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Induction and Clinical Scoring of Chronic-Relapsing Experimental Autoimmune Encephalomyelitis
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Cognitive Impairment in Autoimmune Encephalitis: Characterization and Predicting Long-term Outcomes.

S Jha1, R C Mundlamuri1, Suvarna Alladi1

  • 1Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India.

Neurology India
|November 11, 2025
PubMed
Summary
This summary is machine-generated.

Autoimmune encephalitis (AE) frequently causes cognitive impairment, especially in late-onset cases. Factors like age, psychiatric issues, and EEG abnormalities predict poor cognitive outcomes in AE patients.

Keywords:
Autoimmune encephalitiscognitioncognitive impairment

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Area of Science:

  • Neurology
  • Neuroimmunology
  • Cognitive Science

Background:

  • Autoimmune encephalitis (AE) is increasingly recognized as a significant cause of reversible cognitive impairment.
  • Understanding the specific cognitive deficits and recovery patterns in AE is crucial for patient management.

Purpose of the Study:

  • To investigate cognitive domains affected in various AE subtypes.
  • To assess cognitive profile changes over time and identify predictors of residual impairment.

Main Methods:

  • Cognitive assessments were age-stratified (Vineland, MoCA, ACE-III).
  • Psychiatric manifestations were screened using the Neuropsychiatric Inventory.
  • Assessments were repeated after a 6-month follow-up period.

Main Results:

  • Cognitive impairment was universal in late-onset AE (100%) and prevalent in adults (85%) and children (58%).
  • Late-onset AE and anti-LGI-1 positivity were associated with common cognitive impairment.
  • Predictors of poor cognitive outcomes included advanced age, mutism, hallucinations, incontinence, altered consciousness, psychiatric issues, high mRS scores, and abnormal EEG.

Conclusions:

  • Cognitive impairment is a hallmark of autoimmune encephalitis, with new learning, memory, and fluency domains being severely affected.
  • Late-onset AE, abnormal EEG, high mRS scores, and psychiatric comorbidities are significant predictors of poor cognitive outcomes.