Altered cerebral blood flow in patients with anti-NMDAR encephalitis

Miao, Ailiang; Liu, Qianqian; Li, Zonghong; Li, Wen; Wang, Lingling; Ge, Junbo; Yu, Changjun; Wang, Yingxin; Huang, Shuyang; Yu, Yuanwen; Shi, Qi; Sun, Jiao; Wang, Xiaoshan

doi:10.1007/s00415-020-09747-x

Cited by 15 publications

(7 citation statements)

References 43 publications

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“…Second, we found alterations in functional connectivity and network characteristic for regional network organization, especially in the occipital and temporal lobes which were the majority regions with significant reduction and weakening. The results were similar to other studies on metabolic patterns and MRI (Peer et al, 2017;Probasco et al, 2018;Miao et al, 2020;Li et al, 2021) and suggested similarities in the pathological process leading to abnormal functional and structural changes. The disruption of the network related to clinical symptoms can improve the understanding of the neuropathological mechanisms, e.g., the disconnections between the network and the cognitive impairment (Lin et al, 2019).…”

Section: Discussionsupporting

confidence: 91%

Cerebral Metabolic Network in Patients With Anti-N-Methyl-D-Aspartate Receptor Encephalitis on 18F-FDG PET Imaging

et al. 2022

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BackgroundAnti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is the most common autoimmune encephalitis (AE), and the prognosis may significantly be improved if identified earlier and immune-related treated more effectively. This study evaluated the brain metabolic network using fluorodeoxyglucose positron emission tomography (FDG PET).Material and methodsFDG PET imaging of patients with NMDAR encephalitis was used to investigate the metabolic connectivity network, which was analyzed using the graph theory. The results in patients were compared to those in age- and sex-matched healthy controls.ResultsThe hub nodes were mainly in the right frontal lobe in patients with NMDAR encephalitis. The global and local efficiencies in most brain regions were significantly reduced, and the shortest characteristic path length was significantly longer, especially in the temporal and occipital lobes. Significant network functions of topology properties were enhanced in the right frontal, caudate nucleus, and cingulate gyrus. In addition, the internal connection integration in the left cerebral hemisphere was poor, and the transmission efficiency of Internet information was low.ConclusionThe present findings indicate that those characteristic and connections of metabolic network were changed in the brain by graph theory analysis quantitatively, which is helpful to better understand neuropathological and physiological mechanisms in patients with anti-NMDAR encephalitis.

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Section: Discussionsupporting

confidence: 91%

Cerebral Metabolic Network in Patients With Anti-N-Methyl-D-Aspartate Receptor Encephalitis on 18F-FDG PET Imaging

et al. 2022

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“…This study also found that the left precuneus, left SMG, and right SPG had microstructural changes and were associated with mRS scores. A previous study showed decreased cerebellar blood flow in the precuneus in patients with anti-NMDAR encephalitis (Miao et al, 2020), while this study found that KFA decreased in the left precuneus. Thus, we hypothesized that structural damage to nerve fibers and other structures of precuneus led to a decrease in metabolism.…”

Section: Gray Matter Microstructural Changes and Their Relationship W...contrasting

confidence: 64%

Diffusion kurtosis imaging and diffusion tensor imaging parameters applied to white matter and gray matter of patients with anti-N-methyl-D-aspartate receptor encephalitis

et al. 2022

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ObjectivesTo compare parameters of diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI) to evaluate which can better describe the microstructural changes of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis patients and to characterize the non-Gaussian diffusion patterns of the whole brain and their correlation with neuropsychological impairments in these patients.Materials and methodsDTI and DKI parameters were measured in 57 patients with anti-NMDAR encephalitis and 42 healthy controls. Voxel-based analysis was used to evaluate group differences between white matter and gray matter separately. The modified Rankin Scale (mRS) was used to evaluate the severity of the neurofunctional recovery of patients, the Montreal Cognitive Assessment (MoCA) was used to assess global cognitive performance, and the Hamilton Depression Scale (HAMD) and fatigue severity scale (FSS) were used to evaluate depressive and fatigue states.ResultsPatients with anti-NMDAR encephalitis showed significantly decreased radial kurtosis (RK) in the right extranucleus in white matter (P < 0.001) and notably decreased kurtosis fractional anisotropy (KFA) in the right precuneus, the right superior parietal gyrus (SPG), the left precuneus, left middle occipital gyrus, and left superior occipital gyrus in gray matter (P < 0.001). Gray matter regions with decreased KFA overlapped with those with decreased RK in the left middle temporal gyrus, superior temporal gyrus (STG), supramarginal gyrus (SMG), postcentral gyrus (POCG), inferior parietal but supramarginal gyrus, angular gyrus (IPL) and angular gyrus (ANG) (P < 0.001). The KFA and RK in the left ANG, IPL and POCG correlated positively with MoCA scores. KFA and RK in the left ANG, IPL, POCG and SMG correlated negatively with mRS scores. KFA in the left precuneus and right SPG as well as RK in the left STG correlated negatively with mRS scores. No significant correlation between KFA and RK in the abnormal brain regions and HAMD and FSS scores was found.ConclusionThe microstructural changes in gray matter were much more extensive than those in white matter in patients with anti-NMDAR encephalitis. The brain damage reflected by DKI parameters, which have higher sensitivity than parameters of DTI, correlated with cognitive impairment and the severity of the neurofunctional recovery.

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“…Imaging evaluation of autoimmune encephalitis has also been performed with other modalities, such as in cases of anti- N -methyl- d -aspartate (NMDA) receptor antibody encephalitis. ASL and SPECT have been reported to show increased cerebral blood flow [ 6 , 7 ]. In cases of anti-LGI1 encephalitis, ASL and 18 F-FDG-PET have been used to evaluate the state of disease.…”

Section: Discussionmentioning

confidence: 99%

Serial assessment of multimodality imaging in anti-leucine-rich glioma-inactivated 1 antibody encephalitis: A case report

2022

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Altered cerebral blood flow in patients with anti-NMDAR encephalitis

Cited by 15 publications

References 43 publications

Cerebral Metabolic Network in Patients With Anti-N-Methyl-D-Aspartate Receptor Encephalitis on 18F-FDG PET Imaging

Cerebral Metabolic Network in Patients With Anti-N-Methyl-D-Aspartate Receptor Encephalitis on 18F-FDG PET Imaging

Diffusion kurtosis imaging and diffusion tensor imaging parameters applied to white matter and gray matter of patients with anti-N-methyl-D-aspartate receptor encephalitis

Serial assessment of multimodality imaging in anti-leucine-rich glioma-inactivated 1 antibody encephalitis: A case report

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