DIAGNOSTIC TESTS FOR NEUROLOGICAL DISEASES

 

MYASTHENIA GRAVIS (the classic assays and 3 new assays)

LAMBERT-EATON MYASTHENIC SYNDROME (LEMS)

MYOSITIS (polymyositis, dermatomyositis)

PERIPHERAL NEUROPATHIES (Guillain-Barre, Miller Fisher, etc)

MULTIPLE SCLEROSIS

NEUROMYELITIS OPTICA (NMO)

PARANEOPLASTIC SYNDROMES

AUTOIMMUNE ENCEPHALITIS

Syndromes related to autoimmune encephalitis:

- Limbic and NMDA encephalitis

- Autoimmune cerebellar ataxia

- Autoimmune Epilepsy

- Autoimmune Dementia

- Behavior disorders

- Sleep disorders of autoimmune etiology.

- Hypothalamic dysfunction

- Vision Disorders of autoimmune etiology

- Stiff-Person Syndrome / PERM

- Autoimmune chorea

- Opsoclonus & myoclonus

- Brainstem syndrome

- Autoimmune myelopathy

- Sensorimotor neuropathy

CREUTZFELDT-JACOB DISEASE

ALZHEIMER DISEASE 

WORKING HOURS

Monday-Friday 7:30 to 18:00
Saturday: 9.00-11.00

 

Diagnostic services (13/4/2018)

MYASTHENIA GRAVIS (MG)

Antibodies against:

• Acetylcholine receptor (AChR) (by 2 RIAs).

• MuSK (by 2 RIAs)

In addition to the classical RIAs, all samples are also tested with our new ~5-10X more sensitive RIA for further confirmation of the result (especially useful in the case of ambiguous or borderline results).

• Titin (by ELISA and RIA). Recommended in MG patients (usually positive in AChR antibodies), under 50 years of age, supporting the presence thymoma. In negative anti-AChR / MuSK, and negative anti-Titin with ELISA, we also apply a highly sensitive RIA, free of extra charge, as supportive information for the final diagnosis of MG by the physician (Stergiou et al. J. Neuroimmunol. 2016).

• Ryanodine receptor (RyR). It is recommended to MG patients (usually positive in anti-AChR antibodies), as a further indication of the presence of thymoma

 

New tests for MG

Antibodies against:

• LRΡ4. This is the new antigen for MG, detected in ~9-19% of “seronegative” MG patients (according to Zhang, Tzartos et al. Arch Neurol, 2012. Zisimopoulou, Tzartos et al. J. Autoimm. 2013)

• MuSK with cell based assay (CBA). Detected in ~13% of the “seronegative” MG patients (according to Vincent et al. Ann. NYAS 2012 and Tsonis et al. J. Neuroimmunol. 2013).

• AChR clusters or "low affinity" AChR antibodies (according to Leite et al. Brain 2008).

Note: the above three tests (antibodies to LRΡ4, to MuSK and to AChR clusters, all with CBA) are new, recommended for those who are negative in the first two tests, and tend to eliminate the "seronegative" MG. However, false positive results cannot be excluded at this stage.

 

MYASTHENIC SYNDROME LAMBERT-EATON (LEMS)

• Antibodies against calcium channels (VGCC) type P/Q and type N

 

AUTOIMMUNE DISAUTONOMIA

• Antibodies against ganglionic α3 AChR and against Hu(ANNA-1)

 

MYOSITIS (Polymyositis / Dermatomyositis)

• Antibodies against Mi-2α, Mi-2β, Ku, PM-Scl100, PM-Scl75, SRP, Jo-1, PL-7, Pl-12, OJ, EJ, Ro-52, ΤΙF1γ, MDA5, NXP2, SAE1 

Necrotizing Myositis
• Antibodies against HMGCR (related to the use of statins) and to SRP (signal recognition particle)
 

Inclusion Body Myositis

• Antibodies againstMup44 (cytosolic 5- nucleotidase 1A, cN-1A)

 

PERIPHERAL NEUROPATHIES

• Antibodies against gangliosides GM1, GM2, GM3, GM4, GD1a, GD1b, GD2, GD3, GT1, GT2, GQ1b, Sulfatide

• Antibodies against SGPG and the protein MAG (myelin associated glycoprotein).

• Antibodies against Contactin-1 and Neurofascin-155

 

NEUROMYELITIS OPTICA (NMO) or Devic’s disease

Antibodies against the proteins:

• Aquaporin-4 (AQP4)

• Myelin oligodendrocyte glycoprotein (MOG)

• Aquaporin-1 (AQP1, according to Tzartos et al. Plos1, 2013) 

• Detection of the protein GFAP in CSF during relapse

 

MULTIPLE SCLEROSIS

• Detection of oligoclonal IgG bands in serum and CSF

• Determination of albumin and IgG concentration in serum and CSF

 

PARANEOPLASTIC SYNDROMES

• Antibodies against: Hu (ANNA-1), Ri (ANNA-2), Yo (PCA-1), PNMA2 (Ma2/Ta), CV2 (CRMP-5), amphiphysin, recoverin, SOX1 (AGNA), zic4, Tr(DNER)

• Antibodies against ITPR1 (Inositol 1,4,5-trisphosphate receptor 1, I3PR) και CARP VIII (Carbonic anhydrase-related protein VIII) and TR(DNER) by CBA

 

AUTOIMMUNE ENCEPHALITIS

Antibodies against:

• Potassium channels (VGKC. Kv1.1, 1.2, 1.6)

• Caspr2, LGI1 (proteins associated with potassium channels)

• NMDAR, AMPAR1, 2 and GABARb

• GAD65 (glutamic acid decarboxylase)

• Glycine Receptor

• mGluR1,mGluR5,GABAAR,DPPX,Iglon5

• Dopamine Receptor

• Neurexin-3α

 

Antibody test packages for syndromes related to autoimmune encephalitis:

 

Limbic and NMDA encephalitis

• NMDAR, AMPAR1,2, GABARb, GAD65, Caspr2+LGI1

• mGLuR5, Paraneoplastic antigens, VGΚC

Autoimmune cerebellar ataxia

•    Paraneoplastic antigens

•    GAD65, mGluR1, ITPR1, CARP VIII

•    VGCC-P/Q, VGCC-N

Autoimmune epilepsy

•    VGKC and Caspr2+LGI1

•    Paraneoplastic antigens (Ma1/2, CRMP-5/CV2, Amphiphysin, SOX1, Tr)    

•    NMDAR, AMPAR1,2, GABAΒR, GABAAR, mGluR5, GAD65

Autoimmune dementia

•    VGKC and Caspr2+LGI1

•    Paraneoplastic antigens (Hu, Ri, Yo, CRMP5/ CV2, Amphiphysin, SOX1, Tr)

•    NMDAR, AMPAR1,2, GABAΒR, GAD65

Behavior disorders

•    NMDAR,  Caspr2+LG1, AMPAR1,2, VGΚC

Sleep disorders of autoimmune etiology

•   Caspr2+LG1,  AQP4,  NMDAR,  IgLON5

•   Paraneoplastic antigens (Ma2, Ri)

Hypothalamic dysfunction

•   Paraneoplasticantigens

•   CASPR2+LGI1, AQP4,  VGΚC

Vision disorders of autoimmune etiology

•   AQP4, MOG 

•   Paraneoplastic (CRMP-5/CV2, recoverin, Hu,Yo,Ma2,Ri,Tr)  ,  VGCC-P/Q

Stiff-Person Syndrome / PERM

•   GAD65,  Glycine Receptor

•   Paraneoplastic

•   DPPX

Autoimmune Chorea

•   Paraneoplastic (Hu,CV2)  

•   GAD65, Caspr2+LG1

Opsoclonus & Myoclonus

•   Paraneoplastic (Ri, Hu)

•   NMDAR, LG1

Brainstem syndrome

•   AQP4

•   Paraneoplastic (CRMP-5, PCA-2, Hu, Ri, amphiphysin, Ma2)   

Autoimmunemyelopathy

•   AQP4, MOG                 

•   Paraneoplastic (CRMP-5/CV2, amphiphysin, Ηυ, Ri, Yu, Ma2)

Sensorimotor neuropathy

•   Paraneoplastic (Hu, Ri, Yo, CRMP-5/CV2, amphiphysin, SOX1)

 

CREUTZFELDT-JACOB

• Detection of the proteins 14-3-3,  Tau and phospho-Tau(181-p) in the CSF.

• Detection of PrPSc in the CSF, by RT-QuIC.

 

ALZHEIMER

• Detection of the proteins: beta-amyloid(1-42) and (1-40), total Tau and phospho-Tau(181-p)

 

RESEARCH

In addition to our own research for the development of new diagnostics, we also welcome participation in research protocols in collaboration with interested clinicians.

3 Eslin str. Ampelokipoi, Athens, 11523, Tel 210-6411060 & 210-6429969, Fax 210-6411067.

Emails: info@neurodiagnostics.gr & stzartos@gmail.com