{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T06:37:40Z","timestamp":1768804660656,"version":"3.49.0"},"reference-count":27,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,6,17]],"date-time":"2019-06-17T00:00:00Z","timestamp":1560729600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100005762","name":"National Taiwan University Hospital","doi-asserted-by":"publisher","award":["UN108\u2010023"],"award-info":[{"award-number":["UN108\u2010023"]}],"id":[{"id":"10.13039\/501100005762","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>High levels of autoantibodies against glutamic acid decarboxylase (<jats:styled-content style=\"fixed-case\">GAD<\/jats:styled-content>\u2010abs) are associated with stiff\u2010person syndrome (<jats:styled-content style=\"fixed-case\">SPS<\/jats:styled-content>). However, the full clinical spectrum associated with<jats:styled-content style=\"fixed-case\">GAD<\/jats:styled-content>\u2010abs in Asians is unclear. The clinical and immunological features of patients positive for<jats:styled-content style=\"fixed-case\">GAD<\/jats:styled-content>\u2010abs were reviewed in a large Taiwanese series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective case series and immunological investigations were conducted between July 2007 and July 2017 at a tertiary referral centre in Taiwan. Amongst 361 patients with<jats:styled-content style=\"fixed-case\">GAD<\/jats:styled-content>\u2010ab reactivity, 185 with detailed clinical records were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010seven patients (14.59%), with a mean age at assessment of 54.8\u00a0\u00b1\u00a013.9\u00a0years, presented with neurological symptoms. The major neurological presentations (mean<jats:styled-content style=\"fixed-case\">GAD<\/jats:styled-content>\u2010ab concentrations) were<jats:styled-content style=\"fixed-case\">SPS<\/jats:styled-content>(<jats:italic>n<\/jats:italic>\u00a0=\u00a09, 33.3%; 135.45\u00a0\u00b1\u00a027.84\u00a0U\/ml), cerebellar ataxia (<jats:italic>n<\/jats:italic>\u00a0=\u00a03, 11.1%; 95.61\u00a0\u00b1\u00a049.63\u00a0U\/ml), encephalopathy (<jats:italic>n<\/jats:italic>\u00a0=\u00a02, 7.4%; 51.8\u00a0\u00b1\u00a049.64\u00a0U\/ml) and epilepsy (<jats:italic>n<\/jats:italic>\u00a0=\u00a01, 3.7%; 83.3\u00a0U\/ml). Notably, eight patients fulfilling the clinical diagnosis of multiple system atrophy had relatively lower<jats:styled-content style=\"fixed-case\">GAD<\/jats:styled-content>\u2010ab concentrations (2.57\u00a0\u00b1\u00a00.82\u00a0U\/ml), which has not been reported previously. There was no correlation between disease severity and<jats:styled-content style=\"fixed-case\">GAD<\/jats:styled-content>\u2010ab concentration. Patients presenting with comorbid endocrinopathies (<jats:italic>n<\/jats:italic>\u00a0=\u00a015, 55.5%) had higher<jats:styled-content style=\"fixed-case\">GAD<\/jats:styled-content>\u2010ab concentrations than those without endocrinopathies (<jats:italic>n<\/jats:italic>\u00a0=\u00a012, 44.4%; 104.45\u00a0\u00b1\u00a022.51\u00a0U\/ml vs. 34.08\u00a0\u00b1\u00a021.83\u00a0U\/ml,<jats:italic>P<\/jats:italic>\u00a0=\u00a00.04). Of 158 patients (85.4%) without a neurological presentation, 133 had type 1 diabetes mellitus and 20 had diabetes of other aetiologies (type 2 or gestational diabetes mellitus, or diabetes secondary to pancreatitis); the remaining four patients had pure thyroid disorders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A clinical and immunological evaluation of East Asian patients positive for<jats:styled-content style=\"fixed-case\">GAD<\/jats:styled-content>\u2010abs is presented and a different clinical spectrum of anti\u2010<jats:styled-content style=\"fixed-case\">GAD<\/jats:styled-content>syndrome is identified compared to Caucasians.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.14005","type":"journal-article","created":{"date-parts":[[2019,5,27]],"date-time":"2019-05-27T14:00:13Z","timestamp":1558965613000},"page":"1384-1390","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Clinical 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