Spatial and Ecological Factors Modulate the Incidence of Anti-NMDAR Encephalitis-A Systematic Review

Area of Science:

• Neurology
• Epidemiology
• Environmental Science

Background:

• Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an autoimmune disorder with known antigenic triggers.
• The influence of geographic, climatic, and environmental factors on anti-NMDAR encephalitis risk remains unexplored.

Purpose of the Study:

• To investigate the association between geographic, climatic factors and the incidence of anti-NMDAR encephalitis.
• To analyze spatial variations in disease incidence based on geographical localization and temperature.

Main Methods:

• Systematic review and meta-analysis of published anti-NMDAR encephalitis incidence data.
• Multivariate spatial autocorrelation analyses and seasonal analyses.
• Exposure-lag-response modeling to assess temperature impacts.

Main Results:

• Incidence varied globally, with higher rates in Oceania and South America compared to Europe and North America.
• A strong negative correlation was found between incidence and latitude (Pearson's R = -0.88, p < 0.00001).
• Higher incidence correlated with warmer months, higher mean annual temperatures, and increased ultraviolet exposure.

Conclusions:

• Geographic and climatic factors, including latitude, mean annual temperature, and UV exposure, may modify the risk of anti-NMDAR encephalitis.
• This study provides the first evidence linking environmental factors to anti-NMDAR encephalitis risk.