Clinical, Electroencephalogram and Imaging Characteristics of Patients With Anti-LGI1 Antibody Encephalitis: A Multicenter Cohort Study

IF 5 1区医学 Q1 NEUROSCIENCES

CNS Neuroscience & Therapeutics Pub Date : 2025-05-05 DOI:10.1111/cns.70414

Yang Zhao, Yue Yuan, Rong-Ze Wang, Mei Cui, Shu-Fen Chen, Ke-Liang Chen, Meng-Meng Li, Yu-Yuan Huang, Hai-Ning Zhang, Yan Zhang, Meng Zhao, Hui Tian, Li Sun, Jin-Tai Yu

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Abstract

Objectives

To summarize the clinical, electroencephalogram (EEG), and imaging characteristics of patients with anti-leucine-rich glioma-inactivated 1 autoimmune encephalitis (LGI1-AE) and provide a reference for clinical diagnosis and treatment.

Methods

We retrospectively analyzed 88 patients diagnosed with LGI1-AE between January 2018 and April 2024 in the Department of Neurology, Huashan Hospital, Fudan University, and the First Hospital of Jilin University.

Results

This retrospective study analyzed 88 patients diagnosed with LGI1-AE. The initial clinical presentation predominantly featured rapidly progressive cognitive impairment (RPCI) (51.1%) and seizures (50%). Brain magnetic resonance imaging and 18 F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) indicated predominant lesion localization in the unilateral or bilateral temporal lobe and/or basal ganglia. Abnormal EEG was observed in 66 cases (79.5%). LGI1-AE cases had increased power in the low-frequency bands (δ and θ) compared to normal controls. Low-frequency band (δ and θ) power in T3 and Fz channels was positively correlated with LGI1 antibody titers in cerebrospinal fluid (CSF). Spearman correlation analysis showed that baseline modified Rankin Scale (mRS) scores were correlated with serum antibody titers and CSF antibody titers.

Conclusions

Baseline mRS scores and low-frequency power in the frontotemporal region showed a positive correlation with anti-LGI1 antibody titers, suggesting that antibody levels may reflect disease severity in LGI1 autoimmune encephalitis. Further studies are warranted to validate these associations in prospective multicenter cohorts.

Abstract Image

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抗lgi1抗体脑炎患者的临床、脑电图和影像学特征：一项多中心队列研究

目的总结抗-富亮氨酸胶质瘤失活1型自身免疫性脑炎（LGI1-AE）患者的临床、脑电图（EEG）及影像学特征，为临床诊断和治疗提供参考。方法回顾性分析2018年1月至2024年4月复旦大学华山医院神经内科和吉林大学第一医院诊断为LGI1-AE的88例患者。结果回顾性分析88例LGI1-AE患者。最初的临床表现主要表现为快速进行性认知障碍（RPCI）（51.1%）和癫痫发作（50%）。脑磁共振成像和18f -氟脱氧葡萄糖正电子发射断层扫描（18F-FDG PET）显示主要病变定位于单侧或双侧颞叶和/或基底神经节。脑电图异常66例（79.5%）。与正常对照相比，LGI1-AE病例在低频波段（δ和θ）功率增加。T3和Fz通道低频波段（δ和θ）功率与脑脊液LGI1抗体滴度呈正相关。Spearman相关分析显示，基线修正兰金量表（mRS）评分与血清抗体滴度和脑脊液抗体滴度相关。结论基线mRS评分和额颞区低频功率与抗LGI1抗体滴度呈正相关，提示抗体水平可能反映LGI1自身免疫性脑炎的疾病严重程度。需要进一步的研究在前瞻性多中心队列中验证这些关联。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

CNS Neuroscience & Therapeutics 医学-神经科学

CiteScore

7.30

自引率

12.70%

发文量

240

审稿时长

2 months

期刊介绍： CNS Neuroscience & Therapeutics provides a medium for rapid publication of original clinical, experimental, and translational research papers, timely reviews and reports of novel findings of therapeutic relevance to the central nervous system, as well as papers related to clinical pharmacology, drug development and novel methodologies for drug evaluation. The journal focuses on neurological and psychiatric diseases such as stroke, Parkinson’s disease, Alzheimer’s disease, depression, schizophrenia, epilepsy, and drug abuse.