Neuropsychological outcomes in children and adolescents following anti-NMDA receptor encephalitis

Wilkinson-Smith, Alison; Blackwell, Laura S.; Howarth, Robyn

doi:10.1080/09297049.2021.1965110

Cited by 9 publications

(9 citation statements)

References 23 publications

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“…29 Attention/Working Memory Simple auditory attention span (short-term memory)/ working memory was most often assessed using a digit span task, of which 3/5 demonstrated worse forward, 5/5 showed worse backward, and 1/1 showed worse total scores in patients relative to controls, [24][25][26]28,[32][33][34] while impairment rates varied from 0-38.5%. 14,15,30,31 Paced Auditory Serial Addition Test (PASAT) performance was worse among patients relative to controls in 1 study. 27 Visual attention/working memory was most often assessed using a block tapping (or similar) test, with variable results (1/ 3 worse compared with controls or normative data, 0%-29% impairment).…”

Section: Anti-nmda-r Ae Verbal Memorymentioning

confidence: 76%

“…List learning tasks were the most used verbal memory measures, with worse performance in patients compared with controls and/or normative data or ≥25% normative impairment in 7/10 for immediate and delayed recall each and 2/2 for recognition. 15,[23][24][25][26][27][28][29][30][31] Story and verbal pair recall tasks were used in 2 and 1 study each, all of which showed worse performance than controls or normative data in immediate and delayed recall. 31,32 Visual Memory…”

Section: Anti-nmda-r Ae Verbal Memorymentioning

confidence: 99%

“…Semantic fluency was the most used language measure, with patients performing worse than controls or normative data in half the studies (0%-25% impairment). 14,15,25,28,[30][31][32][33]35 Phonemic fluency was also commonly examined, with worse performance compared with normative data or controls was observed in 2/3 studies (0%-38% impairment). 2,14,15,[29][30][31][32]35 Naming was assessed in 5 studies, with worse performance compared with controls or normative data in only 1 of 3 (14%-25% impairment).…”

Section: Languagementioning

confidence: 99%

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Neuropsychological Testing in Autoimmune Encephalitis: A Scoping Review

2024

Neurol Neuroimmunol Neuroinflamm

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Background and ObjectivesIdentifying optimal methods for evaluation and monitoring of cognitive outcomes in AE is important for clinical care and research. This scoping review aimed to evaluate neuropsychological tests (NPT) that are most frequently impaired in AE cohorts to provide recommendations for a standardized NPT battery for AE outcome. MethodsPubMed search for studies examining NPT in patients with AE was conducted on June 9, 2023. Studies were screened for inclusion/exclusion criteria as follows: at least 1 NPT, individual NPT test scores with comparison with healthy controls or normative data and neural-IgG status, total sample size ≥5, and English manuscript available. ResultsThe search yielded 5,393 studies, of which 3,359 were screened, 107 were full text reviewed, and 32 met inclusion/exclusion criteria, anti-NMDA-R (k = 18), anti-LGI1 (k = 10), anti-GABA B -R (k = 2), anti-GAD-65 (k = 4), and anti-CASPR2 (k = 3). The cognitive domains most frequently impaired were visual and verbal episodic memory, attention/working memory, processing speed, and aspects of executive functions. DiscussionGiven the dearth of literature examining NPT in AE in combination with small sample sizes and methodological differences, more research in this area is needed. However, we provide recommendations for a test battery to be used in future studies, with the aim of standardizing research in this area. Based on the available literature, we recommend the use of comprehensive NPT batteries, spanning all cognitive domains. The highest yield measures may include the tests of (1) visual and verbal learning/memory, (2) basic and sustained attention, (3) processing speed, and (4) executive functions.

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Section: Anti-nmda-r Ae Verbal Memorymentioning

confidence: 76%

Section: Anti-nmda-r Ae Verbal Memorymentioning

confidence: 99%

Section: Languagementioning

confidence: 99%

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Neuropsychological Testing in Autoimmune Encephalitis: A Scoping Review

2024

Neurol Neuroimmunol Neuroinflamm

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“…In spite of these findings, data on memory performance in pediatric age are poor. However, memory deficits have been found in children with anti-NMDAR encephalitis even after some years from symptoms onset [ 22 , 31 , 33 , 40 , 54 ]. Moura et al presented the case of a 15 years-old girl diagnosed with anti-NMDAR encephalitis who, despite improvement in both the neurological and psychiatric symptoms, still experienced difficulties in verbal memory, concentration and attention almost three years after the onset of the disease [ 22 ].…”

Section: Resultsmentioning

confidence: 99%

“…There is evidence that, in adult patients, an inappropriate treatment path could significantly influence the caregiver’s burden [ 57 ]. In a recent study, concerns on at least one measure of neuropsychological (executive functioning), adaptive and emotional behavior were reported in almost 90% of caregivers [ 54 ].…”

Section: Resultsmentioning

confidence: 99%

Neuropsychological Sequelae, Quality of Life and Adaptive Behavior in Children and Adolescents with Anti-NMDAR Encephalitis: A Narrative Review

et al. 2021

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Anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis is a rare autoimmune illness characterized by a constellation of often severe, but treatable, psychiatric and neurological symptoms. Whereas symptoms such as psychosis and bizarre and abnormal motor behavior are common in adults, pediatric patients typically present with behavioral changes, irritability and sleep dysfunction. The recovery phase is usually slow and may be associated with longstanding adaptive, behavioral and neuropsychological problems. Very few studies explored the cognitive and adaptive sequelae in children with anti-NMDAR encephalitis. The present review article suggests that, although most children and adolescents return to their daily life and previous activities, they may have a low quality of life and show neuropsychological sequelae involving language, memory, especially verbal memory, and attentional resources, even after several months from the hospital discharge. In particular, the available results reveal difficulties in cognitive skills involving executive functions. This impairment is considered the “core” of the cognitive profile of young patients with anti-NMDAR encephalitis. On the other hand, some cognitive skills, such as general intelligence, show good overall recovery over time. Additional neuropsychological research evaluating larger samples, more homogenous methods and longitudinal studies is required.

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