Therapy response in seronegative versus seropositive autoimmune encephalitis

Area of Science:

• Neurology
• Immunology
• Clinical Medicine

Background:

• Autoimmune encephalitis (AE) is classified as seropositive or seronegative based on detectable antibodies to neuronal antigens.
• Limited data exists on the efficacy of treatments for seronegative AE, necessitating further investigation.

Purpose of the Study:

• To evaluate the response to immunotherapy in seronegative autoimmune encephalitis (AE) patients.
• To compare treatment outcomes in seronegative AE with those in seropositive AE cases.

Main Methods:

• A retrospective analysis of 150 autoimmune encephalitis (AE) patients treated between 2010 and 2020.
• Therapy response was assessed using clinical global impression and the modified Rankin Scale (mRS).

Main Results:

• The study included 74 seronegative (49.3%) and 76 seropositive (50.7%) AE patients.
• Most patients (80.4%) received immunotherapy, primarily glucocorticoids (76.4%).
• Significant improvement was observed in both seronegative (92.5%) and seropositive (86.4%) AE patients treated with immunotherapy, with no significant difference between groups. Favorable neurological outcomes (mRS 0-2) doubled from baseline in both groups during follow-up.

Conclusions:

• Immunotherapy demonstrates substantial benefit for both seronegative and seropositive autoimmune encephalitis (AE) patients.
• Treatment with immunotherapy should be considered for all AE patients, irrespective of antibody detection.