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在抗NMDA受体脑炎中异常的大脑MRI:临床和预后影响

Laura Khatib¹, Julie Pique², Nicolas Lundahl Ciano-Petersen³

¹Centre de Ressources et Compétences Sclérose En Plaques (CRC SEP), Centre Hospitalier Universitaire de Montpellier & INM.

Neurology(R) neuroimmunology & neuroinflammation

|February 25, 2025

概括

在抗N-甲基-d-酸盐受体脑炎 (NMDARE) 中的大脑MRI可以显示边缘或外边缘病变. 多发性硬化症样和广泛的病变与糟糕的结果和重叠的脱髓化综合征有关.

科学领域:

神经免疫学神经免疫学
神经辐射学神经辐射学
临床神经学临床神经学

背景情况:

异常的大脑MRI发现与抗N-甲基-d-酸盐受体脑炎 (NMDARE) 的不良预后相关.
描述MRI病变对于理解NMDARE病理生理学和患者结果至关重要.

研究的目的:

在NMDARE患者中描述大脑MRI病变.
评估这些病变的临床和预后关联.

主要方法:

对NMDARE患者的回顾性队列研究,可用的大脑MRI和至少一年的随访.
对边缘和外边缘病变的MRI扫描进行审查,包括MS类,广泛和的模式.
多变量逻辑回归分析以确定两年结果,恢复定义为修改的兰金级得分≤1.

主要成果:

14.5%的患者患有边缘超强度,16.1%患有边缘外伤.
额外边缘病变包括MS类型,广泛型和毛型,其中一些与边缘病变重叠.
与没有额外边缘病变 (76.5%) 的患者相比,2年后MS类或广泛的病变与较低的康复率 (分别为41.7%和25%) 相关.
类似于多发性硬化症的病变独立地与2年内没有恢复相关 (aOR 0.1).

结论:

NMDARE的大脑MRI发现包括边缘超强度和三个边缘外损伤模式.
类似于MS的广泛病变与重叠的脱髓化综合征和较差的临床结果相关.
这些MRI特征对监测NMDARE患者和预测预后有实际意义.

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