{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T19:56:15Z","timestamp":1793908575235,"version":"4.8.0"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Prognostic determinants in anti-glutamic acid decarboxylase (GAD) antibody-associated epilepsy remain unclear, and no validated predictive model exists. We aimed to identify prognostic factors and develop a predictive model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter cohort included patients diagnosed with anti-GAD antibody-associated epilepsy before September 2024. Data encompassed demographics, seizure semiology, cellular and serological parameters, neuroimaging and electrophysiological findings, and treatment regimens. Favorable outcome was defined as seizure-free for \u226512 months following immunotherapy and antiseizure medications, poor outcome was defined as persistent seizures. Prognostic factors were analyzed and a predictive model was constructed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 91 patients, 22 (24%) achieved seizure freedom, whereas 69 (76%) continued to experience seizures despite appropriate treatment. Poor prognosis was associated with focal seizures (50% vs. 81%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.004), temporal lobe epilepsy (TLE) (23% vs. 75%,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001), musicogenic epilepsy (n = 5, all with poor seizure control), and higher seizure frequency [\u22651 seizure\/month (67% vs. 97%,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001)]. In contrast, a shorter disease duration from symptom onset to diagnosis [3 (IQR 0.9\u201326.0) vs. 8 (IQR 1.5\u201336.0) months,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.025], a shorter interval to initiation of immunotherapy [3 (IQR 1.0\u201314.0) vs. 7 (IQR 1.9\u201327.3) months,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.005], higher CD8\n                      <jats:sup>+<\/jats:sup>\n                      T-cell counts (829.5 \u00b1 473.9 vs. 619.5 \u00b1 338.6 cells\/\u00b5L,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.035) were associated with favorable outcomes. Multivariate logistic regression identified TLE (OR = 0.098, 95% CI: 0.028\u20130.341,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001) and seizure frequency (OR = 0.067, 95% CI: 0.010\u20130.450,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.005) as independent predictors of prognosis. The prognostic model based on these two variables demonstrated good discrimination (AUC = 0.807, 95% CI: 0.696\u20130.919,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001) and calibration (Hosmer\u2013Lemeshow\n                      <jats:italic>\u03c7\u00b2<\/jats:italic>\n                      = 0.124,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.740), with sensitivity of 81.8%, specificity of 72.5%, and overall accuracy of 74.7%. Internal validation with bootstrapping confirmed model stability. Risk stratification further classified patients into low- (8.7%), intermediate- (49.3\u201358.9%), and high-risk (93.6%) groups for poor prognosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Focal seizures, TLE, and higher seizure frequency were associated with poor prognosis, whereas early diagnosis, timely treatment, and higher peripheral CD8\n                      <jats:sup>+<\/jats:sup>\n                      T-cell counts were associated with favorable outcomes. TLE and seizure frequency independently predicted clinical outcomes in anti-GAD antibody-associated epilepsy. The logistic regression model effectively stratified patients, identifying those likely to achieve seizure freedom versus refractoriness.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1738062","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T05:33:44Z","timestamp":1770183224000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Prognostic factors and a preliminary prognostic model in anti-GAD antibody-associated epilepsy"],"prefix":"10.3389","volume":"17","author":[{"given":"Lin","family":"Bai","sequence":"first","affiliation":[{"name":"Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaochuan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Beijing Huiren Technology Development Co., Ltd.","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haitao","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Le","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Nanjing Brain Hospital, The Affiliated Brain Hospital of Nanjing Medical University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiqin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Henan Provincial People\u2019s Hospital","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Neurology, Affiliated Hospital of Hebei University","place":["Baoding, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yueli","family":"Zou","sequence":"additional","affiliation":[{"name":"Department of Neurology, The Second Hospital of Hebei Medical University","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siyuan","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongzhi","family":"Guan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences","place":["Beijing, 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