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Brain magnetic resonance imaging predictors in anti‐N‐methyl‐D‐aspartate receptor encephalitis

OBJECTIVE: Brain magnetic resonance imaging (MRI) findings in anti‐N‐methyl‐D‐aspartate receptor (NMDAR) encephalitis are nonspecific and rarely have obvious associations with clinical characteristics and outcomes. This study aimed to comprehensively describe the MRI features of patients with NMDAR...

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Autores principales: Zhao, Ying‐Ying, Han, Bing, Qin, Cui‐Hong, Shi, Xue‐Xiu, Yun, Wen‐Jing, Wang, Meng, Yuan, Bo, Sun, Tong‐Wen, Wang, Hai‐Xu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9735371/
https://www.ncbi.nlm.nih.gov/pubmed/36314483
http://dx.doi.org/10.1002/acn3.51690
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author Zhao, Ying‐Ying
Han, Bing
Qin, Cui‐Hong
Shi, Xue‐Xiu
Yun, Wen‐Jing
Wang, Meng
Yuan, Bo
Sun, Tong‐Wen
Wang, Hai‐Xu
author_facet Zhao, Ying‐Ying
Han, Bing
Qin, Cui‐Hong
Shi, Xue‐Xiu
Yun, Wen‐Jing
Wang, Meng
Yuan, Bo
Sun, Tong‐Wen
Wang, Hai‐Xu
author_sort Zhao, Ying‐Ying
collection PubMed
description OBJECTIVE: Brain magnetic resonance imaging (MRI) findings in anti‐N‐methyl‐D‐aspartate receptor (NMDAR) encephalitis are nonspecific and rarely have obvious associations with clinical characteristics and outcomes. This study aimed to comprehensively describe the MRI features of patients with NMDAR encephalitis, examine their associations with clinical characteristics, and evaluate their predictive power for disease recurrence and prognosis. METHODS: We retrospectively extracted the clinical data and brain MRI findings of 144 patients with NMDAR encephalitis. Patients underwent a 2‐year follow‐up to assess disease outcomes. We evaluated the associations of brain MRI findings at the onset with clinical characteristics, recurrence, and prognosis. RESULTS: Initial MRI showed typical abnormalities in 65 patients (45.1%); of these, 34 (29.3%) developed recurrence and 10 (9.4%) had poor prognosis (mRS ≥3). Binary logistic regression analyses revealed that insula abnormalities were associated with acute seizure (odds ratio [OR] = 3.048, 95% confidence interval [CI]: 1.026–9.060) and white matter lesions were associated with cognitive impairment (OR = 2.730, 95% CI: 1.096–6.799). Risk factors for a poor 2‐year prognosis included a higher number of brain MRI abnormalities (OR = 1.573, 95% CI: 1.129–2.192) and intensive care unit (ICU) admissions (OR = 15.312, 95% CI: 1.684–139.198). The risk factors for 2‐year recurrence included abnormalities of the thalamus (HR = 3.780, 95% CI: 1.642–8.699). INTERPRETATIONS: Brain MRI features of patients with NMDAR encephalitis were associated with clinical manifestations, prognosis, and recurrence. Higher numbers of MRI abnormalities and ICU admissions were predictive of poor prognosis. Abnormalities of the thalamus constituted a recurrence‐related risk factor.
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spelling pubmed-97353712022-12-12 Brain magnetic resonance imaging predictors in anti‐N‐methyl‐D‐aspartate receptor encephalitis Zhao, Ying‐Ying Han, Bing Qin, Cui‐Hong Shi, Xue‐Xiu Yun, Wen‐Jing Wang, Meng Yuan, Bo Sun, Tong‐Wen Wang, Hai‐Xu Ann Clin Transl Neurol Research Articles OBJECTIVE: Brain magnetic resonance imaging (MRI) findings in anti‐N‐methyl‐D‐aspartate receptor (NMDAR) encephalitis are nonspecific and rarely have obvious associations with clinical characteristics and outcomes. This study aimed to comprehensively describe the MRI features of patients with NMDAR encephalitis, examine their associations with clinical characteristics, and evaluate their predictive power for disease recurrence and prognosis. METHODS: We retrospectively extracted the clinical data and brain MRI findings of 144 patients with NMDAR encephalitis. Patients underwent a 2‐year follow‐up to assess disease outcomes. We evaluated the associations of brain MRI findings at the onset with clinical characteristics, recurrence, and prognosis. RESULTS: Initial MRI showed typical abnormalities in 65 patients (45.1%); of these, 34 (29.3%) developed recurrence and 10 (9.4%) had poor prognosis (mRS ≥3). Binary logistic regression analyses revealed that insula abnormalities were associated with acute seizure (odds ratio [OR] = 3.048, 95% confidence interval [CI]: 1.026–9.060) and white matter lesions were associated with cognitive impairment (OR = 2.730, 95% CI: 1.096–6.799). Risk factors for a poor 2‐year prognosis included a higher number of brain MRI abnormalities (OR = 1.573, 95% CI: 1.129–2.192) and intensive care unit (ICU) admissions (OR = 15.312, 95% CI: 1.684–139.198). The risk factors for 2‐year recurrence included abnormalities of the thalamus (HR = 3.780, 95% CI: 1.642–8.699). INTERPRETATIONS: Brain MRI features of patients with NMDAR encephalitis were associated with clinical manifestations, prognosis, and recurrence. Higher numbers of MRI abnormalities and ICU admissions were predictive of poor prognosis. Abnormalities of the thalamus constituted a recurrence‐related risk factor. John Wiley and Sons Inc. 2022-10-31 /pmc/articles/PMC9735371/ /pubmed/36314483 http://dx.doi.org/10.1002/acn3.51690 Text en © 2022 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Research Articles
Zhao, Ying‐Ying
Han, Bing
Qin, Cui‐Hong
Shi, Xue‐Xiu
Yun, Wen‐Jing
Wang, Meng
Yuan, Bo
Sun, Tong‐Wen
Wang, Hai‐Xu
Brain magnetic resonance imaging predictors in anti‐N‐methyl‐D‐aspartate receptor encephalitis
title Brain magnetic resonance imaging predictors in anti‐N‐methyl‐D‐aspartate receptor encephalitis
title_full Brain magnetic resonance imaging predictors in anti‐N‐methyl‐D‐aspartate receptor encephalitis
title_fullStr Brain magnetic resonance imaging predictors in anti‐N‐methyl‐D‐aspartate receptor encephalitis
title_full_unstemmed Brain magnetic resonance imaging predictors in anti‐N‐methyl‐D‐aspartate receptor encephalitis
title_short Brain magnetic resonance imaging predictors in anti‐N‐methyl‐D‐aspartate receptor encephalitis
title_sort brain magnetic resonance imaging predictors in anti‐n‐methyl‐d‐aspartate receptor encephalitis
topic Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9735371/
https://www.ncbi.nlm.nih.gov/pubmed/36314483
http://dx.doi.org/10.1002/acn3.51690
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