Cardiac sympathetic dysfunction in anti-NMDA receptor encephalitis

Area of Science:

• Neurology
• Cardiology
• Autonomic Neuroscience

Background:

• Anti-NMDA receptor (anti-NMDAR) encephalitis is associated with significant patient morbidity due to autonomic dysfunctions.
• Cardiac autonomic function assessment is crucial for understanding and managing anti-NMDAR encephalitis complications.

Purpose of the Study:

• To evaluate cardiac autonomic functions in patients with anti-NMDAR encephalitis using heart rate variability (HRV) analysis.
• To compare HRV parameters between anti-NMDAR encephalitis patients, herpes encephalitis patients, and healthy controls.
• To investigate the association between cardiac autonomic dysfunction and functional outcomes in anti-NMDAR encephalitis.

Main Methods:

• A retrospective, single-center case-control study design.
• Inclusion of 11 patients with anti-NMDAR encephalitis, 9 with herpes encephalitis (HSE), and 15 age- and sex-matched controls.
• Analysis of 5-minute resting electrocardiogram data to measure heart rate variability (HRV) parameters, including total power and low-frequency (LF) power.

Main Results:

• Anti-NMDAR encephalitis patients exhibited significantly lower total power and low-frequency (LF) power compared to controls, indicating cardiac autonomic dysfunction.
• The sympathetic system appears particularly affected in anti-NMDAR encephalitis patients.
• No significant differences in HRV parameters were observed between HSE patients and controls.
• Cardiac autonomic dysfunction correlated with poorer functional outcomes at 3 months post-illness in anti-NMDAR encephalitis patients.

Conclusions:

• Patients with anti-NMDAR encephalitis demonstrate significant cardiac autonomic dysfunction, primarily impacting sympathetic activity.
• This cardiac autonomic dysfunction is a predictor of functional outcomes in anti-NMDAR encephalitis.
• HRV analysis is a valuable tool for assessing autonomic function in anti-NMDAR encephalitis.