{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T04:55:02Z","timestamp":1791262502560,"version":"4.1.0"},"reference-count":59,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"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>Neuronal antibodies detected during evaluation of rapidly progressive dementia may indicate treatable autoimmune encephalitis or incidental seroreactivity in prion disease. We estimated their frequency in sporadic Creutzfeldt-Jakob disease (sCJD), separately from diagnostic yield in suspected CJD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Under a registered protocol (PROSPERO CRD420261458659), MEDLINE\/PubMed, Embase and CENTRAL were searched on 12 July 2026 and with expanded antibody terms on 13 September 2026. Screening, extraction and JBI appraisal were performed independently in duplicate with third-reviewer adjudication. The primary outcome was neuronal-surface\/synaptic antibody positivity in datasets with standardized testing. We report the aggregate proportion with an exact 95% confidence interval and model-based summaries from logistic-normal GLMM and beta-binomial models, which estimate different quantities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Forty-three reports were retained, including six independent datasets with 241 tested patients. All four low-level positives arose in one cohort: aggregate 4\/241 (1.66%; 95% CI 0.45\u20134.19), GLMM 0.36% (lower bound &amp;lt;0.01%, upper bound 3.38%), and beta-binomial 1.21% (0.07\u201319.67). Restricting positivity to an identified neuronal-surface antigen gave 3\/241 (1.24%; 0.26\u20133.59). Excluding two datasets at high risk of bias gave 4\/154 (2.60%; 0.71\u20136.52); excluding the dataset with inseparable diagnostic-certainty groups gave 4\/220 (1.82%; 0.50\u20134.59). No antibody was detected in 51 pathologically confirmed patients with directly linkable testing results from two non-overlapping datasets (0\/51; exact upper 95% bound 7.0%). This selected subset does not encompass all pathologically confirmed patients or exclude antibody positivity in confirmed disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Neuronal-surface antibodies were uncommon on the assays used, but estimates depend on antibody definition, denominator composition and model assumptions. Frequency in sCJD does not establish the probability of autoimmune disease after a positive antibody result. Interpretation requires the antibody identity, specimen, assay confirmation, phenotype and strength of prion evidence; autoimmune encephalitis and sCJD can coexist.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420261458659<\/jats:ext-link>\n                      , identifier CRD420261458659.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1966990","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T04:25:26Z","timestamp":1791260726000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Neuronal-surface antibodies are uncommon in patients with a final diagnosis of sporadic Creutzfeldt-Jakob disease: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Najeeb","family":"Qadi","sequence":"first","affiliation":[{"name":"Neuroscience Centre of Excellence, King Faisal Specialist Hospital and Research Centre","place":["Riyadh, Saudi Arabia"]},{"name":"College of Medicine, Alfaisal University","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amaal","family":"Aldakheel","sequence":"additional","affiliation":[{"name":"Neuroscience Centre of Excellence, King Faisal Specialist Hospital and Research Centre","place":["Riyadh, Saudi Arabia"]},{"name":"College of Medicine, Alfaisal University","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eslam","family":"Shosha","sequence":"additional","affiliation":[{"name":"Neuroscience Centre of Excellence, King Faisal Specialist Hospital and Research Centre","place":["Riyadh, Saudi Arabia"]},{"name":"College of Medicine, Alfaisal University","place":["Riyadh, Saudi Arabia"]},{"name":"Division of Neurology, Department of Medicine, McMaster University","place":["Hamilton, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(20)30477-4","article-title":"Biomarkers and diagnostic guidelines for sporadic Creutzfeldt-Jakob disease","volume":"20","author":"Hermann","year":"2021","journal-title":"Lancet Neurol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1016\/S1474-4422(15)00401-9","article-title":"A clinical approach to diagnosis of autoimmune encephalitis","volume":"15","author":"Graus","year":"2016","journal-title":"Lancet Neurol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneuroim.2026.578865","article-title":"Antibodies in Creutzfeldt-Jakob disease: a systematic review of patient characteristics, diagnostics, and clinical implications","volume":"413","author":"Bilavu","year":"2026","journal-title":"J Neuroimmunol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2014-308695","article-title":"Neuronal antibodies in patients with suspected or confirmed sporadic Creutzfeldt-Jakob disease","volume":"86","author":"Rossi","year":"2015","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"B6","doi-asserted-by":"publisher","first-page":"14","DOI":"10.5334\/tohm.753","article-title":"Spectrum and pattern of movement disorders in patients with sporadic Creutzfeldt-Jakob disease","volume":"13","author":"Gurram","year":"2023","journal-title":"Tremor Other Hyperkinet Mov (N Y)"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1002\/jrsm.1348","article-title":"Seriously misleading results using inverse of Freeman-Tukey double arcsine transformation in meta-analysis of single proportions","volume":"10","author":"Schwarzer","year":"2019","journal-title":"Res Synth Methods"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.103892","article-title":"Sporadic Creutzfeldt-Jakob disease with spinal cord lesions: a case report","volume":"18","author":"Akanuma","year":"2026","journal-title":"Cureus"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.7754\/Clin.Lab.2025.250810","article-title":"Potential pathogenic role of glycine receptor \u03b11 autoantibodies in sporadic Creutzfeldt-Jakob disease","volume":"72","author":"Wu","year":"2026","journal-title":"Clin Lab"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.46997\/revecuatneurol33100115","article-title":"Encephalitis and rapidly progressive dementia due to probable prion disease presenting with a non-convulsive status epilepticus. 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