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Related Experiment Video

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Induction and Clinical Scoring of Chronic-Relapsing Experimental Autoimmune Encephalomyelitis
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Cognitive and Patient-Reported Outcome Measures in LGI-1-IgG Autoimmune Encephalitis.

Tatchaporn Ongphichetmetha1,2, Carol Swetlik1, Nicolas Thompson3,4

  • 1Mellen Center, Cleveland Clinic, Cleveland, Ohio, USA.

Annals of Clinical and Translational Neurology
|June 21, 2025
PubMed
Summary

Autoimmune encephalitis (AE) patients experience lasting cognitive and physical impairments not fully captured by standard clinical measures. Cognitive outcome measures (CogOs) and patient-reported outcomes (PROs) offer a more comprehensive assessment of these long-term effects.

Keywords:
LGI1autoimmunecognitionencephalitispatient‐reported outcomesquality of lifeseizures

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Area of Science:

  • Neurology
  • Immunology
  • Clinical Outcomes Research

Background:

  • Autoimmune encephalitis (AE) lacks standardized clinical outcome measures.
  • Cognitive outcome measures (CogOs) and patient-reported outcomes (PROs) may better reflect AE symptoms than clinician-reported outcomes (ClinROs).

Purpose of the Study:

  • To evaluate the utility of CogOs and PROs in assessing long-term outcomes in LGI-1-IgG autoimmune encephalitis (AE).
  • To compare the sensitivity of CogOs and PROs versus traditional ClinROs in capturing AE-related impairments.

Main Methods:

  • Retrospective cohort study of LGI-1-IgG AE patients.
  • Utilized Rey Auditory Verbal Learning Test (RAVLT) and Brief Visuospatial Memory Test (BVMT) for CogOs.
  • Employed Neuro-QoL and PROMIS Global Physical (GPH) and Mental Health (GMH) for PROs.
  • Correlated CogOs and PROs with ClinROs (mRS, CASE) using Spearman's rank correlation.

Main Results:

  • LGI-1-IgG AE patients showed long-term impairments in cognition (BVMT 56%, RAVLT 20% >12 months post-diagnosis) and physical/mental health (Neuro-QoL, PROMIS).
  • CogOs (RAVLT, BVMT) showed limited correlation with ClinROs.
  • PROs (Neuro-QoL, PROMIS) correlated with both CogOs and ClinROs, indicating broader symptom capture.
  • ClinROs improved over time, but did not fully reflect cognitive or PRO deficits.

Conclusions:

  • LGI-1-IgG AE is associated with persistent cognitive, physical, and social role impairments.
  • CogOs and PROs provide objective, comprehensive measures of AE outcomes, surpassing the sensitivity of traditional ClinROs.
  • These findings support the integration of CogOs and PROs into AE clinical assessments and research for a fuller understanding of patient recovery.