诊断和治疗n -甲基- d -天冬氨酸受体抗体介导（NMDAR）脑炎患者与精神分裂症患者和健康对照的认知结局和表现

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

Psychiatry Research: Neuroimaging Pub Date : 2025-03-17 DOI:10.1016/j.pscychresns.2025.111983

Eric Kelleher , David Mothersill , April Hargreaves , Helen Barry , Shane Smyth , Elijah Chaila , Peter Boers , Dominick JH. McCabe , Brian Sweeney , Daniel Costello , Kieran C. Murphy , David Cotter , Colin P. Doherty , Gary Donohoe , Aiden Corvin

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引用次数: 0

摘要

认知功能障碍可能是n -甲基- d -天冬氨酸受体脑炎（NMDAR脑炎）的后遗症，工作记忆通常受到影响。本研究使用神经认知测试组和工作记忆范式检查了NMDAR脑炎治疗患者的认知结果，并与健康对照组进行了比较。精神分裂症患者。方法采用剑桥自动神经心理测试（CANTAB）对曾接受过NMDAR脑炎治疗的成年患者的工作记忆进行评估；情景记忆。患者在功能性磁共振成像（fMRI）扫描期间完成N-back任务。结果与先前研究中的精神分裂症患者和健康对照进行了比较。结果共纳入12例患者[女性11例；平均（SD）年龄37（12）岁；免疫治疗前的平均（SD）持续时间为7.09（2.43）周。数据比较了14例精神分裂症患者[10名女性；平均（SD）年龄39（12岁）和14名健康对照[7名女性；平均（SD）年龄30(6)岁。在字母数字排序、空间工作记忆、逻辑记忆I、1-back和2-back表现上观察到显著差异(Cohen’s d = 0.766至1.254,p<；0.05)，精神分裂症患者表现较差。虽然NMDAR脑炎患者的表现略低于健康对照组，但这些差异均无统计学意义。在单背或双背表演时，神经激活没有显著差异。结论：研究结果表明，NMDAR脑炎患者的认知能力随着时间的推移趋于正常。及时使用免疫疗法治疗与改善认知预后相关。精神科应了解自身免疫性脑炎的临床特点。

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Cognitive outcomes and performance of patients diagnosed and treated for N-Methyl-D-Aspartate receptor antibody-mediated (NMDAR) encephalitis compared with patients with schizophrenia and healthy controls

Background

Cognitive dysfunction may be a sequelae of N-Methyl-D-Aspartate receptor encephalitis (NMDAR encephalitis) with working memory commonly affected. This study examined cognitive outcomes in patients treated for NMDAR encephalitis using a neurocognitive test battery and a working memory paradigm, compared with healthy controls & patients with schizophrenia.

Methods

Adult patients previously treated for NMDAR encephalitis were assessed using the Cambridge Automated Neuropsychological Test Battery (CANTAB) for working memory & episodic memory. Patients completed the N-back task during functional MRI (fMRI) scanning. Results were compared to patients with schizophrenia and healthy controls from a prior study.

Results

Twelve patients were recruited [11 women; mean (SD) age 37(12) years; Mean (SD) duration until immunotherapy treatment 7.09 (2.43) weeks]. Data were compared to 14 patients with schizophrenia [10 women; mean (SD) age 39 (12) years] and 14 healthy controls [7 women; mean (SD) age 30 (6) years]. Significant differences in letter number sequencing, spatial working memory, logical memory I, 1-back, and 2-back performance were observed (Cohen's d = 0.766 to 1.254, p< 0.05), driven by poorer performance by patients with schizophrenia. While patients with NMDAR encephalitis exhibited slightly lower performance compared with healthy controls, none of these differences were statistically significant. No significant differences in neural activation during 1-back or 2-back performance were observed.

Conclusions

Study findings suggest cognitive performance in patients treated for NMDAR encephalitis approaches normal over time. Prompt treatment with immunotherapy is associated with improved cognitive outcomes. Psychiatric services should be aware of the clinical features of autoimmune encephalitis.

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来源期刊

Psychiatry Research: Neuroimaging 医学-精神病学

CiteScore

3.80

自引率

0.00%

发文量

审稿时长

22.5 weeks

期刊介绍： The Neuroimaging section of Psychiatry Research publishes manuscripts on positron emission tomography, magnetic resonance imaging, computerized electroencephalographic topography, regional cerebral blood flow, computed tomography, magnetoencephalography, autoradiography, post-mortem regional analyses, and other imaging techniques. Reports concerning results in psychiatric disorders, dementias, and the effects of behaviorial tasks and pharmacological treatments are featured. We also invite manuscripts on the methods of obtaining images and computer processing of the images themselves. Selected case reports are also published.