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Aim of Review The presence of isolated, reversible lesions in the splenium of the corpus callosum (SCC) is essential to confirm the diagnosis of mild encephalitis/encephalopathy. The lesions usually heal within a month after the onset of neurological symptoms. Magnetic resonance imaging (MRI) has increasingly been used as a diagnostic tool, which has led to the publication of an increasing number of case reports. These have highlighted some inconsistencies about encephalitis/encephalopathy. First, the condition is not always mild and may be severe. Second, reversible lesions in the SCC have been identified in various diseases and conditions other than viral encephalitis/encephalopathy. Third, lesions in SCC are not always completely reversible. On this note, this review describes the specific clinical and radiological features of encephalitis/encephalopathy. Findings The reversible lesion in SCC is an MRI finding observable in a wide variety of diseases and conditions. Thus, it should be considered as a secondary change rather than a peculiar feature associated with mild encephalitis/encephalopathy. If reversible lesions are present in the SCC, the symptoms and prognosis are not necessarily favorable, with manifestations of encephalitis/encephalopathy varying from absent to severe. Neuroradiological features that appear as isolated high‐intensity signals on diffusion‐weighted images and a decreased apparent diffusion coefficient of the lesion might indicate a diagnosis of cytotoxic edema. Findings of previous studies suggest that cytokine‐mediated cytotoxic edema of the SCC may be an important pathophysiological manifestation of this condition. Conclusion The reversible lesions in the SCC found on MRI are not exclusive to encephalitis/encephalopathy but may be secondary to other disorders.

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Aim: Identification of sensitive surrogate markers that indicate disease progression in amyotrophic lateral sclerosis might be useful in clinical trials and clinical care. Determination of the creatinine/cystatin C (Cr/CysC) ratio eliminates the effect of renal function on serum creatinine levels; therefore, we considered that the ratio might serve as a surrogate marker of residual muscle mass. We studied the Cr/ CysC ratio as a useful surrogate marker of residual muscle mass in patients with amyotrophic lateral sclerosis. Methods: A total of 103 participants were recruited: 62 patients with amyotrophic lateral sclerosis and 41 healthy controls. Serum levels of Cr and CysC were measured in both groups. We subsequently investigated the correlation between the Cr/CysC ratio and disease severity in patients with amyotrophic lateral sclerosis. Results:The ratio was significantly lower in the amyotrophic lateral sclerosis group than in the control group. Furthermore, the ratio decreased as the severity of amyotrophic lateral sclerosis increased. The Cr/CysC ratio might be a better and more reliable method than the serum Cr level as a means of monitoring residual muscle mass of the entire body in patients with amyotrophic lateral sclerosis. Conclusion:The present results show that the Cr/CysC ratio might be a suitable candidate for a useful and quantitative surrogate marker for the assessment of disease severity and progression in patients with amyotrophic lateral sclerosis.

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BackgroundIncreasing numbers of patients with elevated anti-N-methyl-D-aspartate (NMDA) receptor antibody titers presenting exclusively with psychiatric symptoms have been reported. The aim of the present study was to clarify the prevalence of elevated serum anti-NMDA receptor antibody titers in patients with new-onset or acute exacerbations of psychiatric symptoms. In addition, the present study aimed to investigate the association between elevated anti-NMDA receptor titers and psychiatric symptoms.MethodsThe present collaborative study included 59 inpatients (23 male, 36 female) presenting with new-onset or exacerbations of schizophrenia-like symptoms at involved institutions from June 2012 to March 2014. Patient information was collected using questionnaires. Anti-NMDA receptor antibody titers were measured using NMDAR NR1 and NR2B co-transfected human embryonic kidney (HEK) 293 cells as an antigen (cell-based assay). Statistical analyses were performed for each questionnaire item.ResultsThe mean age of participants was 42.0 ± 13.7 years. Six cases had elevated serum anti-NMDA antibody titers (10.2 %), four cases were first onset, and two cases with disease duration >10 years presented with third and fifth recurrences. No statistically significant difference in vital signs or major symptoms was observed between antibody-positive and antibody-negative groups. However, a trend toward an increased frequency of schizophrenia-like symptoms was observed in the antibody-positive group.ConclusionSerum anti-NMDA receptor antibody titers may be associated with psychiatric conditions. However, an association with specific psychiatric symptoms was not observed in the present study. Further studies are required to validate the utility of serum anti-NMDA receptor antibody titer measurements at the time of symptom onset.

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