Medicine  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0147-8159","authenticated-orcid":false,"given":"Jeffrey W.","family":"Britton","sequence":"additional","affiliation":[{"name":"Department of Neurology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8659-3801","authenticated-orcid":false,"given":"Kelsey M.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Neurology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,31]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneuroim.2020.577189"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2019.04.007"},{"key":"e_1_2_15_4_1","unstructured":"The Human Protein Atlas. Available from:https:\/\/www.proteinatlas.org\/ENSG00000136750\u2010GAD2\/tissue. Accessed November 5 2025."},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awn183"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-025-08330-4"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2014.04.009"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2016.5429"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awac404"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.18086"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2020-325275"},{"key":"e_1_2_15_12_1","doi-asserted-by":"publisher","DOI":"10.4065\/73.12.1161"},{"key":"e_1_2_15_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.16888"},{"key":"e_1_2_15_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(15)00401-9"},{"key":"e_1_2_15_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/braincomms\/fcaf106"},{"key":"e_1_2_15_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12991-024-00493-2"},{"key":"e_1_2_15_17_1","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000200422"},{"key":"e_1_2_15_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.25565"},{"key":"e_1_2_15_19_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2022.990553"},{"key":"e_1_2_15_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2019.09.003"},{"key":"e_1_2_15_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/0006-8993(94)91855-4"},{"key":"e_1_2_15_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cortex.2019.02.005"},{"key":"e_1_2_15_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.2012.01691.x"}],"container-title":["Epilepsia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/epi.70068","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/epi.70068","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/epi.70068","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T13:05:06Z","timestamp":1776431106000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/epi.70068"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,31]]},"references-count":22,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1002\/epi.70068"],"URL":"https:\/\/doi.org\/10.1002\/epi.70068","archive":["Portico"],"relation":{},"ISSN":["0013-9580","1528-1167"],"issn-type":[{"value":"0013-9580","type":"print"},{"value":"1528-1167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,31]]},"assertion":[{"value":"2025-09-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}