Structural Hippocampal Damage Following Anti-N-Methyl-D-Aspartate Receptor Encephalitis

Finke, Carsten; Kopp, Ute A.; Pajkert, Anna; Behrens, Janina; Leypoldt, Frank; Wuerfel, Jens; Ploner, Christoph J.; Prüß, Harald; Paul, Friedemann

doi:10.1016/j.biopsych.2015.02.024

Cited by 126 publications

(125 citation statements)

References 41 publications

Supporting

Mentioning

108

Contrasting

Unclassified

Order By: Relevance

“…[53] However, cognitive deficits may across extended periods of time, and are presumed to reflect alterations in functional connectivity and white matter integrity that may be overlooked with standard clinical MR imaging. [16, 18] Our experience further advances this hypothesis, and emphasizes the potential application of longitudinal fMRI in appraising intrinsic activity and predicting meaningful clinical outcomes in a single case.…”

Section: Discussionmentioning

confidence: 83%

See 1 more Smart Citation

N-methyl-D-aspartate receptor encephalitis mediates loss of intrinsic activity measured by functional MRI

et al. 2016

View full text Add to dashboard Cite

Spontaneous brain activity is required for the development and maintenance of normal brain function. Many disease processes disrupt the organization of intrinsic brain activity but few pervasively reduce the amplitude of resting state blood oxygen level dependent (BOLD) fMRI fluctuations. We report the case of a female with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis, longitudinally studied during the course of her illness in order to determine the contribution of NMDAR signaling to spontaneous brain activity. Resting state BOLD fMRI was measured at the height of her illness and 18 weeks following discharge from hospital. Conventional resting state networks were defined using established methods. Correlation and covariance matrices were calculated by extracting the BOLD time-series from regions of interest and calculating either the correlation or covariance quantity. The intrinsic activity was compared between visits, and to expected activity from 45 similarly-aged healthy individuals. Near the height of the illness, the patient exhibited profound loss of consciousness, high-amplitude slowing of the electroencephalogram, and a severe reduction in the amplitude of spontaneous BOLD fMRI fluctuations. The patient’s neurological status and measures of intrinsic activity improved following treatment. We conclude that NMDAR-mediated signaling plays a critical role in the mechanisms that give rise to organized spontaneous brain activity. Loss of intrinsic activity is associated with profound disruptions of consciousness and cognition.

show abstract

Section: Discussionmentioning

confidence: 83%

“…[4, 58] Critically, these homeostatic processes depend on ongoing signaling, with the possibility that disruption may contribute to cognitive impairment reported in our patient and others. [16, 18]…”

Section: Discussionmentioning

confidence: 99%

N-methyl-D-aspartate receptor encephalitis mediates loss of intrinsic activity measured by functional MRI

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Anti-NMDA receptor encephalitis has also been associated with hippocampal volume reduction and bilateral hippocampal microstructural integrity impairment, though the frequency of MRi abnormalities is less common in children than adults (Armangue et al, 2012;Finke et al, 2016).…”

Section: Introductionmentioning

confidence: 98%

Neuropsychological characterization of three adolescent females with anti-NMDA receptor encephalitis in the acute, post-acute, and chronic phases: an inter-institutional case series

Hinkle

Porter

Waldron

et al. 2016

The Clinical Neuropsychologist

View full text Add to dashboard Cite

show abstract

“…[49,50*] In contrast, patients with anti-NMDAR encephalitis may develop hippocampal atrophy, which correlates with disease severity and long-term cognitive deficits, but rarely develop MTS. [76**]…”

Section: Introductionmentioning

confidence: 99%

Seizures and risk of epilepsy in autoimmune and other inflammatory encephalitis

Spatola

Dalmau

2017

Current Opinion in Neurology

143

125

View full text Add to dashboard Cite

Purpose of review To assess the seizure manifestations and risk of epilepsy in encephalitis associated to antibodies against neuronal cell-surface (AE) or myelin-associated antigens, and to review several chronic epileptic disorders including, Rasmussen’s encephalitis (RE), fever-induced refractory epileptic syndromes (FIRES), and new-onset refractory status epilepticus (NORSE). Recent findings Seizures are a frequent manifestation of AE. Some AE may associate with characteristic features: faciobrachial dystonic seizures (anti-LGI1 encephalitis), EEG extreme delta brush (anti-NMDAR), or multifocal FLAIR-MRI abnormalities (anti-GABAAR). In anti-LGI1 encephalitis, cortical, limbic, and basal ganglia dysfunction results in different types of seizures. AE or myelin-antibody associated syndromes are often immunotherapy-responsive and appear to have a low risk for chronic epilepsy. In contrast patients with seizures related to GAD65-antibodies (an intracellular antigen) frequently develop epilepsy and have suboptimal response to treatment (including surgery). RE or FIRES may occur with autoantibodies of unclear significance and rarely respond to immunotherapy. A study of patients with NORSE showed that 30% developed chronic epilepsy. Summary Although seizures are frequent in all types of AE, the risk for chronic epilepsy is dependent on the antigen: lower if located on the cell-surface, and higher if intracellular. For other disorders (RE, FIRES, NORSE) the prognosis remains poor.

show abstract

Structural Hippocampal Damage Following Anti-N-Methyl-D-Aspartate Receptor Encephalitis

Cited by 126 publications

References 41 publications

N-methyl-D-aspartate receptor encephalitis mediates loss of intrinsic activity measured by functional MRI

N-methyl-D-aspartate receptor encephalitis mediates loss of intrinsic activity measured by functional MRI

Neuropsychological characterization of three adolescent females with anti-NMDA receptor encephalitis in the acute, post-acute, and chronic phases: an inter-institutional case series

Seizures and risk of epilepsy in autoimmune and other inflammatory encephalitis

Contact Info

Product

Resources

About