Klinik für Psychiatrie und Psychotherapie

Research focus

In recent years, there has been a dramatic increase in the awareness of immunological encephalopathies in neuropsychiatry. Several case reports and case series have reported immunological encephalopathies mimicking dysexecutive, psychotic, depressive, and demential syndromes. Pathophysiologically, antineuronal antibodies against neuronal cell surface antigens (e.g., NMDAR-antibodies), against intracellular synaptic antigens (e.g., GAD-antibodies), and against intracellular onconeural antigens (e.g., Hu-antibodies) need to be distinguished. Moreover, thyroid autoantibodies (e.g., TPO-antibodies) could be associated with steroid responsive encephalopathy in patients with autoimmune thyroiditis (SREAT-syndrome). Epileptic and paraepileptic phenomena seem to play an important role in the clinical presentation of IEs. Therapeutic approaches with immunomodulatory treatment (e.g., corticosteroids, plasmapharesis) are promising, but clear therapeutical algorithms are still missing. Our neuroimmunological research focuses on underlying pathomechanisms and on identifying therapeutic opportunities and algorithms.

Research projects

Ongoing research projects:

• Neuroimmunological findings in psychiatric disorders: A prospective analysis of the Freiburg University Hospital’s CSF sample
• Immunological encephalopathies in psychiatry: A systematic review
• Immunological encephalopathies in psychiatry: A cumulative case series (“GENERATE-PSYCH-DATABASE”)
• Cerebrospinal fluid biomarkers of schizophreniform disorders (“RiSC-Project”)
• Pathophysiology of thyroid-autoantibodies in neuropsychiatric disorders
• Pathophysiology of rheumatoid markers in neuropsychiatric disorders
• DCE-measurement for analyses of the blood-brain-barrier function
• EEG alterations in patients with immunological encephalopathies and other neuropsychiatric disorders

Planned research projects:

• Multimodal imaging in patients with immunological encephalopathies
• Cerebrospinal fluid biomarkers of affective disorders

Recently completed:

• Neuroimmunological findings in psychotic and affective disorders: A retrospective analysis of the Freiburg University Hospital’s CSF sample

Selected publications

• Endres, D., Dersch, R., Hochstuhl, B., Fiebich, B., Hottenrott, T., Perlov, E., Maier, S., Berger, B., Baumgartner, A., Venhoff, N., Stich, O., Tebartz van Elst, L., 2017. Intrathecal Thyroid Autoantibody Synthesis in a Subgroup of Patients With Schizophreniform Syndromes. J Neuropsychiatry Clin Neurosci. [Epub ahead of print]
• Endres, D., Perlov, E., Dersch, R., Baumgartner, A., Hottenrott, T., Berger, B., Stich, O., Tebartz van Elst, L., 2016. Evidence of cerebrospinal fluid abnormalities in patients with depressive syndromes. Journal of Affective Disorders, 198,178-184
• Tebartz van Elst, L., Stich, O., Endres, D., 2015. Depressionen und Psychosen bei immunologischen Enzephalopathien. PSYCH up2date 9, 265-280.
• Endres, D., Perlov, E., Baumgartner, A., Hottenrott, T., Dersch, R., Stich, O., Tebartz van Elst, L., 2015. Immunological findings in psychotic syndromes: a tertiary care hospital's CSF sample of 180 patients. Front Hum Neurosci. 9, 476.
• Stich, O., and Rauer, S., 2014. Paraneoplastische neurologische Syndrome und Autoimmunenzephalitiden [Paraneoplastic neurological syndromes and autoimmune encephalitis]. Nervenarzt 85, 485-501.
• Tebartz van Elst, L., Krishnamoorthy, E.S., Schulze-Bonhage, A., Altenmüller, D.-M., Richter, H., Ebert, D., Feige, B., 2011. Local area network inhibition: a model of a potentially important paraepileptic pathomechanism in neuropsychiatric disorders. Epilepsy Behav 22, 231–239.