White matter abnormalities and multivariate pattern analysis in anti-NMDA receptor encephalitis
Shengyu Yang1, Ying Wu1, Lanfeng Sun1
1Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Frontiers in Psychiatry
|October 10, 2022
Summary
White matter damage is common in anti-NMDA receptor encephalitis and correlates with disease severity. Diffusion tensor imaging and machine learning can identify these alterations and aid diagnosis.
Area of Science:
- Neuroimaging
- Neurology
- Medical Science
Background:
- Anti-NMDA receptor (NMDAR) encephalitis is a severe autoimmune neurological disorder.
- Understanding white matter (WM) microstructural changes is crucial for diagnosing and managing NMDAR encephalitis.
Purpose of the Study:
- To investigate white matter (WM) microstructural alterations in anti-NMDAR receptor encephalitis.
- To explore the correlation between WM changes and disease severity.
- To evaluate the potential of imaging biomarkers for discriminating patients from healthy controls.
Main Methods:
- Diffusion tensor imaging (DTI) was performed on 32 patients with anti-NMDAR encephalitis and 26 healthy controls.
- Tract-based spatial statistics (TBSS) and atlas-based analysis were used to assess WM microstructural integrity.
- Multivariate pattern analysis (MVPA), a machine learning algorithm, was employed for classification.
Main Results:
- Patients showed reduced fractional anisotropy (FA) in multiple WM tracts, including the corpus callosum and cingulum.
- Increased mean diffusivity (MD) and radial diffusivity (RD) were observed in various WM regions.
- WM abnormalities in the cingulum, fornix, and internal capsule correlated significantly with disease severity.
Conclusions:
- Widespread white matter lesions are characteristic of anti-NMDAR encephalitis.
- WM alterations play a significant role in the pathophysiology of the disease.
- Combining TBSS and MVPA offers valuable insights for both group and individual patient assessment.
Related Concept Videos
01:19Encephalitis l: Introduction
Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
01:26Encephalitis ll: Pathophysiology
Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...