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March 2022; 9 (2) ArticleOpen Access

Population-Based Epidemiology Study of Paraneoplastic Neurologic Syndromes

View ORCID ProfileShailee Shah, Eoin P. Flanagan, View ORCID ProfilePritikanta Paul, Carin Y. Smith, Sandra C. Bryant, Michelle F. Devine, Vanda A. Lennon, Andrew McKeon, Sean J. Pittock, Divyanshu Dubey
First published December 22, 2021, DOI: https://doi.org/10.1212/NXI.0000000000001124
Shailee Shah
From the Department of Neurology (S.S., E.P.F., P.P., M.F.D., V.A.L., A.M., S.J.P., D.D.), Mayo Clinic; Department of Laboratory Medicine and Pathology (E.P.F., V.A.L., A.M., S.J.P., D.D.), Mayo Clinic College of Medicine; Department of Quantitative Health Sciences (C.Y.S., S.C.B.), Mayo Clinic; Olmsted Medical Center (M.F.D.); and Department of Immunology (V.A.L.), Mayo Clinic, Rochester, MN.
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  • ORCID record for Shailee Shah
  • For correspondence: shah.shailee@mayo.edu
Eoin P. Flanagan
From the Department of Neurology (S.S., E.P.F., P.P., M.F.D., V.A.L., A.M., S.J.P., D.D.), Mayo Clinic; Department of Laboratory Medicine and Pathology (E.P.F., V.A.L., A.M., S.J.P., D.D.), Mayo Clinic College of Medicine; Department of Quantitative Health Sciences (C.Y.S., S.C.B.), Mayo Clinic; Olmsted Medical Center (M.F.D.); and Department of Immunology (V.A.L.), Mayo Clinic, Rochester, MN.
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  • For correspondence: flanagan.eoin@mayo.edu
Pritikanta Paul
From the Department of Neurology (S.S., E.P.F., P.P., M.F.D., V.A.L., A.M., S.J.P., D.D.), Mayo Clinic; Department of Laboratory Medicine and Pathology (E.P.F., V.A.L., A.M., S.J.P., D.D.), Mayo Clinic College of Medicine; Department of Quantitative Health Sciences (C.Y.S., S.C.B.), Mayo Clinic; Olmsted Medical Center (M.F.D.); and Department of Immunology (V.A.L.), Mayo Clinic, Rochester, MN.
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  • ORCID record for Pritikanta Paul
  • For correspondence: pritikanta.paul@gmail.com
Carin Y. Smith
From the Department of Neurology (S.S., E.P.F., P.P., M.F.D., V.A.L., A.M., S.J.P., D.D.), Mayo Clinic; Department of Laboratory Medicine and Pathology (E.P.F., V.A.L., A.M., S.J.P., D.D.), Mayo Clinic College of Medicine; Department of Quantitative Health Sciences (C.Y.S., S.C.B.), Mayo Clinic; Olmsted Medical Center (M.F.D.); and Department of Immunology (V.A.L.), Mayo Clinic, Rochester, MN.
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  • For correspondence: smith.carin@mayo.edu
Sandra C. Bryant
From the Department of Neurology (S.S., E.P.F., P.P., M.F.D., V.A.L., A.M., S.J.P., D.D.), Mayo Clinic; Department of Laboratory Medicine and Pathology (E.P.F., V.A.L., A.M., S.J.P., D.D.), Mayo Clinic College of Medicine; Department of Quantitative Health Sciences (C.Y.S., S.C.B.), Mayo Clinic; Olmsted Medical Center (M.F.D.); and Department of Immunology (V.A.L.), Mayo Clinic, Rochester, MN.
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  • For correspondence: bryant@mayo.edu
Michelle F. Devine
From the Department of Neurology (S.S., E.P.F., P.P., M.F.D., V.A.L., A.M., S.J.P., D.D.), Mayo Clinic; Department of Laboratory Medicine and Pathology (E.P.F., V.A.L., A.M., S.J.P., D.D.), Mayo Clinic College of Medicine; Department of Quantitative Health Sciences (C.Y.S., S.C.B.), Mayo Clinic; Olmsted Medical Center (M.F.D.); and Department of Immunology (V.A.L.), Mayo Clinic, Rochester, MN.
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  • For correspondence: devine.michelle@mayo.edu
Vanda A. Lennon
From the Department of Neurology (S.S., E.P.F., P.P., M.F.D., V.A.L., A.M., S.J.P., D.D.), Mayo Clinic; Department of Laboratory Medicine and Pathology (E.P.F., V.A.L., A.M., S.J.P., D.D.), Mayo Clinic College of Medicine; Department of Quantitative Health Sciences (C.Y.S., S.C.B.), Mayo Clinic; Olmsted Medical Center (M.F.D.); and Department of Immunology (V.A.L.), Mayo Clinic, Rochester, MN.
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  • For correspondence: lennon.vanda@mayo.edu
Andrew McKeon
From the Department of Neurology (S.S., E.P.F., P.P., M.F.D., V.A.L., A.M., S.J.P., D.D.), Mayo Clinic; Department of Laboratory Medicine and Pathology (E.P.F., V.A.L., A.M., S.J.P., D.D.), Mayo Clinic College of Medicine; Department of Quantitative Health Sciences (C.Y.S., S.C.B.), Mayo Clinic; Olmsted Medical Center (M.F.D.); and Department of Immunology (V.A.L.), Mayo Clinic, Rochester, MN.
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  • For correspondence: mckeon.andrew@mayo.edu
Sean J. Pittock
From the Department of Neurology (S.S., E.P.F., P.P., M.F.D., V.A.L., A.M., S.J.P., D.D.), Mayo Clinic; Department of Laboratory Medicine and Pathology (E.P.F., V.A.L., A.M., S.J.P., D.D.), Mayo Clinic College of Medicine; Department of Quantitative Health Sciences (C.Y.S., S.C.B.), Mayo Clinic; Olmsted Medical Center (M.F.D.); and Department of Immunology (V.A.L.), Mayo Clinic, Rochester, MN.
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  • For correspondence: pittock.sean@mayo.edu
Divyanshu Dubey
From the Department of Neurology (S.S., E.P.F., P.P., M.F.D., V.A.L., A.M., S.J.P., D.D.), Mayo Clinic; Department of Laboratory Medicine and Pathology (E.P.F., V.A.L., A.M., S.J.P., D.D.), Mayo Clinic College of Medicine; Department of Quantitative Health Sciences (C.Y.S., S.C.B.), Mayo Clinic; Olmsted Medical Center (M.F.D.); and Department of Immunology (V.A.L.), Mayo Clinic, Rochester, MN.
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  • For correspondence: dubey.divyanshu@mayo.edu
Full PDF
Citation
Population-Based Epidemiology Study of Paraneoplastic Neurologic Syndromes
Shailee Shah, Eoin P. Flanagan, Pritikanta Paul, Carin Y. Smith, Sandra C. Bryant, Michelle F. Devine, Vanda A. Lennon, Andrew McKeon, Sean J. Pittock, Divyanshu Dubey
Neurol Neuroimmunol Neuroinflamm Mar 2022, 9 (2) e1124; DOI: 10.1212/NXI.0000000000001124

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Article Information

vol. 9 no. 2 e1124
DOI: 
https://doi.org/10.1212/NXI.0000000000001124
PubMed: 
34937736

Published By: 
Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology
Online ISSN: 
2332-7812
History: 
  • Received August 17, 2021
  • Accepted in final form November 15, 2021
  • First Published December 22, 2021.

Copyright & Usage: 
Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND), which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Author Disclosures

    1. Shailee Shah, MD (shah.shailee{at}mayo.edu),
    2. Eoin P. Flanagan, MBBCh (flanagan.eoin{at}mayo.edu),
    3. Pritikanta Paul, MD (pritikanta.paul{at}gmail.com),
    4. Carin Y. Smith, BS (smith.carin{at}mayo.edu),
    5. Sandra C. Bryant, MS (bryant{at}mayo.edu),
    6. Michelle F. Devine, MD (devine.michelle{at}mayo.edu),
    7. Vanda A. Lennon, MD, PhD (lennon.vanda{at}mayo.edu),
    8. Andrew McKeon, MD (mckeon.andrew{at}mayo.edu),
    9. Sean J. Pittock, MD (pittock.sean{at}mayo.edu) and
    10. Divyanshu Dubey, MD (dubey.divyanshu{at}mayo.edu)
  1. Shailee Shah, MD (shah.shailee{at}mayo.edu),
  2. Scientific Advisory Boards:
    1. NONE

    Gifts:
    1. NONE

    Funding for Travel or Speaker Honoraria:
    1. NONE

    Editorial Boards:
    1. NONE

    Patents:
    1. NONE

    Publishing Royalties:
    1. NONE

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. NONE

    Speakers' Bureaus:
    1. NONE

    Other Activities:
    1. NONE

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. NONE

    Research Support, Government Entities:
    1. NONE

    Research Support, Academic Entities:
    1. NONE

    Research Support, Foundations and Societies:
    1. NONE

    Stock/Stock Options/Board of Directors Compensation:
    1. NONE

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. NONE

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. NONE

  3. Eoin P. Flanagan, MBBCh (flanagan.eoin{at}mayo.edu),
  4. Scientific Advisory Boards:
    1. Served on advisory boards for Alexion, Genentech and Horizon Therapeutics

    Gifts:
    1. NONE

    Funding for travel or speaker honoraria:
    1. Speaker honoraria from Pharmacy Times.

    Editorial Boards:
    1. Editorial Board Member for the Journal of the Neurological Sciences 2021 onward; Editorial board member of Neuroimmunology Reports.

    Patents:
    1. NONE

    Publishing Royalties:
    1. Dr Flanagan is an author of a chapter on MOG antibody associated disease in UpToDate and will receive Royalties for this from 2021 onwards.

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. NONE

    Speakers' Bureaus:
    1. NONE

    Other Activities:
    1. NONE

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. Dr Flanagan was a site primary investigator in a randomized clinical trial on Medi551 in neuromyelitis optica spectrum disorder run by Medimmune. I receive compensation for time related to that activity.

    Research Support, Government Entities:
    1. Dr Flanagan has received funding from the NIH (R01NS113828).

    Research Support, Academic Entities:
    1. NONE

    Research Support, Foundations and Societies:
    1. NONE

    Stock/Stock Options/Board of Directors Compensation:
    1. NONE

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. NONE

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. NONE

  5. Pritikanta Paul, MD (pritikanta.paul{at}gmail.com),
  6. Carin Y. Smith, BS (smith.carin{at}mayo.edu),
  7. Scientific Advisory Boards:
    1. NONE

    Gifts:
    1. NONE

    Funding for Travel or Speaker Honoraria:
    1. NONE

    Editorial Boards:
    1. NONE

    Patents:
    1. NONE

    Publishing Royalties:
    1. NONE

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. NONE

    Speakers' Bureaus:
    1. NONE

    Other Activities:
    1. NONE

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. NONE

    Research Support, Government Entities:
    1. NONE

    Research Support, Academic Entities:
    1. NONE

    Research Support, Foundations and Societies:
    1. NONE

    Stock/Stock Options/Board of Directors Compensation:
    1. NONE

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. NONE

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. NONE

  8. Sandra C. Bryant, MS (bryant{at}mayo.edu),
  9. Scientific Advisory Boards:
    1. NONE

    Gifts:
    1. NONE

    Funding for Travel or Speaker Honoraria:
    1. NONE

    Editorial Boards:
    1. NONE

    Patents:
    1. NONE

    Publishing Royalties:
    1. NONE

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. NONE

    Speakers' Bureaus:
    1. NONE

    Other Activities:
    1. NONE

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. NONE

    Research Support, Government Entities:
    1. NONE

    Research Support, Academic Entities:
    1. NONE

    Research Support, Foundations and Societies:
    1. NONE

    Stock/Stock Options/Board of Directors Compensation:
    1. NONE

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. NONE

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. NONE

  10. Michelle F. Devine, MD (devine.michelle{at}mayo.edu),
  11. Scientific Advisory Boards:
    1. NONE

    Gifts:
    1. NONE

    Funding for Travel or Speaker Honoraria:
    1. NONE

    Editorial Boards:
    1. NONE

    Patents:
    1. My immediate family member has patents pending for Klh11 and Luzp4 as makers for germ cell tumor and neurological autoimmunity

    Publishing Royalties:
    1. NONE

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. NONE

    Speakers' Bureaus:
    1. NONE

    Other Activities:
    1. NONE

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. NONE

    Research Support, Government Entities:
    1. NONE

    Research Support, Academic Entities:
    1. NONE

    Research Support, Foundations and Societies:
    1. NONE

    Stock/Stock Options/Board of Directors Compensation:
    1. NONE

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. NONE

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. NONE

  12. Vanda A. Lennon, MD, PhD (lennon.vanda{at}mayo.edu),
  13. Scientific Advisory Boards:
    1. NONE

    Gifts:
    1. NONE

    Funding for Travel or Speaker Honoraria:
    1. NONE

    Editorial Boards:
    1. NONE

    Patents:
    1. Vanda Lennon receives royalties 1) from RSR/Kronus for sale of aquaporin-4 autoantibody testing kits and 2) for commercial aquaporin-4 autoantibody testing performed outside Mayo Clinic.

    Publishing Royalties:
    1. NONE

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. NONE

    Speakers' Bureaus:
    1. NONE

    Other Activities:
    1. NONE

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. NONE

    Research Support, Government Entities:
    1. NIH R01 NS110949, Co-Principal Investigator, 2020-2024

    Research Support, Academic Entities:
    1. NONE

    Research Support, Foundations and Societies:
    1. MN Partnership for Biotechnology and Medical Genomics, grant # ML2017, Chapter 89, Art, section #4 (e) Sub-award # P007067701

    Stock/Stock Options/Board of Directors Compensation:
    1. NONE

    License fee payments, Technology or Inventions:
    1. 1) RSR/Kronus for sale of aquaporin-4 autoantibody testing kits. 2) Non-Mayo sites performing "home brew" diagnostic testing for aquaporin-4 autoantibody.

    Royalty Payments, Technology or Inventions:
    1. Dr. Lennon has a potential financial interest in the technologies listed below: "Aquaporin-4 as an aid for cancer diagnosis".

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. NONE

  14. Andrew McKeon, MD (mckeon.andrew{at}mayo.edu),
  15. Scientific Advisory Boards:
    1. NONE

    Gifts:
    1. NONE

    Funding for Travel or Speaker Honoraria:
    1. NONE

    Editorial Boards:
    1. I am a member of the editorial board of Neurology: Neuroimmunology and Neuroinflammation

    Patents:
    1. Patent applications pending for the following IgGs: Septin 5, Septin 7, GFAP, PDE10A,Kelch-11 and MAP1B as markers of neurological autoimmunity and paraneoplastic disorders

    Publishing Royalties:
    1. NONE

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. Has consulted for Roche and Janssen without personal compensation

    Speakers' Bureaus:
    1. NONE

    Other Activities:
    1. NONE

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. Euroimmun Alexion

    Research Support, Government Entities:
    1. NONE

    Research Support, Academic Entities:
    1. NONE

    Research Support, Foundations and Societies:
    1. NONE

    Stock/Stock Options/Board of Directors Compensation:
    1. NONE

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. I have received royalties from MAP1B antibody commercialization.

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. NONE

  16. Sean J. Pittock, MD (pittock.sean{at}mayo.edu) and
  17. Scientific Advisory Boards:
    1. Alexion Pharmaceutical Advisory Board - Compensation to Mayo Clinic Medimmune/Viele Bio Advisory Board - Compensation to Mayo Clinic Astellas - Compensation to Mayo UCB pharmaceuticals - Personal compensation Hoffman/LaRoche - Personal compensation

    Gifts:
    1. NONE

    Funding for Travel or Speaker Honoraria:
    1. NONE

    Editorial Boards:
    1. NONE

    Patents:
    1. Dr. Pittock has a patent Patent# 8,889,102 (Application#12-678350) - Neuromyelitis Optica Autoantibodies as a Marker for Neoplasia issued, and a patent Patent# 9,891,219B2 (Application#12-573942) - Methods for Treating Neuromyelitis Optica (NMO) by Administration of Eculizumab to an individual that is Aquaporin-4 (AQP4)-IgG Autoantibody positive issued. Dr Pittock has a patent pending for GFAP, Septin-5, Kelch11 and MAP1B autoantibodies as biomarkers of neurological autoimmunity.

    Publishing Royalties:
    1. NONE

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. Dr. Pittock has provided consultation to Alexion Pharmaceuticals and Medimmune/Viela Bio but has received no personal fees or personal compensation for these consulting activities. All compensation for consulting activities is paid directly to Mayo Clinic. Dr. Pittock received personal compensation for consultation services to Genentech, Sage Therapeutics, and Prime Therapeutics.

    Speakers' Bureaus:
    1. NONE

    Other activities:
    1. No activity to report. I am a salaried employee of Mayo Clinic and salary is fixed specialty dependent and not impacted by test volume or laboratory income.

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. Dr Pittock has received research funding from Grifols, Medimmune/Viela Bio, Alexion and the National Institute of Health (NIH).

    Research Support, Government Entities:
    1. NONE

    Research Support, Academic Entities:
    1. NONE

    Research Support, Foundations and Societies:
    1. NONE

    Stock/Stock Options/Board of Directors Compensation:
    1. NONE

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. NONE

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. NONE

  18. Divyanshu Dubey, MD (dubey.divyanshu{at}mayo.edu)
  19. Scientific Advisory Boards:
    1. Dr. Divyanshu Dubey has attended UCB Advisory Board Meeting in Lyon, France on September 23, 2019. All compensation for consulting activities is paid directly to Mayo Clinic.

    Gifts:
    1. Dr. Dubey has consulted for UCB, Immunovant and Astellas pharmaceuticals. All compensation for consulting activities is paid directly to Mayo Clinic.

    Funding for Travel or Speaker Honoraria:
    1. NONE

    Editorial Boards:
    1. Dr. Dubey is on the editorial board of Journal of Clinical Medicine.

    Patents:
    1. Dr. Dubey has patent pending for Klech like protein 11 and Leucine zipper 4 as a marker of neurological autoimmunity and germ cell tumors.

    Publishing Royalties:
    1. NONE

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. NONE

    Speakers' Bureaus:
    1. NONE

    Other Activities:
    1. NONE

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. Dr. Dubey has received research support from Grifols pharmaceuticals.

    Research Support, Government Entities:
    1. NONE

    Research Support, Academic Entities:
    1. NONE

    Research Support, Foundations and Societies:
    1. NONE

    Stock/Stock Options/Board of Directors Compensation:
    1. NONE

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. NONE

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. NONE

  1. From the Department of Neurology (S.S., E.P.F., P.P., M.F.D., V.A.L., A.M., S.J.P., D.D.), Mayo Clinic; Department of Laboratory Medicine and Pathology (E.P.F., V.A.L., A.M., S.J.P., D.D.), Mayo Clinic College of Medicine; Department of Quantitative Health Sciences (C.Y.S., S.C.B.), Mayo Clinic; Olmsted Medical Center (M.F.D.); and Department of Immunology (V.A.L.), Mayo Clinic, Rochester, MN.
  1. Correspondence
    Dr. Dubey dubey.divyanshu{at}mayo.edu
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