alexa Symptoms and Therapeutic Options of the Anti-NMDA Receptor Encephalitis According To a Neural Network | OMICS International
ISSN: 2161-0940
Anatomy & Physiology: Current Research
Like us on:
Make the best use of Scientific Research and information from our 700+ peer reviewed, Open Access Journals that operates with the help of 50,000+ Editorial Board Members and esteemed reviewers and 1000+ Scientific associations in Medical, Clinical, Pharmaceutical, Engineering, Technology and Management Fields.
Meet Inspiring Speakers and Experts at our 3000+ Global Conferenceseries Events with over 600+ Conferences, 1200+ Symposiums and 1200+ Workshops on
Medical, Pharma, Engineering, Science, Technology and Business

Symptoms and Therapeutic Options of the Anti-NMDA Receptor Encephalitis According To a Neural Network

Felix-Martin Werner1,2* and Rafael Covenas2

1Higher Vocational School of Elderly Care and Occupational Therapy, Euro Academy, Pobneck, Thuringia, 07381, Germany

2Laboratory of Neuroanatomy of the Peptidergic Systems (Lab. 14), Institute of Neurosciences of Castilla y León (INCYL), University of Salamanca, Salamanca, Castilla León, 37007, Spain

*Corresponding Author:
Felix-Martin Werner
University of Salamanca, Instituto de Neurociencias de Castilla y León (INCYL)
Laboratorio de Neuroanatomía de los Sistemas Peptidérgicos (Lab. 14)
c/ Pintor Fernando Gallego, 137007-Salamanca, Spain
Tel: +34923294400
E-mail: [email protected]

Received date: January 04, 2016 Accepted: January 05, 2016 Published date: January 11, 2016

Citation: Werner FM and Covenas R (2016) Symptoms and Therapeutic Options of the Anti-NMDA Receptor Encephalitis According To a Neural Network. Anat Physiol 6:e136. doi:10.4172/2161-0940.1000e136

Copyright: © 2016 Werner FM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Visit for more related articles at Anatomy & Physiology: Current Research


Anti-NMDA receptor encephalitis; Neural network; Symptoms; Therapeutic options


The anti-NMDA receptor encephalitis concerns above all young women and girls and can occur as the paraneoplastic syndrome of a teratome or without a primary cause. A neural network is developed in order to explain the symptoms of the disease and to derive the possible therapies.

Material and Methods

In the midbrain glutaminergic neurons weakly inhibit serotonergic neurons via NMDA receptors, so that serotonergic neurons have a high activity through 5-HT1A receptors. Activated by the serotonergic neurons, GABAergic neurons strongly inhibit via GABAA receptors noradrenergic neurons, which transmit a weak impulse to glutaminergic neurons via alpha1 receptors. These alterations hint the changes in awaremess.

In the mesolimbic system glutaminergic neurons strongly inhibit via NMDA receptors serotonergic neurons, which have a high activity via 5-HT2A receptors. Since dopaminergic and serotonergic neurons activate each other through D2 and 5-HT2A receptors in the A10 cell group, dopamine hyperactivity via D2 receptors occurs as well. This explains the psychotic symptoms and also mania which happens in some cases [1].

In the extrapyramidal system glutaminergic neurons in the putamen weakly inhibit via NMDA receptors dopaminergic neurons weakly activate muscarinic cholinergic neurons. The dopaminergic neurons in the caudate nucleus enhance via D2 receptors the GABAergic inhibition in the external globus pallidus of glutaminergic neurons in the nucleus subthalamicus. Since the glutaminergic neurons weakly inhibit dopaminergic neurons in the substantia nigra via NMDA receptors, dopamine hyperactivity is enhanced. The glutaminergic neurons in the nucleus subthalamicus transmit a weak activating impulse to GABAergic neurons in the internal globus palidus, which inhibit muscarinic cholinergic neurons in the putamen. These alterations lead to catatonic movement disturbances [1].

In the hippocampus a blockade of the NMDA receptors leads to dopamine hyperactivity and serotonin and GABA hypoactivity. This neurotransmitter alteration can cause epileptic seizures and a status epilepticus (Figure 1) [2].


Figure 1: Neuronal pathways, classical neurotransmitters and neuropeptides involved in Parkinson’s disease in the extrapyramidal system. 5-HT: serotonin; Ach: acetylcholine; DA: dopamine; GABA: gamma-aminobutyric acid; Glu: glutamate; NA: noradrenaline. The following subreceptors are indicated: alpha1: alpha1 receptor, a subreceptor of the noradrenergic receptor; GABAA: GABAA receptor, a subreceptor of the GABA receptor; 5-HT1A: 5-HT1A receptor, a subreceptor of the serotonergic receptor; 5-HT2A: 5- HT2A receptor, a subreceptor of the serotoninergic receptor; D2: D2 receptor, a subreceptor of the dopaminergic receptor; kappa: kappa receptor: a subreceptor of the opioid receptor; M4: M4 receptor: a subreceptor of the muscarinic cholinergic receptor; NMDA: NMDA (N-methyl-D-aspartate) receptor, a subreceptor of the ionotropic glutaminergic receptor; A plus mark indicates a postsynaptic excitatory impulse; a minus mark indicates a presynaptic inhibitory impulse.


The following therapies can be performed in this disease:

• Plasmapheresis in order to normalize the neurotransmitter alterations.

• Immunotherapy. Werner [2] made experiments about immunotherapy. According to these results, a strong immunological reaction is possible, if the antigen/antibody ratio is equivalent. After an administration of antibodies, anti-antibodies are formed. It remains to be investigated in experiments when after the first administration of antibodies and in which concentration this ratio between the primary antibody and the secondary antibody is achieved so that a strong immunological reaction occurs.

• Benzodiazepines and antipsychotic drugs in order to reduce dopamine and serotonin hyperactivity. Among the antipsychotic drugs quetiapine and clozapine with a strong 5-HT2A antagonistic effect should be preferred, because a blockade of 5-HT2A receptors counteracts glutamate deficiency [1].


This neural network, which should be examined in depth, enables the explanation of the symptoms and the finding of therapies of the disease.


Select your language of interest to view the total content in your interested language
Post your comment

Share This Article

Relevant Topics

Article Usage

  • Total views: 8122
  • [From(publication date):
    January-2016 - Mar 25, 2018]
  • Breakdown by view type
  • HTML page views : 8056
  • PDF downloads : 66

Post your comment

captcha   Reload  Can't read the image? click here to refresh

Peer Reviewed Journals
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2018-19
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri & Aquaculture Journals

Dr. Krish

[email protected]

1-702-714-7001Extn: 9040

Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals


[email protected]

1-702-714-7001Extn: 9042

Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001Extn: 9040

Clinical Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

Food & Nutrition Journals

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

General Science

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics & Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Materials Science Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Nursing & Health Care Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001Extn: 9038

Neuroscience & Psychology Journals

Nathan T

[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

Ann Jose

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001Extn: 9042

© 2008- 2018 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version