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Transdiagnostic hippocampal damage patterns in neuroimmunological disorders.
Josephine Heine1, Harald Prüß2, Michael Scheel3
1Charité - Universitätsmedizin Berlin, Department of Neurology, Berlin, Germany; Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany.
Neuroimmunological diseases like MS and encephalitis cause shared hippocampal shape changes, impacting memory. Neuromyelitis optica spectrum disorder, however, did not show these hippocampal deformations.
Area of Science:
- Neuroimmunology
- Neuroimaging
- Cognitive Neuroscience
Background:
- Hippocampal damage is common in neuroimmunological disorders, leading to cognitive deficits.
- Comparative analyses of shared hippocampal damage patterns across these diseases are lacking.
- This study investigates shared hippocampal morphology and cognitive deficits in four neuroimmunological diseases.
Purpose of the Study:
- To identify shared hippocampal shape deformations and associated cognitive deficits across multiple sclerosis, neuromyelitis optica spectrum disorder, anti-NMDAR encephalitis, and anti-LGI1 encephalitis.
- To compare hippocampal morphology patterns using a transdiagnostic approach.
- To explore the relationship between hippocampal deformations, volume loss, and cognitive performance.
Main Methods:
- MRI-based vertex-wise hippocampal shape analysis in 120 patients and 79 controls.
- Assessment of hippocampal volume and surface displacement (scalar projection values).
- Cognitive testing including verbal memory and semantic fluency.
Main Results:
- Inward hippocampal deformations observed in multiple sclerosis, anti-NMDAR encephalitis, and anti-LGI1 encephalitis (up to 32% of surface).
- Neuromyelitis optica spectrum disorder patients showed no significant hippocampal deformations.
- Deformations, mainly on the hippocampal head, correlated with volume loss and cognitive deficits in memory and fluency for MS and autoimmune encephalitis.
- A shared vulnerability zone identified in the left anterior hippocampus (CA1 subfield) across disorders.
Conclusions:
- Distinct hippocampal shape deformations characterize certain neuroimmunological diseases, suggesting shared downstream mechanisms of immune-mediated damage.
- The left anterior hippocampus (CA1) appears particularly susceptible to neuroinflammation in these conditions.
- Findings illuminate common pathophysiologic pathways for cognitive deficits and highlight the hippocampus as a vulnerable target in autoimmunity.
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