Electroclinical biomarkers of autoimmune encephalitis.

Abstract

OBJECTIVE:

To evaluate the utility of electroencephalography (EEG) changes as diagnostic and prognostic biomarkers in acute autoimmune encephalitis (AIE).

METHODS:

One hundred and thirty-one patients with AIE were recruited retrospectively across 7 hospitals. Clinical data were collected during admission and at 12 months. EEGs were reviewed using a standard reporting proforma. Associations between EEG biomarkers, AIE subtypes, and clinical outcomes were assessed using logistic regression modeling.

RESULTS:

Presence of superimposed fast activity (OR 34.33; 95% CI 3.90, 4527.27; p < 0.001), fluctuating EEG abnormality (OR 6.60; 95% CI 1.60, 37.59; p = 0.008), and hemispheric focality (OR 28.48; 95% CI 3.14, 3773.14; p < 0.001) were significantly more common in N-methyl-d-aspartate receptor (NMDAR) antibody-associated patients with AIE compared to other AIE subtypes. Abnormal background rhythm was associated with a poor mRS (modified Rankin score) at discharge (OR 0.29; 95% CI 0.10, 0.75; p = 0.01) and improvement in mRS at 12 months compared with admission mRS (3.72; 95% CI 1.14, 15.23; p = 0.04).

SIGNIFICANCE:

We have identified EEG biomarkers that differentiate NMDAR AIE from other subtypes. We have also demonstrated EEG biomarkers that are associated with poor functional outcomes.

• Authors: Robb Wesselingh, James Broadley, Katherine Buzzard, David Tarlinton, Udaya Seneviratne, Chris Kyndt, Jim Stankovich, Paul Sanfilippo, Cassie Nesbitt, Wendyl D'Souza, Richard Macdonell, Helmut Butzkueven, Terence J O'Brien, Mastura Monif
• Journal: Epilepsy & behavior : E&B (Epilepsy Behav) Vol. 128 Pg. 108571 (03 2022) ISSN: 1525-5069 [Electronic] United States
• PMID: 35101840 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2022 Elsevier Inc. All rights reserved.

Chemical References

• Biomarkers

Topics

• Anti-N-Methyl-D-Aspartate Receptor Encephalitis (complications)
• Biomarkers
• Electroencephalography
• Hashimoto Disease (complications, diagnosis)
• Humans
• Retrospective Studies