Abstract Details

Title Novel EEG Biomarker to Distinguish Anti-NMDAR Encephalitis from Other Types of Autoimmune Encephalitis

Topic Multiple Sclerosis

Presentation(s) P1 - Poster Session 1 (9:00 AM-5:00 PM)

Poster/Presentation
Number 295

Objective To identify the biomarker of electroencephalogram (EEG) to facilitate early distinction between anti-N-methyl-D-aspartate receptor encephalitis (NMDARE) and other types of autoimmune encephalitis (other AEs).

Background The electroencephalographic features of NMDARE, which include extreme delta brush and excessive beta activity, have been reported. However, it is uncertain how the characteristic findings of NMDARE can help distinguish it from other AEs.

Design/Methods We reviewed the admission EEGs of the patients who fulfilled the diagnostic criteria 2016 (Graus criteria) of definite NMDARE and other AEs, and were treated at our department between January 2014 and October 2020. The power value (PV) analyses of all subjective EEGs were implemented using the following method: 1) extract the 13 regions of interest that were randomly selected 10-second artifact and seizure free area, 2) compare the total PV after fast Fourier transform on C3-C4 channels in each frequency band. Statistical significance was tested using the Mann-Whitney U test.

Results Nine patients with NMDARE (median age: 21 years; 8 women) and 12 with other AEs (median age: 37.5 years; 6 women) met the Graus criteria and were enrolled in the study. Based on the comparative analyses of the PV, novel indicators were identified, namely Fast Slow Ratio (FSR) (PV of total β/PV of total δ+θ). The median FSR (0.139 vs. 0.029, p=0.004) was significantly higher for NMDARE group than the other AEs group. The ROC curve area of FSR was 0.86 (95% CI 0.70-1.00), and cutoff value of 0.047 yielded a specificity of 75.0% and sensitivity of 100.0%.

Conclusions Novel EEG indicators, FSR, is non-invasive biomarkers that appear useful in early distinction between NMDARE and other AEs.

Authors/Disclosures
Tomotaka Mizoguchi PRESENTER	Tomotaka Mizoguchi has nothing to disclose.
Makoto Hara, MD (Nihon University School of Medicine)	Dr. Hara has nothing to disclose.
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