Prognostic factors and a preliminary prognostic model in anti-GAD antibody-associated epilepsy

作者：Lin Bai, Nan Lin, Xiaochuan Zhang, Haitao Ren, Le Zhang, Jie Lu, Huiqin Liu, Yun Cai, Yueli Zou, Siyuan Fan, Qiang Lu, Hongzhi Guan · 发表于：Frontiers in Immunology · 年份：2026 · DOI：10.3389/fimmu.2026.1738062 · 被引用次数：1 · 研究领域：Autoimmune Neurological Disorders and Treatments、Epilepsy research and treatment、Glycogen Storage Diseases and Myoclonus

Background 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. Methods 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 ≥12 months following immunotherapy and antiseizure medications, poor outcome was defined as persistent seizures. Prognostic factors were analyzed and a predictive model was constructed. Results 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%, p = 0.004), temporal lobe epilepsy (TLE) (23% vs. 75%, p < 0.001), musicogenic epilepsy (n = 5, all with poor seizure control), and higher seizure frequency [≥1 seizure/month (67% vs. 97%, p < 0.001)]. In contrast, a shorter disease duration from symptom onset to diagnosis [3 (IQR 0.9–26.0) vs. 8 (IQR 1.5–36.0) months, p = 0.025], a shorter interval to initiation of immunotherapy [3 (IQR 1.0–14.0) vs. 7 (IQR 1.9–27.3) months, p = 0.005], higher CD8 + T-cell counts (829.5 ± 473.9 vs. 619.5 ± 338.6 cells/µL, p = 0.035)...