Flortaucipir (tau) PET in LGI1 antibody encephalitis

Abstract

The contributors to persistent cognitive impairment and hippocampal atrophy in leucine‐rich glioma‐inactivated 1 antibody encephalitis (LGI1) patients are unknown. We evaluated whether tau neuropathology measured with [18F]flortaucipir PET neuroimaging associated with persistent cognitive impairment and hippocampal atrophy in four recovering LGI1 patients (3 men; median age, 67 [37–88] years). Imaging findings in cases were compared with those observed in age‐ and gender‐similar cognitively normal individuals (n = 124) and individuals with early‐symptomatic Alzheimer disease (n = 11). Elevated [18F]flortaucipir retention was observed in the two LGI1 patients with hippocampal atrophy and persistent cognitive impairment, including one with autopsy‐confirmed Alzheimer disease. Tau neuropathology may associate with cognitive complaints and hippocampal atrophy in recovering LGI1 patients.

Alzheimer's disease cerebrospinal fluid biomarkers differentiate patients with Creutzfeldt–Jakob disease and autoimmune encephalitis

“…One patient with immunosuppressant‐responsive NIF‐autoantibody‐mediated AE was also given an initial diagnosis of comorbid AD dementia based on clinical symptoms and CSF consistent with AD pathology (low Aβ 42 , elevated p‐tau, t‐tau and abnormal p‐tau/Aβ 42 ratio). This is consistent with previous literature describing AD co‐pathology in older patients with AE [15, 16].…”

Review and meta-analysis of neuropsychological findings in autoimmune limbic encephalitis with autoantibodies against LGI1, CASPR2, and GAD65 and their response to immunotherapy

“…For a summary of the following description see the Supplement. [38][39][40][41][42][43][44][45]) and 5 report a MMSE score in a non-pathological range in a total of 14 patients (see [46][47][48][49], Elben, n.p., 2020).…”

“…Dong et al report cognitive functioning as per the Glasgow Coma Scale (GCS) after initiation of immunotherapy (corticosteroids, intravenous immunoglobulin) with a mean score of 14 for 7 patients, with a range of 7-15, which reflects severely impaired consciousness to a normal, conscious state [59]. Day et al depict raw scores using the Clinical Dementia Rating (CDR) after immunotherapy (corticosteroids, immunoglobulins, rituximab), resulting in a mean score of 0.8 in 4 patients [46], which is above the cut-off score of 0.7 for early symptomatic Alzheimer´s Disease. [57].…”

Autoimmune antibody-induced neuronal hyperactivity triggers pathological Tau in IgLON5 disease

“…LGI1 patients 38 . It should be investigated whether Tau pathology in other immune-related secondary tauopathies, e.g., subacute sclerosing panencephalitis (SSPE 39 ; measles late reaction) and head-nodding syndrome 40 ( involving DJ-1 antibodies), occurs in response to antibody-triggered neuronal hyperactivity as well.…”