Book Review: I-Cubed and The Autoimmune Brain, A Five-Step Plan

The Autoimmune Brain1 explains I-Cubed, a shorthand for post-infectious autoimmunity that results from the multiplier effect of infection, immunity and inflammation, when protective immunity becomes the source of autoimmunity, conditioned by applicable environmental and genetic predisposing factors. In keeping with the post-infectious autoimmune nature of I-Cubed, neurologic and psychiatric symptoms evolve beyond a standard of care course of antibiotic therapy. Extensive serologic, electrophysiological and neuroradiographic diagnostic testing provides clues to areas of central, peripheral and autonomic nervous system, and systemic involvement that guide therapy. A multimodality therapeutic approach employing immune modulatory (Ig) therapy that addresses the underlying mechanisms and not just the symptoms of Cubed disorders is most effective. Representative cases of post-infectious autoimmunity associated with Lyme disease and PANDAS are presented.