Distributions and network changes of brain activity in the acute phase of anti-NMDAR encephalitis: a MEG study

This study aimed to elucidate the distributions of abnormal activities, as well as the functional connectivity and topological properties of brain networks, in patients diagnosed with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis.

From February 2016 to February 2025, acute-phase magnetoencephalography (MEG) data were successfully acquired from 16 patients diagnosed with anti-NMDAR encephalitis at the Affiliated Brain Hospital of Nanjing Medical University. MEG was employed to evaluate the power spectral density (PSD) across multiple frequency bands. Further analysis concentrated on functional connectivity and the topological characteristics of brain networks in order to identify distinctive neurophysiological features associated with the condition.

During the acute phase, the PSD in the delta band (1-3 Hz) showed greater power in posterior regions and lower power in anterior regions, with the highest energy concentrated bilaterally in the occipitoparietal and temporal areas. In the theta band (5-7 Hz), the PSD was predominantly localized to the bilateral occipitoparietal regions. The beta1 band (13-20 Hz) was primarily distributed in the right temporo-occipitoparietal regions, while the beta2 band (20-30 Hz) was predominantly distributed in the left temporal, occipitoparietal, and certain frontal regions. Functional connectivity analysis revealed enhanced connections between the left caudal anterior cingulate (CAC_L) and the left superior parietal lobe in the delta and theta bands. Increased connectivity was also observed between the left frontal pole and Precuneus_L, CAC_L, and the left superior temporal gyrus (STG_L)in the theta and beta2 bands. Furthermore, enhanced connectivity between STG_L and Pericalcarine_R was observed in the theta, beta2, and gamma bands. Patients with anti-NMDAR encephalitis demonstrated significantly reduced global efficiency and notable increases in average path length, local efficiency, and clustering coefficient in multiple bands, suggesting local clustering of brain networks during the acute phase.

Alterations in PSD distribution and brain networks across different frequency bands may provide valuable insights into the electrophysiological changes observed in the brains of anti-NMDAR encephalitis patients. Furthermore, these findings may offer valuable mechanistic insights that could contribute to the development of future diagnostic strategies.