Autoimmune movement disorders are associated with a complex spectrum of biomarkers, symptoms and treatments. In this test specific episode of the "Answers From the Lab" podcast, Andrew McKeon, M.B., B.Ch., M.D., explains how Mayo Clinic Laboratories' expanded evaluation guides clinical decision making in a rapidly evolving area of patient care.

"This launch is exciting because it broadens the repertoire of biomarkers available for evaluating patients with autoimmune movement disorders," Dr. McKeon says. "It will help clinicians to identify an autoimmune disorder and to determine if a patient's disorder is likely paraneoplastic."

Four recently identified biomarkers — septin-5, septin-7, neurochondrin, and adaptor protein-3B2 — have been added to the existing movement disorders evaluation. All four of these antibodies have been shown to respond to immunotherapy. In line with Mayo Clinic Laboratories' phenotype-specific approach, the movement disorders evaluation doesn't include antibodies associated with other autoimmune neurological conditions.

"It's really important that clinicians drill down on the phenotype and establish the trajectory of a patient's illness. We've designed phenotype-specific evaluations with that in mind," Dr. McKeon says.

Listen to learn more about Mayo Clinic Laboratories' expanded movement disorders panel.

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Testing

MDC2 | Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid

MDS2 | Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Serum

Useful information

MDC2 | Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid

Evaluating patients with suspected paraneoplastic or other autoimmune movement disorders including patients with ataxia, brainstem encephalitis, chorea, dyskinesias, myoclonus, and parkinsonism using spinal fluid specimens

MDS2 | Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Serum

Evaluating patients with suspected paraneoplastic or other autoimmune movement disorders including patients with ataxia, brainstem encephalitis, chorea, dyskinesias, myoclonus, and parkinsonism in serum specimens

Specimen requirements

MDC2 | Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid

Patient Preparation:

1. For optimal antibody detection, specimen collection is recommended prior to initiation of immunosuppressant medication, or corticosteroid or intravenous immunoglobulin (IVIg) treatment.

Container/Tube: Sterile vial

Specimen Volume: 4 mL

Preferred: Vial number 1

Acceptable: Any vial

MDS2 | Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Serum

Patient Preparation:

1. For optimal antibody detection, specimen collection is recommended prior to initiation of immunosuppressant medication or intravenous immunoglobulin (IVIg) treatment.
2. This test should not be requested in patients who have recently received radioisotopes, therapeutically or diagnostically, because of potential assay interference. The specific waiting period before specimen collection will depend on the isotope administered, the dose given, and the clearance rate in the individual patient. Specimens will be screened for radioactivity prior to analysis. Radioactive specimens received in the laboratory will be held 1 week and assayed if sufficiently decayed or canceled if radioactivity remains.

Submission Container/Tube: Plastic vial

Specimen Volume: 4 mL

Preferred: Red top

Acceptable: Serum gel

Performance information

MDC2 | Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid

Analytic time: 8 to 11 days

Days performed: Profile tests: Monday through Sunday; Reflex tests: Varies

MDS2 | Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Serum

Analytic time: 10 to 13 days

Days performed: Profile tests: Monday through Sunday; Reflex tests: Varies

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