Risk Factors and Brain Metabolic Mechanism of Sleep Disorders in Autoimmune Encephalitis

Liu, Xiao; Yu, Tingting; Zhao, Xiaobin; Yu, Ping; Lv, Ruijuan; Wang, Chunxue; Lin, Aiming; Wang, Qun

doi:10.3389/fimmu.2021.738097

Cited by 8 publications

(3 citation statements)

References 36 publications

(32 reference statements)

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“…In research examining primary nocturnal enuresis in children, disturbances in arousal were linked to diminished functional connectivity between the thalamus and CPL (26). In the study conducted by Liu and colleagues (27), it was also observed that individuals suffering from sleep disorders exhibited elevated metabolic activity in both the thalamus and the CPL. Xie et al ( 28) investigated the spontaneous brain activity in patients with obstructive sleep apnea (OSA) using the percentage of amplitude fluctuation (PerAF).…”

Section: Discussionmentioning

confidence: 97%

Functional connectivity alterations in the thalamus among patients with bronchial asthma

Wang,

Huang,

Dai

et al. 2024

Front. Neurol.

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ObjectiveBronchial Asthma (BA) is a common chronic respiratory disease worldwide. Earlier research has demonstrated abnormal functional connectivity (FC) in multiple cognition-related cortices in asthma patients. The thalamus (Thal) serves as a relay center for transmitting sensory signals, yet the modifications in the thalamic FC among individuals with asthma remain uncertain. This research employed the resting-state functional connectivity (rsFC) approach to explore alterations in thalamic functional connectivity among individuals with BA.Patients and methodsAfter excluding participants who did not meet the criteria, this study finally included 31 patients with BA, with a gender distribution of 16 males and 15 females. Subsequently, we recruited 31 healthy control participants (HC) matched for age, gender, and educational background. All participants underwent the Montreal Cognitive Assessment (MoCA) and the Hamilton Depression Rating Scale (HAMD) assessment. Following this, both groups underwent head magnetic resonance imaging scans, and resting-state functional magnetic resonance imaging (rs-fMRI) data was collected. Based on the AAL (Automated Anatomical Labeling) template, the bilateral thalamic regions were used as seed points (ROI) for subsequent rsFC research. Pearson correlation analysis was used to explore the relationship between thalamic functional connectivity and neuropsychological scales in both groups. After controlling for potential confounding factors such as age, gender, intelligence, and emotional level, a two-sample t-test was further used to explore differences in thalamic functional connectivity between the two groups of participants.ResultCompared to the HC group, the BA group demonstrated heightened functional connectivity (FC) between the left thalamus and the left cerebellar posterior lobe (CPL), left postcentral gyrus (PCG), and right superior frontal gyrus (SFG). Concurrently, there was a decrease in FC with both the Lentiform Nucleus (LN) and the left corpus callosum (CC). Performing FC analysis with the right thalamus as the Region of Interest (ROI) revealed an increase in FC between the right thalamus and the right SFG as well as the left CPL. Conversely, a decrease in FC was observed between the right thalamus and the right LN as well as the left CC.ConclusionIn our study, we have verified the presence of aberrant FC patterns in the thalamus of BA patients. When compared to HCs, BA patients exhibit aberrant alterations in FC between the thalamus and various brain areas connected to vision, hearing, emotional regulation, cognitive control, somatic sensations, and wakefulness. This provides further confirmation of the substantial role played by the thalamus in the advancement of BA.

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Section: Discussionmentioning

confidence: 97%

Functional connectivity alterations in the thalamus among patients with bronchial asthma

Wang,

Huang,

Dai

et al. 2024

Front. Neurol.

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“…Prior studies have reported that sleep disorders are considerable condition in autoimmune encephalitis, because which could interfere patients' recovery and quality of life 30,31 . The potential mechanism may be related to the involvement of middle‐line structures in brain, including hippocampus, basal ganglia, thalamus, and hypothalamus 32 . Future research should assess whether optimizing sleep disorders may improve prognosis of seizures.…”

Section: Discussionmentioning

confidence: 99%

“… 30 , 31 The potential mechanism may be related to the involvement of middle‐line structures in brain, including hippocampus, basal ganglia, thalamus, and hypothalamus. 32 Future research should assess whether optimizing sleep disorders may improve prognosis of seizures. In addition, hyponatremia is specific symptom of anti‐LGI1 encephalitis, the prevalence has been reported in approximately 53%–65% of patients.…”

Section: Discussionmentioning

confidence: 99%

Factors predicting neuronal surface antibodies in the elderly with new‐onset and unknown seizures

Liu

et al. 2022

Ann Clin Transl Neurol

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Objective To investigate risk factors of neuronal surface antibodies (NSAbs) and develop a nomogram that could identify patients at the odds of NSAbs among the elderly (aged 60 years or older) with new‐onset seizures of unknown etiology. Methods Clinical data for aged ≥60 years diagnosed with new‐onset seizures of unknown etiology were retrospectively reviewed. A nomogram based on multivariable logistic regression was constructed. Model performance of nomogram was evaluated using area under the curve (AUC), calibration curve, decision curve analysis (DCA), and clinical impact curve (CIC). Meanwhile, it was internally validated by bootstrap validation in current cohort. Results Of 147 patients included in final analysis, 68 (46.3%) had NSAbs‐mediated encephalitis. Six factors were identified: duration of seizures less than 3 months (OR:14.259; 95% CI: 4.480–45.386), focal‐onset seizures (OR:12.457; 95% CI: 2.710–57.261), psychiatric deficits (OR:10.063; 95% CI: 3.231–31.343), sleep disorders (OR:3.091; 95% CI: 1.011–9.454), hyponatremia (OR:6.252; 95% CI: 1.445–27.043), and medial temporal lobe (MTL) lesions on MRI (OR:4.102; 95% CI: 1.382–12.169). The nomogram had a good discrimination with an AUC of 0.916 and with a corrected AUC of 0.881 after the bootstrapping validation, our model also exhibited a better predictive performance than scoring systems commonly used clinically. Additionally, the calibration curve showed that predicted NSAbs‐positive rates of nomogram were closely aligned with actual observed results. Moreover, the nomogram achieved well on clinical utility by using the DCA and CIC. Interpretation Our nomogram may provide a convenient and useful tool for identifying the elderly with new‐onset seizures of unknown etiology who are at risk of NSAbs‐mediated encephalitis, which would allow these patients receive earlier immunotherapy.

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Distinctive sleep complaints and polysomnographic findings in antibody subgroups of autoimmune limbic encephalitis

Küçükali,

Yılmaz,

Karadeniz

et al. 2024

Neurol Sci

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Introduction Sleep disturbances are being increasingly recognized in association with autoimmune encephalitis (AIE). We investigated the prevalence of sleep-related symptoms and polysomnographic features of patients with AIE and the long-term outcomes in these patients in a multi-center, prospective study from Turkey. Methods We prospectively evaluated patients with definite AIE in a common database including demographics, AIE-related and sleep-related symptomatology. Maximum and latest modified Rankin scores (mRS) and Liverpool Outcome Score (LOS) were noted. Results Of 142 patients, 87 patients (61.3%) fulfilled the criteria for definite AIE (mean age, 46.8+18.8 years; 51.7% women; mean disease duration, 21.0+38.4 months). 78.9% of patients had at least one or more new onset or worsened sleep-related symptomatology: insomnia (55.3%), excessive daytime sleepiness (EDS, 28.0%), sleep apnea (18.7%), REM sleep behavior disorder (RBD, 17.3%), restless legs syndrome (10.7%) and oneiric stupor (9.3%). Sleep efficiency, N3 and REM sleep were decreased and N1 sleep was increased in patients with Ab[+] AIE. LOS points were highest in those with insomnia and sleep apnea, and lowest in those with EDS, RBD and oneiric stupor. RBD and sleep apnea were more common in anti-LG1 Ab[+] group than anti-NMDAR Ab[+] group. Index of periodic leg movements was highest in anti-LG1 Ab[+] group. Patients with EDS and oneiric stupor had more common memory problems. Maximum and latest mRS scores were positively correlated with EDS and oneiric stupor. EDS, RBD and oneiric stupor were negatively correlated with LOS points. Conclusion Our study emphasizes the presence and importance of early diagnosis of sleep disturbances in AIE in regard to their deteriorative influences on disease prognosis.

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Risk Factors and Brain Metabolic Mechanism of Sleep Disorders in Autoimmune Encephalitis

Cited by 8 publications

References 36 publications

Functional connectivity alterations in the thalamus among patients with bronchial asthma

Functional connectivity alterations in the thalamus among patients with bronchial asthma

Factors predicting neuronal surface antibodies in the elderly with new‐onset and unknown seizures

Distinctive sleep complaints and polysomnographic findings in antibody subgroups of autoimmune limbic encephalitis

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