Possible explanations included the involvement of cerebellar dysfunction in the high-titer group since cerebellar ataxia was one of the most common anti-GAD antibody-related neurological disorders in adults and often present with subacute or chronic onset of gait ataxia and dysarthria with normal or mild cerebellar atrophy on behalf of the CHEESE Study Group neuroimaging (Honnorat et al., 2001). This evidence concerns the gene GAD1 and aceruloplasminemia.