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A Standardized Pipeline for Examining Human Cerebellar Grey Matter Morphometry using Structural Magnetic Resonance Imaging
Published on: February 4, 2022
Early Gray Matter Volume Changes in Pediatric Anti-NMDA Receptor Encephalitis: A Voxel-Based Morphometry Analysis
Pradeep Javarayee1, Daniel Ackom2, Janine Taitt-Tap1
1Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA.
Journal of Child Neurology
|July 28, 2026
Summary
Pediatric anti-N-methyl-D-aspartate (anti-NMDAR) encephalitis shows early gray matter volume reductions in children, detectable by MRI. These brain changes correlate with disease severity and patient outcomes.
Area of Science:
- Neuroimaging
- Pediatric Neurology
- Neuroimmunology
Background:
- Pediatric anti-N-methyl-D-aspartate (anti-NMDAR) encephalitis often presents with normal or nonspecific findings on conventional MRI, despite significant neurological and psychiatric symptoms.
- Adult studies indicate widespread structural brain involvement in anti-NMDAR encephalitis, but pediatric data are limited.
- Understanding early structural brain changes in pediatric anti-NMDAR encephalitis is crucial for diagnosis and management.
Purpose of the Study:
- To identify regional gray matter volume (GMV) abnormalities in pediatric anti-NMDAR encephalitis using voxel-based morphometry (VBM).
- To investigate the association between GMV deficits and clinical markers, including disease burden and 1-year outcomes.
Main Methods:
- Retrospective cross-sectional study involving 12 pediatric patients with anti-NMDAR encephalitis and 36 age/sex-matched healthy controls.
- Pretreatment structural MRI data analyzed using whole-brain VBM (SPM25 with DARTEL normalization).
- Voxel-wise group comparisons adjusted for covariates, with cluster-level family-wise error correction (P < .05).
Main Results:
- Significant regional GMV reductions were observed in pediatric anti-NMDAR encephalitis patients compared to controls.
- The most prominent GMV reduction cluster was in the left calcarine fissure and surrounding cortex, with additional deficits in frontal and parietal regions.
- GMV in the left middle frontal gyrus correlated with cerebrospinal fluid white blood cell count and worse 1-year modified Rankin Scale (mRS) outcome.
Conclusions:
- Voxel-based morphometry (VBM) effectively identified early regional gray matter volume abnormalities on pretreatment MRI in pediatric anti-NMDAR encephalitis.
- These findings suggest structural brain involvement even in the early stages of the disease.
- Further validation in larger, prospective cohorts is needed to confirm these hypothesis-generating results.
