A boy with autism spectrum disorder with antibodies to the NMDA-type glutamate receptor: nine-year follow-up, changes in cognitive function

Herein, we report a 12-year-old boy with autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) who showed a cognitive decline at age 7 and tested positive for cerebrospinal fluid (CSF) N-methyl-D-aspartate (NMDA)-type glutamate receptor (GluR) antibodies using an enzyme-linked immunosorbent assay (ELISA). His cognitive function developed between ages 3 and 5, reaching a total domain developmental quotient (DQ) of 61 on the revised Kyoto Scale of Psychological Development 2001. Despite multiple treatments, his total domain DQ declined to 21 at 10 years and 3 months of age and further to 16 at 12 years and 0 month. The child regressed in cognitive function, losing previously acquired knowledge and skills, resulting in an unbalanced profile. Previously recorded strengths, weaknesses, and preferences were no longer evident. The anti-NMDA-type GluR antibodies might hinder the regaining of cognitive functions once lost and the reconstruction of developmental characteristics in patients with ASD/ADHD. Patients with ASD and ADHD who test positive for NMDA-type GluR antibodies (ELISA) may not follow a typical clinical course.