Fig. 1: Longitudinal evaluation of symptoms in relation to rituximab treatment.

A Longitudinal evaluation of symptoms was conducted with the symptom rating scales: Brief Psychiatric Rating Scale (BPRS) and Yale-Brown Obsessive-Compulsive Scale (YBOCS). The horizontal line indicates a BPRS score of 24 reflecting no current symptoms. B CSF and blood was repeatedly sampled at six-month intervals. Levels of sCD27 in CSF and plasma are shown compared to healthy controls, shown as individual grey dots (CSF n = 6, plasma n = 51). C Indirect IHC staining intensity for anti-mouse brain IgG counterstained with DAPI, using CSF. Shown are case and control mean signal intensities for seven brain regions corrected for background. Healthy controls (n = 6) shown as individual grey dots with an error bar ± 2 SD from mean control intensity. Subiculum was not available for Case 1. Subregions are indicated as follows: slm-lacunosum, so- oriens layer, sp- pyramidal layer, sr-radiatum layer, sg-granule cell layer, mo-molecular layer and po-polymorph layer, gr- granular layer and pu-purkinje layer. D Indirect IHC demonstrating CSF IgG reactivity (green) against neuronal structures in mouse thalamic regions with DAPI counterstaining (blue). Arrows indicate CSF autoantibody staining of a subset of cytosolic neuronal-like cells in the mouse thalamic region for all three cases (a-c) but not controls (d). Synaptic features around the cells are seen in case 1 (a) and 3 (c). Sagittal overview demonstrating location of thalamic regions (e).