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Abnormal Brain MRI Findings in Anti-N-Methyl-D-Aspartate Receptor Encephalitis and Correlation With Outcomes

Chunyan Lei1, Xiaolong Chang1, Haijiang Li1

  • 1Department of Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, China.

Frontiers in Neurology
|April 1, 2022
PubMed
Abstract

Insights

Abnormal brain MRI findings are common in Chinese patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis, affecting over 70%. While these MRI abnormalities correlate with cognitive decline, they do not predict long-term mortality or functional outcomes.

Area of Science:

  • Neurology
  • Neuroimaging
  • Immunology

Background:

  • Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a severe autoimmune neurological disorder.
  • Brain MRI findings in anti-NMDAR encephalitis show wide variability in prevalence, ranging from 11% to 83% in reported studies.
  • Understanding MRI prevalence and its correlation with clinical outcomes in specific populations, such as Chinese patients, is crucial for diagnosis and management.

Purpose of the Study:

  • To determine the prevalence of abnormal brain MRI findings in Chinese patients diagnosed with anti-NMDAR encephalitis.
  • To investigate the association between abnormal MRI findings and clinical outcomes, including cognitive function, mortality, and functional status, in this patient cohort.

Main Methods:

  • A retrospective analysis of 52 consecutive Chinese patients with anti-NMDAR encephalitis was conducted.
  • Patients were categorized into "MRI-normal" and "MRI-abnormal" groups based on brain MRI results post-admission.
  • Clinicodemographic data, electroencephalography (EEG) results, Mini-Mental State Examination (MMSE) scores, and modified Rankin Scale (mRS) scores at 3 and 12 months were compared between groups.

Main Results:

  • Abnormal brain MRI findings were present in 71.15% (37/52) of the studied patients.
  • Patients with abnormal MRI were more likely to be male and had EEG abnormalities.
  • No significant differences were observed in clinical symptoms, mortality rates, relapse rates, or mRS scores between the MRI-normal and MRI-abnormal groups at 3 and 12 months.
  • However, patients with abnormal MRI findings exhibited significantly lower MMSE scores at both 3 and 12 months post-admission compared to those with normal MRI.

Conclusions:

  • The prevalence of abnormal brain MRI findings is high in Chinese patients with anti-NMDAR encephalitis.
  • Abnormal MRI findings are associated with cognitive impairment (lower MMSE scores) in patients with anti-NMDAR encephalitis.
  • Brain MRI abnormalities in this cohort did not correlate with short-term or long-term mortality or functional outcomes (mRS scores).
Keywords:
anti-NMDAR encephalitisbrain MRIclinical characteristicclinical outcomecognitive function

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