Structural network topology in limbic encephalitis is associated with amygdala enlargement, memory performance and serostatus

Bauer, Tobias; David, Bastian; Ernst, Leon; Becker, Albert; Helmstaedter, Christoph; Wagner, Jan; Weber, Bernd; Elger, Christian E.; Surges, Rainer; Rüber, Theodor

doi:10.1111/epi.16691

Cited by 9 publications

(16 citation statements)

References 17 publications

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“…For encephalitis associated with other type of NSA-Ab, as CASPR2, GABAAR, GABABR and AMPAR, imaging studies focused on follow-up findings are not available except on very small groups or case reports [ 38 , 123 , 129 , 130 , 131 ], generally reporting bilateral mediotemporal abnormalities with possible and variable extra hippocampal involvement, but more in-depth studies are needed for a better characterization.…”

Section: Secondary Neurodegeneration In Patients With Autoimmune Ence...mentioning

confidence: 99%

Neural Surface Antibodies and Neurodegeneration: Clinical Commonalities and Pathophysiological Relationships

et al. 2023

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Autoimmune encephalitis and neurodegenerative disorders share several clinical features, including behavioural and psychiatric manifestations, cognitive impairment, sleep and movement disorders. Therefore, it is not surprising that autoimmune encephalitis is one of the main differential diagnoses of rapidly progressive dementia. However, more chronic presentations of autoimmune disorders have been reported and can lead to the misdiagnosis of a neurodegenerative disease. On the other hand, antibodies against neuronal proteins, such as those directed against NMDAR, can occur during established neurogenerative disorders, and their role in this context is still unclear. They might be simple bystanders or modify the disease course and phenotype. Indeed, autoimmune encephalitis can leave long-term cognitive sequelae and specific antibodies to neuronal surface antigens are associated with clinical and pathological neurodegenerative features. Here we review the link between these antibodies and neurodegeneration. In particular we discuss: (a) the possibility that autoimmune encephalitis presents as a neurodegenerative disease, identifying the red flags that can help in the differential diagnosis between antibody-mediated and neurodegenerative disorders; (b) the occurrence of antibodies against neuronal surface antigens in patients with neurodegenerative disorders and their possible role in the disease course; and (c) the long-term cognitive and neuroradiological changes associated with autoimmune encephalitis, as well as the biomarkers that can help to predict the cognitive outcome. Finally, we review the clinical and pathological features of IgLON5 antibodies-related encephalitis, a unique model of the relationship between antibodies and neurodegeneration.

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Section: Secondary Neurodegeneration In Patients With Autoimmune Ence...mentioning

confidence: 99%

Neural Surface Antibodies and Neurodegeneration: Clinical Commonalities and Pathophysiological Relationships

et al. 2023

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“…43 A recent study utilizing structural T1W MRI and DTI in patients with limbic encephalitis due to autoantibodies against glutamic acid decarboxylase 65 (associated with amygdala enlargement) showed altered global network topology as compared to healthy controls and patients with HS. 44 In general, non-paraneoplastic AME demonstrates abnormal signal and variable diffusion restriction in the limbic structures, whereas paraneoplastic forms may additionally include extra-limbic signal abnormalities, leukoencephalopathy, cerebellar degeneration, and brainstem encephalitis. 45 Limbic encephalitis has classic clinical and radiology features, consisting of temporal lobe seizures, memory impairment, mood fluctuations, and involvement of the medial temporal lobe.…”

Section: Other Causes Of Temporal Lobe Epilepsymentioning

confidence: 99%

The changing landscape in epilepsy imaging: Unmasking subtle and unique entities

Adin¹,

Durand²,

Zucconi³

et al. 2022

Diagn Interv Radiol

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Dramatic changes have occurred recently in the field of epilepsy, including a fundamental shift in the etiology of epileptogenic substrates found at surgery. Hippocampal sclerosis (HS) is no longer the most common etiology found at epilepsy surgery and this decrease has been associated with an increase in the incidence of focal cortical dysplasia and encephaloceles. Significant advances have been made in molecular biology and genetics underlying the basis of malformations of cortical development (MCD), and our ability to detect epileptogenic abnormalities with magnetic resonance imaging has markedly improved. This article begins with a discussion of these trends and reviews imaging techniques essential for detecting subtle epilepsy findings. Representative examples of subtle imaging findings are presented, which are often overlooked but should not be missed. These include temporal lobe encephaloceles, MCD, especially focal cortical dysplasia, HS, hippocampal malformation (also known as HIMAL), ulegyria, autoimmune encephalitis, and Rasmussen's encephalitis. Recent findings on the pathophysiology and genetic underpinnings of several causes of localization-related epilepsy are incorporated. For instance, it has been recently found that focal cortical dysplasia IIb, tuberous sclerosis, hemimegalencephaly, and gangliogliomas are all the result of mutations of the mammalian target of rapamycin pathway for cell growth.

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“…The pathological changes might involve NMDAR-Ab, which changes intrinsic cortical connections and neuronal population dynamics (Rosch et al, 2018;Dalmau et al, 2019). To the best of our knowledge, most studies in the literature have focused on changes in brain networks using magnetic resonance imaging (MRI) and electroencephalography (EEG) in patients with encephalitis (Peer et al, 2017;Xu et al, 2017;Heine et al, 2018;Symmonds et al, 2018;Bauer et al, 2020;Li et al, 2021;Wang et al, 2021), while the use of 18 F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) has not been reported before, which is earlier for recognition and more sensitive than MRI (Novy et al, 2016;Yuan et al, 2016;Wei et al, 2020;Seniaray et al, 2021). Metabolic brain network analysis based on graph theory has proved useful in analyzing brain activity changes and is widely used in neuropsychological imaging (Huang et al, 2020;Rajagopalan and Pioro, 2020).…”

Section: Introductionmentioning

confidence: 99%

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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Structural network topology in limbic encephalitis is associated with amygdala enlargement, memory performance and serostatus

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Cited by 9 publications

References 17 publications

Neural Surface Antibodies and Neurodegeneration: Clinical Commonalities and Pathophysiological Relationships

Neural Surface Antibodies and Neurodegeneration: Clinical Commonalities and Pathophysiological Relationships

The changing landscape in epilepsy imaging: Unmasking subtle and unique entities

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

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