This exploratory study provides preliminary evidence of distinct clinical and molecular signatures in autoantibody-positive neurodegeneration. ARRB1 and CAPN2 may contribute to cognitive resilience in this group, while UGGT1 appears associated with cognitive decline in autoantibody-negative cases. Owing to the limited sample size, these findings should be considered hypothesis-generating and warrant validation in larger, independent cohorts before consideration as biomarkers or therapeutic targets.