Autoimmune Brain Disorder Center at Lenox Hill Hospital
New York, New York 10075
This center at Lenox Hill Hospital is dedicated to providing research and clinical services.
Multiple lines of evidence from human and experimental studies support the pathogenic role of neuroinflammation also known as brain inflammation and neuroimmunological abnormalities or brain autoimmunity in a wide rage of neuropsychiatric disorders. While systemic autoimmune diseases such as systemic lupus erythematosus are well-documented causes of neuropsychiatric disorders, isolated brain disorders associated with either neuroinflammation or neuroimmunological abnormalities such as autoimmune encephalitis presenting with various neuropsychiatric symptoms often go either under-recognized or erroneously diagnosed as classical mental illnesses.
Brain tissue injury triggers an inflammatory response consisting of highly specialized immune cells such as those derived from the blood such as inflammatory and lymphocytes cells and the brain such as astroglial and microglial cells. Under normal conditions, neuroinflammation is short-lived and beneficial. This beneficial neuroinflammation is crucial in limiting and reversing the neural injury, removing the brain tissue debris, and promoting the recovery. Under pathological conditions, neuroinflammation can become relentlessly progressive and harmful. The immune and inflammatory cells associated with harmful neuroinflammation release excess destructive pro-inflammatory substances that can further damage the surrounding healthy brain tissue, leading to persistent injurious inflammation, resulting in ongoing expansion of the brain tissue damage. Patients with such pathological conditions may suffer from a wide range of neurological and neuropsychiatric problems that can be severe and disabling, although at times reversible with the proper anti-inflammatory therapy.
Autoimmune encephalitis is a form of autoimmune brain disorder in which the immune system attacks the brain, resulting in acute-onset seizures, psychiatric features, and cognitive deficits. Immune cells and autoantibodies targeting specific antigens located on the surface of nerve cells within the brain typically mediate the immunological attack. Although neurological symptoms eventually emerge, psychiatric manifestations, ranging from anxiety and mood changes to psychosis with delusions and hallucinations mimicking schizophrenia can initially dominate or precede neurological features. Psychiatric presentations can include normal brain MRI and cerebrospinal fluid (CSF) analysis. In some of these patients no harmful autoantibodies against the brain cells are identified, making the diagnosis much more elusive. The latter cases are referred to as “seronegative autoimmune encephalitis” as opposed to those associated with harmful autoantibodies (seropositive autoimmune encephalitis). The prevalence of seronegative autoimmune encephalitis presenting primarily with neuropsychiatric disorders is currently unknown. Although neuropsychiatric and neurological abnormalities associated with autoimmune encephalitis are often severe, but are frequently reversible with early and effective immune therapy.
Further investigation into the pathophysiology of the neurological conditions associated with harmful neuroinflammation or autoantibody against brain cells is warranted in order to advance the diagnostic testing, develop novel treatments, and improve the functional outcomes.
One research endeavor is aimed at better understanding of the mechanisms that regulate the seesaw imbalance between beneficial and harmful neuroinflammation, and finding the treatment that can reverse such imbalance in favor of beneficial neuroinflammation.
Our research also focuses on the discovery and the validation of the blood or CSF biomarkers as well as the novel autoantibodies that can reliably identify patients with autoimmune brain disorders and neuroinflammation. These discoveries may help target new preventive and symptomatic therapies. The research team include basic science researcher in neuroimmunology and basic science laboratory.
Our center is dedicated to providing comprehensive evaluation and innovative multidisciplinary care for patients who are suspected to have autoimmune brain disorders such as autoimmune encephalitis, and neuroinflammation. Our team includes academic neurologists with advanced expertise in the evaluation and treatment of autoimmune brain diseases and neuroinflammation, neuropsychiatrist, psychiatrist, psychologist, basic neuroimmunology scientists, clinical coordinators, nurse practitioners, nurses, and social workers. This center will also provide physicians with an opportunity for clinical fellowship training and expanding scientific knowledge base in this rapidly emerging field of autoimmune brain diseases and neuroinflammation.
Souhel Najjar, MD
- Senior Vice President and Executive Director, Neurology Service Line,
Lenox Hill Hospital and Staten Island University Hospital
Chair and Professor, Neurology,
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
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