Brain Atrophy Can Predict the Severity and Prognosis of Anti-N-Methyl-D-Aspartate Receptor Encephalitis
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Background and Purpose Compare clinical and lab characteristics of anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis cases with and without brain atrophy. Methods Assess cerebral atrophy using median temporal lobe atrophy (MTA) and global cortical atrophy (GCA) scores in 82 anti-NMDAR encephalitis cases. Results GCA (+) cases had higher proportions of status epilepticus (p<0.001), memory problems (p=0.031), sepsis (p<0.001), and mechanical ventilation need (p=0.001) than GCA (-) cases. MTA (+) cases had higher memory problems (p<0.001) and sepsis (p=0.002) than MTA (-) cases. GCA (+) and MTA (+) groups had higher max modified Rankin Scale (mRS) (p<0.001, p=0.002) and 1-year mRS (p<0.001, p=0.004) scores than GCA (-) and MTA (-) groups. GCA (+) group had a longer hospital stay and a larger proportion of cases with limited treatment response (both p<0.001) than the GCA (-) group. GCA (p=0.005) was found to be a significant predictive factor for the mRS score 1 year after onset in multiple linear regression analysis. Conclusions MTA and GCA may be associated with severity and prognosis in anti-NMDAR encephalitis.
Abstract
Background and Purpose Compare clinical and lab characteristics of anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis cases with and without brain atrophy. Methods Assess cerebral atrophy using median temporal lobe atrophy (MTA) and global cortical atrophy (GCA) scores in 82 anti-NMDAR encephalitis cases. Results GCA (+) cases had higher proportions of status epilepticus (p<0.001), memory problems (p=0.031), sepsis (p<0.001), and mechanical ventilation need (p=0.001) than GCA (-) cases. MTA (+) cases had higher memory problems (p<0.001) and sepsis (p=0.002) than MTA (-) cases. GCA (+) and MTA (+) groups had higher max modified Rankin Scale (mRS) (p<0.001, p=0.002) and 1-year mRS (p<0.001, p=0.004) scores than GCA (-) and MTA (-) groups. GCA (+) group had a longer hospital stay and a larger proportion of cases with limited treatment response (both p<0.001) than the GCA (-) group. GCA (p=0.005) was found to be a significant predictive factor for the mRS score 1 year after onset in multiple linear regression analysis. Conclusions MTA and GCA may be associated with severity and prognosis in anti-NMDAR encephalitis.