Functional and structural brain changes in anti-N-methyl-D-aspartate receptor encephalitis
Standard
Functional and structural brain changes in anti-N-methyl-D-aspartate receptor encephalitis. / Finke, Carsten; Kopp, Ute A; Scheel, Michael; Pech, Luisa-Maria; Soemmer, Carina; Schlichting, Jeremias; Leypoldt, Frank; Brandt, Alexander U; Wuerfel, Jens; Probst, Christian; Ploner, Christoph J; Prüss, Harald; Paul, Friedemann.
in: ANN NEUROL, Jahrgang 74, Nr. 2, 01.08.2013, S. 284-96.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Functional and structural brain changes in anti-N-methyl-D-aspartate receptor encephalitis
AU - Finke, Carsten
AU - Kopp, Ute A
AU - Scheel, Michael
AU - Pech, Luisa-Maria
AU - Soemmer, Carina
AU - Schlichting, Jeremias
AU - Leypoldt, Frank
AU - Brandt, Alexander U
AU - Wuerfel, Jens
AU - Probst, Christian
AU - Ploner, Christoph J
AU - Prüss, Harald
AU - Paul, Friedemann
N1 - © 2013 American Neurological Association.
PY - 2013/8/1
Y1 - 2013/8/1
N2 - OBJECTIVE: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune encephalitis with a characteristic neuropsychiatric syndrome and severe and prolonged clinical courses. In contrast, standard clinical magnetic resonance imaging (MRI) remains normal in the majority of patients. Here, we investigated structural and functional brain changes in a cohort of patients with anti-NMDAR encephalitis.METHODS: Twenty-four patients with established diagnosis of anti-NMDAR encephalitis and age- and gender-matched controls underwent neuropsychological testing and multimodal MRI, including T1w/T2w structural imaging, analysis of resting state functional connectivity, analysis of white matter using diffusion tensor imaging, and analysis of gray matter using voxel-based morphometry.RESULTS: Patients showed significantly reduced functional connectivity of the left and right hippocampus with the anterior default mode network. Connectivity of both hippocampi predicted memory performance in patients. Diffusion tensor imaging revealed extensive white matter changes, which were most prominent in the cingulum and which correlated with disease severity. In contrast, no differences in T1w/T2w structural imaging and gray matter morphology were observed between patients and controls.INTERPRETATION: Anti-NMDAR encephalitis is associated with characteristic alterations of functional connectivity and widespread changes of white matter integrity despite normal findings in routine clinical MRI. These results may help to explain the clinicoradiological paradox in anti-NMDAR encephalitis and advance the pathophysiological understanding of the disease. Correlation of imaging abnormalities with disease symptoms and severity suggests that these changes play an important role in the symptomatology of anti-NMDAR encephalitis.
AB - OBJECTIVE: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune encephalitis with a characteristic neuropsychiatric syndrome and severe and prolonged clinical courses. In contrast, standard clinical magnetic resonance imaging (MRI) remains normal in the majority of patients. Here, we investigated structural and functional brain changes in a cohort of patients with anti-NMDAR encephalitis.METHODS: Twenty-four patients with established diagnosis of anti-NMDAR encephalitis and age- and gender-matched controls underwent neuropsychological testing and multimodal MRI, including T1w/T2w structural imaging, analysis of resting state functional connectivity, analysis of white matter using diffusion tensor imaging, and analysis of gray matter using voxel-based morphometry.RESULTS: Patients showed significantly reduced functional connectivity of the left and right hippocampus with the anterior default mode network. Connectivity of both hippocampi predicted memory performance in patients. Diffusion tensor imaging revealed extensive white matter changes, which were most prominent in the cingulum and which correlated with disease severity. In contrast, no differences in T1w/T2w structural imaging and gray matter morphology were observed between patients and controls.INTERPRETATION: Anti-NMDAR encephalitis is associated with characteristic alterations of functional connectivity and widespread changes of white matter integrity despite normal findings in routine clinical MRI. These results may help to explain the clinicoradiological paradox in anti-NMDAR encephalitis and advance the pathophysiological understanding of the disease. Correlation of imaging abnormalities with disease symptoms and severity suggests that these changes play an important role in the symptomatology of anti-NMDAR encephalitis.
KW - Adult
KW - Anti-N-Methyl-D-Aspartate Receptor Encephalitis
KW - Female
KW - Functional Neuroimaging
KW - Hippocampus
KW - Humans
KW - Leukoencephalopathies
KW - Magnetic Resonance Imaging
KW - Male
KW - Middle Aged
KW - Nerve Net
KW - Neuropsychological Tests
KW - Severity of Illness Index
KW - Young Adult
U2 - 10.1002/ana.23932
DO - 10.1002/ana.23932
M3 - SCORING: Journal article
C2 - 23686722
VL - 74
SP - 284
EP - 296
JO - ANN NEUROL
JF - ANN NEUROL
SN - 0364-5134
IS - 2
ER -