Brain Atrophy Can Predict the Severity and Prognosis of Anti-N-Methyl-D-Aspartate Receptor Encephalitis.

IF 3.1 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Clinical Neurology Pub Date : 2025-09-01 DOI:10.3988/jcn.2024.0524

Yinyao Lin, Haiyan Li, Yanling Li, Yuge Wang, Yongqiang Dai, Bingjun Zhang

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Abstract

Background and purpose: Compare clinical and lab characteristics of anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis cases with and without brain atrophy.

Methods: Assess cerebral atrophy using median temporal lobe atrophy (MTA) and global cortical atrophy (GCA) scores in 82 anti-NMDAR encephalitis cases.

Results: GCA (+) cases had higher proportions of status epilepticus (p<0.001), memory problems (p=0.031), sepsis (p<0.001), and mechanical ventilation need (p=0.001) than GCA (-) cases. MTA (+) cases had higher memory problems (p<0.001) and sepsis (p=0.002) than MTA (-) cases. GCA (+) and MTA (+) groups had higher max modified Rankin Scale (mRS) (p<0.001, p=0.002) and 1-year mRS (p<0.001, p=0.004) scores than GCA (-) and MTA (-) groups. GCA (+) group had a longer hospital stay and a larger proportion of cases with limited treatment response (both p<0.001) than the GCA (-) group. GCA (p=0.005) was found to be a significant predictive factor for the mRS score 1 year after onset in multiple linear regression analysis.

Conclusions: MTA and GCA may be associated with severity and prognosis in anti-NMDAR encephalitis.

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脑萎缩可预测抗n -甲基- d -天冬氨酸受体脑炎的严重程度和预后。

背景与目的：比较伴有和不伴有脑萎缩的抗n -甲基- d -天冬氨酸受体（anti-NMDAR）脑炎患者的临床和实验室特征。方法：对82例抗nmdar脑炎患者采用颞叶中位萎缩（MTA）和脑皮质整体萎缩（GCA）评分评价脑萎缩程度。结果：GCA（+）组癫痫持续状态发生率（pp=0.031）、脓毒症发生率（pp=0.001）高于GCA（-）组。MTA（+）组记忆问题发生率高于MTA（-）组（pp=0.002）。GCA（+）组和MTA（+）组的最大修正Rankin量表（mRS）评分（pp=0.002）和1年mRS评分（pp=0.004）均高于GCA（-）组和MTA（-）组。多元线性回归分析发现，GCA（+）组住院时间较长，治疗反应有限的病例比例较大（均pp=0.005）是发病后1年mRS评分的重要预测因素。结论：MTA和GCA可能与抗nmdar脑炎的严重程度和预后有关。

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

Journal of Clinical Neurology 医学-临床神经学

CiteScore

4.50

自引率

6.50%

发文量

审稿时长

>12 weeks

期刊介绍： The JCN aims to publish the cutting-edge research from around the world. The JCN covers clinical and translational research for physicians and researchers in the field of neurology. Encompassing the entire neurological diseases, our main focus is on the common disorders including stroke, epilepsy, Parkinson''s disease, dementia, multiple sclerosis, headache, and peripheral neuropathy. Any authors affiliated with an accredited biomedical institution may submit manuscripts of original articles, review articles, and letters to the editor. The JCN will allow clinical neurologists to enrich their knowledge of patient management, education, and clinical or experimental research, and hence their professionalism.