Research Focus Overview
The Autoimmune Neurology Research Team
The Autoimmune Neurology Research Team studies autoimmune and inflammatory neurological disorders, including autoimmune encephalitis, paraneoplastic encephalitis, MOG-IgG associated disorder (MOGAD) and neuromyelitis optica spectrum disorder (NMOSD), neurosarcoidosis and immune-checkpoint-inhibitor-related neuroinflammatory disorders.
Our overall goal is to improve our care and the lives of our patients by examining the clinical and biological features of these disorders. This helps us better understand the underlying disease, natural history and factors that can modify the outcomes for our patients.
We have built a longitudinal clinical registry and biorepository of blood and CSF from people with autoimmune neurological disorders. Additionally, we have prospectively collected longitudinal advanced neuroimaging and cognitive measures, which enables us to examine biomarkers and clinical outcomes of autoimmune neurological disorders.
We are also conducting several clinical trials of experimental therapeutics in autoimmune neurological disorders (autoimmune encephalitis and MOGAD). This enables our patients to access the latest potential therapeutic options, participate in large multi-center studies and contribute to greater scientific understanding of these diseases.
Contact Information
Amy Kunchok, MD
kunchoa@ccf.org
Funding Sources
- Cleveland Clinic Neurological Institute Clinician Scientist Career Development Award 2025-2027: Advanced neuroimaging and association with clinical outcomes in autoimmune encephalitis.
- Cleveland Clinic Imaging Institute pilot study grant: 7T MRI in MOGAD
- Cleveland Clinic Lerner Research Institute, Research Program Committee (RPC): Biomarkers of disease activity and clinical outcomes in autoimmune encephalitis.
- Foundation of the Consortium of Multiple Sclerosis Centers: Characterizing Clinical, Cognitive, and Radiological Outcomes in Patients with MOG Antibody Disorder and Multiple Sclerosis.
- Society for Clinical Neuropsychology: Investigating long-term cognitive and functional outcomes of patients with anti-LGI-1 encephalitis.
Publications
Afzal S, Li Y, Lapin B, Hua LH, Kennedy LB, Ma WW, McGinley M, Cohen JA, Kunchok A. Inflammatory disease in people with multiple sclerosis treated with immune checkpoint inhibitors. Ann Clin Transl Neurol. 2024 Dec 31.
Review of the Longitudinal Management of Autoimmune Encephalitis, Potential Biomarkers, and Novel Therapeutics.
Mahadeen AZ, Carlson AK, Cohen JA, Galioto R, Abbatemarco JR, Kunchok A.Neurol Clin Pract. 2024 Aug;14(4):e200306. doi: 10.1212/CPJ.0000000000200306. Epub 2024 May 29.PMID: 38831758 Free PMC article. Review.
Predicting disability and mortality in CV2/CRMP5-IgG associated paraneoplastic neurologic disorders.
Uysal SP, Li Y, Thompson NR, Milinovich A, Abbatemarco JR, Cohen JA, Conway DS, Ontaneda D, Morren JA, Kunchok A.Ann Clin Transl Neurol. 2024 Mar;11(3):710-718. doi: 10.1002/acn3.51991. Epub 2024 Jan 22.PMID: 38251800
Longitudinal Disability, Cognitive Impairment, and Mood Symptoms in Patients With Anti-NMDA Receptor Encephalitis.
Morgan A, Li Y, Thompson NR, Milinovich A, Abbatemarco JR, Cohen JA, Ontaneda D, Punia V, Rae-Grant A, Galioto R, Kunchok A.Neurology. 2024 Feb 27;102(4):e208019. doi: 10.1212/WNL.0000000000208019. Epub 2024 Jan 24.PMID: 38266213
Mustafa R, Flanagan EP, Duffy DJ, Weinshenker BG, Soldán MMP, Kunchok A, Kaisey M, Solomon AJ. Laboratory evaluation for the differential diagnosis of possible multiple sclerosis in the United States: A physician survey. J Neurol Sci. 2023 Oct 15;453:120781. doi: 10.1016/j.jns.2023.120781.
Kim HJ, Aktas O, Patterson KR, Korff S, Kunchok A, Bennett JL, Weinshenker BG, Paul F, Hartung HP, Cimbora D, Smith MA, Mittereder N, Rees WA, She D, Cree BAC. Inebilizumab reduces neuromyelitis optica spectrum disorder risk independent of FCGR3A polymorphism. Ann Clin Transl Neurol. 2023 Dec;10(12):2413-2420. doi: 10.1002/acn3.51911.
Galioto R, Grezmak T, Swetlik C, Abbatemarco JR, Titulaer MJ, Finke C, Kunchok A. Neuropsychological Testing in Autoimmune Encephalitis: A Scoping Review. Neurol Neuroimmunol Neuroinflamm. 2023 Nov 10;11(1):e200179.
Aboseif A, Li Y, Amin M, Lapin B, Milinovich A, Abbatemarco JR, Cohen JA, Punia V, Rae-Grant AD, Galioto R, Kunchok A. Clinical Determinants of Longitudinal Disability in LGI-1-IgG Autoimmune Encephalitis. Neurol Neuroimmunol Neuroinflamm. 2023 Nov 10;11(1):e200178.
Yan C, Huang M, Swetlik C, Toljan K, Mahadeen AZ, Bena J, Kunchok A, Funchain P, McGinley M. Predictors for the Development of Neurological Immune-related Adverse Events of Immune Checkpoint Inhibitors and Impact on Mortality. Eur J Neurol. 2023 Jun 23. doi: 10.1111/ene.15942.
Majed M, Sanchez CV, Bennett JL, Fryer J, Mulligan MD, Redenbaugh V, McKeon A, Mills JR, Wingerchuk DM, Lennon VA, Weinshenker B, Chen JJ, Flanagan EP, Pittock SJ, Kunchok A. Alterations in aquaporin-4-IgG serostatus in 986 patients: a laboratory-based longitudinal analysis. Ann Neurol. 2023 Jun 14. doi: 10.1002/ana.26722.
Kunchok AC, Dalmau JO. Can NfL Be Utilized as a Biomarker of Disease Severity, Activity, and Outcomes in Anti-NMDAR Encephalitis? Neurology. 2023 Apr 4:10.1212/WNL.0000000000207310.
Toljan K, Mahadeen A, Amin M, Rensel M, Jones SE, Ontaneda D, Kunchok AC. Pearls & Oy-sters: Hemorrhagic Myelitis Following SARS-CoV-2 Infection. Neurology. 2023 Mar 29:10.1212/WNL.0000000000207213.
Chen JJ, Flanagan EP, Pittock SJ, Stern NC, Tisavipat N, Bhatti MT, Chodnicki KD, Tajfirouz DA, Jamali S, Kunchok A, Eggenberger ER, Nome MAD, Sotirchos ES, Vasileiou ES, Henderson AD, Arnold AC, Bonelli L, Moss HE, Navarro SEV, Padungkiatsagul T, Stiebel-Kalish H, Lotan I, Wilf-Yarkoni A, Danesh-Meyer H, Ivanov S, Huda S, Forcadela M, Hodge D, Poullin P, Rode J, Papeix C, Saheb S, Boudot de la Motte M, Vignal C, Hacohen Y, Pique J, Maillart E, Deschamps R, Audoin B, Marignier R. Visual Outcomes Following Plasma Exchange for Optic Neuritis: An International Multicenter Retrospective Analysis of 395 Optic Neuritis Attacks. Am J Ophthalmol. 2023 Feb 21:S0002-9394(23)00066-1. doi: 10.1016/j.ajo.2023.02.013.
Toljan K, Amin M, Kunchok A, Ontaneda D. New diagnosis of multiple sclerosis in the setting of mRNA COVID-19 vaccine exposure. J Neuroimmunol. 2022 Jan 15;362:577785.
Kunchok A, Lennon, V, Klein, C, Flanagan E, Dubey D, Zekeridou A, Mills, John R, McKeon A, Pittock S. Autoimmune encephalitis antibody biomarkers: Frequency, age and sex associations. Mayo Clinic Proceedings. 2022 Mar;97(3):547-559
Lambe J, McGinley M, Moss B, Mao-Draayer Y, Kassa R, Ciotti J, Mariotto S, Kunchok A. Myelin oligodendrocyte glycoprotein-IgG associated disorders (MOGAD) following SARS-CoV-2 infection: a case series. Journal of Neuroimmunology. 2022 [in press]
Galioto R, Aboseif A, Krishnan K, Lace J, Kunchok A. Cognitive outcomes in anti-LGI-1 encephalitis. J Int Neuropsychol Soc. 2022 Sep 5:1-10.
Kunchok AC, Ontaneda D, Lee J, Rae-Grant A, Foldvary-Schaefer N, Cohen JA, Jones SE. Magnetic Resonance Imaging Features of Anti-Ma1/Ma2 Paraneoplastic Neurologic Syndrome. Neurology. 2022 Sep 7:10.1212
Valencia-Sanchez C, Guo Y, Krecke KN, Chen JJ, Redenbaugh V, Montalvo M, Elsbernd PM, Tillema JM, Lopez-Chiriboga S, Budhram A, Sechi E, Kunchok A, Dubey D, Pittock SJ, Lucchinetti CF, Flanagan EP. Cerebral cortical encephalitis in MOGAD. Ann Neurol. 2022 Nov 13.
Sechi E, Krecke KN, Messina SA, Buciuc M, Pittock SJ, Chen JJ, Weinshenker BG, Lopez-Chiriboga AS, Lucchinetti CF, Zalewski NL, Tillema JM, Kunchok A, Monaco S, Morris PP, Fryer JP, Nguyen A, Greenwood T, Syc-Mazurek SB, Keegan BM, Flanagan EP. Comparison of MRI Lesion Evolution in Different Central Nervous System Demyelinating Disorders. Neurology. 2021 Jul 14:10.1212/WNL.0000000000012467. doi: 10.1212/WNL.0000000000012467. Epub ahead of print. PMID: 34261784.
Budhram A, Kunchok AC, Flanagan EP. Unilateral Leptomeningeal Enhancement in Myelin Oligodendrocyte Glycoprotein Immunoglobulin G-Associated Disease. JAMA Neurol. 2020 May 1;77(5):648-649. doi: 10.1001/jamaneurol.2020.0001. PMID: 32119057.
Kunchok A, Aksamit AJ Jr, Davis JM 3rd, Kantarci OH, Keegan BM, Pittock SJ, Weinshenker BG, McKeon A. Association Between Tumor Necrosis Factor Inhibitor Exposure and Inflammatory Central Nervous System Events. JAMA Neurol. 2020 Aug 1;77(8):937-946. doi: 10.1001/jamaneurol.2020.1162. PMID: 32421186; PMCID: PMC7235930.
Chen JJ, Flanagan EP, Bhatti MT, Jitprapaikulsan J, Dubey D, Lopez Chiriboga ASS, Fryer JP, Weinshenker BG, McKeon A, Tillema JM, Lennon VA, Lucchinetti CF, Kunchok A, McClelland CM, Lee MS, Bennett JL, Pelak VS, Van Stavern G, Adesina OO, Eggenberger ER, Acierno MD, Wingerchuk DM, Lam BL, Moss H, Beres S, Gilbert AL, Shah V, Armstrong G, Heidary G, Cestari DM, Stiebel-Kalish H, Pittock SJ. Steroid-sparing maintenance immunotherapy for MOG-IgG associated disorder. Neurology. 2020 Jul 14;95(2):e111-e120. doi: 10.1212/WNL.0000000000009758. Epub 2020 Jun 17. PMID: 32554760; PMCID: PMC7455322.
Kunchok A, Flanagan EP, Snyder M, Saadeh R, Chen JJ, Weinshenker BG, McKeon A, Pittock SJ. Coexisting systemic and organ-specific autoimmunity in MOG- IgG1-associated disorders versus AQP4-IgG+ NMOSD. Mult Scler. 2021 Apr;27(4):630-635. doi: 10.1177/1352458520933884. Epub 2020 Jul 7. PMID: 32633603.
Kunchok A, Lechner-Scott J, Granella F, Trojano M, Alroughani R, Sola P, Ferraro D, Lugaresi A, Onofrj M, Ozakbas S, Izquierdo G, Grammond P, Luis Sanchez-Menoyo J, Van Wijmeersch B, Boz C, Pucci E, McCombe P, Grand'Maison F, Spitaleri D, Vucic S, Hupperts R, Jokubaitis V, Sormani MP, Butzkueven H, Kalincik T; MSBase Study Group. Prediction of on-treatment disability worsening in RRMS with the MAGNIMS score. Mult Scler. 2021 Apr;27(5):695-705. doi:10.1177/1352458520936823. Epub 2020 Jul 8. PMID: 32639855.
Hassan MB, Stern C, Flanagan EP, Pittock SJ, Kunchok A, Foster RC, Jitprapaikulsan J, Hodge DO, Bhatti MT, Chen JJ. Population-Based Incidence of Optic Neuritis in the Era of Aquaporin-4 and Myelin Oligodendrocyte Glycoprotein Antibodies. Am J Ophthalmol. 2020 Dec;220:110-114. doi: 10.1016/j.ajo.2020.07.014. Epub 2020 Jul 21. PMID: 32707199.
Kunchok A, Chen JJ, Saadeh RS, Wingerchuk DM, Weinshenker BG, Flanagan EP, Pittock SJ. Application of 2015 Seronegative Neuromyelitis Optica Spectrum Disorder Diagnostic Criteria for Patients With Myelin Oligodendrocyte Glycoprotein IgG-Associated Disorders. JAMA Neurol. 2020 Dec 1;77(12):1572-1575. doi: 10.1001/jamaneurol.2020.2743. PMID: 32777005; PMCID: PMC7418041.
Kunchok A, Flanagan EP, Krecke KN, Chen JJ, Caceres JA, Dominick J, Ferguson I, Kinkel R, Probasco JC, Ruvalcaba M, Santoro JD, Sieloff K, Timothy J, Weinshenker BG, McKeon A, Pittock SJ. MOG-IgG1 and co-existence of neuronal autoantibodies. Mult Scler. 2021 Jul;27(8):1175-1186. doi: 10.1177/1352458520951046. Epub 2020 Sep 10. PMID: 32907470.
Kunchok A, McKeon A. Opsoclonus in Anti-Ma2 Brain-Stem Encephalitis. N Engl J Med. 2020 Sep 24;383(13):e84. doi: 10.1056/NEJMicm1914516. PMID: 32966725.
Singh TD, Hajeb M, Rabinstein AA, Kunchok AC, Pittock SJ, Krecke KN, Bartleson JD, Black DF. SMART syndrome: retrospective review of a rare delayed complication of radiation. Eur J Neurol. 2021 Apr;28(4):1316-1323. doi:10.1111/ene.14632. Epub 2020 Dec 3. PMID: 33159349.
Pittock SJ, Alfugham N, O'Connor K, Hinson S, Kunchok A, Lennon VA, Komorowski L, Probst C, McKeon A. GTPase Regulator Associated with Focal Adhesion Kinase 1 (GRAF1) Immunoglobulin-Associated Ataxia and Neuropathy. Mov Disord Clin Pract. 2020 Sep 14;7(8):904-909. doi: 10.1002/mdc3.13036. PMID:33163561; PMCID: PMC7604666.
Banks SA, Morris PP, Chen JJ, Pittock SJ, Sechi E, Kunchok A, Tillema JM, Fryer JP, Weinshenker BG, Krecke KN, Lopez-Chiriboga AS, Nguyen A, Greenwood TM, Lucchinetti CF, Zalewski NL, Messina SA, Flanagan EP. Brainstem and cerebellar involvement in MOG-IgG-associated disorder versus aquaporin-4-IgG and MS. J Neurol Neurosurg Psychiatry. 2020 Dec 28:jnnp-2020-325121. doi:10.1136/jnnp-2020-325121. Epub ahead of print. PMID: 33372052.
Kunchok A, Zekeridou A, McKeon A. Autoimmune glial fibrillary acidic protein astrocytopathy. Curr Opin Neurol. 2019 Jun;32(3):452-458. doi:10.1097/WCO.0000000000000676. PMID: 30724768; PMCID: PMC6522205.
Waters PJ, Komorowski L, Woodhall M, Lederer S, Majed M, Fryer J, Mills J, Flanagan EP, Irani SR, Kunchok AC, McKeon A, Pittock SJ. A multicenter comparison of MOG-IgG cell-based assays. Neurology. 2019 Mar 12;92(11):e1250-e1255. doi: 10.1212/WNL.0000000000007096. Epub 2019 Feb 6. PMID: 30728305; PMCID: PMC6511109.
Members & Collaborations
- Tatchaporn Ongphichetmetha, MD (Masters Candidate, Case Western Reserve University, Neuroimmunology research fellow)
- Jonathan Lee, MD (Diagnostic Radiology, Cleveland Clinic).
- Rachel Galioto, PhD (Neuropsychology, Cleveland Clinic).
- Justin Abbatemarco, MD (MS and Autoimmune Neurology, Cleveland Clinic).
- Kunio Nakamura, PhD (Biomedical engineering, Cleveland Clinic).
- Stephen Jones, MD, PhD (Diagnostic Radiology, Cleveland Clinic).
- Alex Milinovich (Data analytics, Cleveland Clinic).
- Brandon Moss, MD (MS and Autoimmune Neurology, Cleveland Clinic).
- Alise Carlson, MD (MS and Autoimmune Neurology, Cleveland Clinic).
