好色先生

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Abstract Details

Multimodal Brain MRI and Cognitive Changes in the Post-Acute Stage of Anti-NMDA Receptor Encephalitis
Autoimmune Neurology
P9 - Poster Session 9 (11:45 AM-12:45 PM)
8-003

We aimed to characterize the course of alterations in brain grey matter (GM) volumetry and diffusion-based white matter (WM) connectivity, and their association with cognitive performance during the post-acute stage of anti-NMDAR encephalitis (NMDARe).

NMDARe has a characteristic post-acute symptomatic stage. Previous studies suggested varying degrees of accompanying brain MRI alterations, but did not prospectively assess the longitudinal evolution of these changes and potential associations with cognitive outcomes.
In this prospective longitudinal cohort study, adult NMDARe patients and age-matched healthy participants (HP) were prospectively examined at 4, 8, 12 and 12-24 months from disease onset with paired cognitive and multimodal MRI assessments including whole brain and regional grey matter (GM) volumetry, and diffusion-based WM connectivity quantified with fractional anisotropy. Differences between NMDARe and HP were analyzed using multilevel linear mixed-effect models.

Twenty-one post-acute NMDARe and 19 HP were included. Compared with HP, patients showed similar global brain volume, but specific regional changes that included atrophy of the middle frontal cortex and enlargement of bilateral hippocampus and right amygdala, mainly during the first 8 months from disease onset, which improved over time. NMDARe patients showed differences in 76/2020 (3.8%; p<0.05, family-wise error rate) WM connections, following two distinct dynamic patterns: reduced connectivity in 63/76 (83%) connections, involving bilateral cingulate, parietal cortex and deep GM, which improved rapidly (first 8 months), and increased connectivity in 13/76 (17%) connections, mainly subcortical areas, which stabilized over time. Regional atrophy and decreased WM connectivity largely explained variability in working memory (87%) and learning and memory (86%) outcomes.

In post-acute NMDARe there is an early phase (first 8 months of symptoms) characterized by rapid improvement of volumetric changes and alterations of WM connectivity, followed by stagnation of these MRI alterations (8-24 months after symptom onset). These alterations occur in association with protracted cognitive deficits.
Authors/Disclosures
Mar Guasp, MD (Hospital Clínic Barcelona - IDIBAPS)
PRESENTER 		Dr. Guasp has nothing to disclose.
Francesc Vivó Pascual, MD Mr. Vivó Pascual has nothing to disclose.
Eloy Martínez-Heras, Sr., PhD Mr. Martínez-Heras has nothing to disclose.
Elisabeth Solana, PhD Ms. Solana has nothing to disclose.
Eugenia Martinez-Hernandez, MD (Hospital Clinic Barcelona) Dr. Martinez-Hernandez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Martinez-Hernandez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB. The institution of Dr. Martinez-Hernandez has received research support from Instituto de Salud Carlos III. The institution of Dr. Martinez-Hernandez has received research support from Fundacio La Caixa. Dr. Martinez-Hernandez has received personal compensation in the range of $500-$4,999 for serving as a support for attending meetings and speaker honoraria with UCB. Dr. Martinez-Hernandez has received personal compensation in the range of $500-$4,999 for serving as a speaker honoraria and attending meetings with Alexion. Dr. Martinez-Hernandez has received personal compensation in the range of $500-$4,999 for serving as a support for attending meetings with CSL Behring.
Amaia Muñoz-Lopetegi (Hospital Clinic of Barcelona) Ms. Muñoz-Lopetegi has nothing to disclose.
Thais Armangue, MD (IDIBAPS-HClinic) Dr. Armangue has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. The institution of Dr. Armangue has received research support from ISCIII(Spanish institute of health) -PI21/00316, Marato TV3, La Caixa Research Foundadion, Pablove Foundation (689368), Torrons Vicens Foundation (PFNR0144), 2021 Invest AEP.
Laia Prades Miss Prades has nothing to disclose.
Elianet Fonseca, MD (HOSPITAL CLINICO DE BARCELONA) Dr. Fonseca has nothing to disclose.
Gisela GISELA, MD, PhD The institution of Dr. GISELA has received research support from Instituto de Salud Carlos III. The institution of Dr. GISELA has received research support from European Comission. The institution of Dr. GISELA has received research support from La Marato TV3. The institution of Dr. GISELA has received research support from Fundació Clínic.
Josefina Castro-Fornieles, PhD Dr. Castro-Fornieles has nothing to disclose.
Albert Compte, PhD The institution of Dr. Compte has received research support from La Caixa Banking Foundation. The institution of Dr. Compte has received research support from Spanish Ministry of Science.
Josep O. Dalmau, MD, PhD, FAAN Dr. Dalmau has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Astellas Research Institute of America. Dr. Dalmau has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen Research & Development . Dr. Dalmau has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for 好色先生. An immediate family member of Dr. Dalmau has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Dalmau has received research support from Sage Therapeutics. The institution of Dr. Dalmau has received research support from Edmond J.Safra Foundation . The institution of Dr. Dalmau has received research support from La Caixa Foundation. The institution of Dr. Dalmau has received research support from Spanish Ministry of Health (ISCIII). The institution of Dr. Dalmau has received research support from Euroimmun, Inc. Dr. Dalmau has received intellectual property interests from a discovery or technology relating to health care. An immediate family member of Dr. Dalmau has received intellectual property interests from a discovery or technology relating to health care. Dr. Dalmau has received intellectual property interests from a discovery or technology relating to health care. An immediate family member of Dr. Dalmau has received intellectual property interests from a discovery or technology relating to health care. Dr. Dalmau has received publishing royalties from a publication relating to health care. Dr. Dalmau has received publishing royalties from a publication relating to health care. Dr. Dalmau has received publishing royalties from a publication relating to health care.
Sara Llufriu Sara Llufriu has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Sara Llufriu has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Sara Llufriu has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merci. Sara Llufriu has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Abbot. Sara Llufriu has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi.