Introduction: Anti-leucine-rich glioma-inactivated 1 antibody (anti-LGI1) encephalitis is one of the most common autoimmune encephalitis. Anti-LGI1 encephalitis presented with subacute or acute onset of cognitive impairment, psychiatric disturbances, faciobrachial dystonic seizures (FBDSs), convulsions, and hyponatremia. The common sequela of anti-LGI1 encephalitis is cognitive disorder, but there are few studies on the recovery of cognitive function after immunotherapy. This study aimed to explore clinical characteristics of cognitive impairment and 1-year outcome in patients with anti-LGI1 encephalitis. Methods: The clinical data and characteristics of cognitive impairment of 21 patients with anti-LGI1 encephalitis from 2016 to 2019 in Nanjing Brain Hospital were analyzed retrospectively. At the time of onset of hospitalization and 1 year after discharge, the cognitive functions in these patients were assessed using two cognitive screening scales—Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment-Basic (MoCA-B). Results: Among the 21 patients, 13 were male and 8 were female, aged 51.10 ± 14.69 (age range 20–72) years. Nineteen patients, comprising 90.48%, had recent memory deterioration. Routine electroencephalography (EEG) results of 13 cases were abnormal. EEG results were epileptic or slow-wave activity involving the temporal lobes. Eleven cases of brain MRI were abnormal, and the focus involved the hippocampus and mediotemporal lobe. The decrease of short-term memory [recall scores: 0.57 ± 0.81 (MMSE), 0.76 ± 1.34 (MoCA-B)] is the most obvious at the time of admission. After intravenous (IV) injection of methylprednisolone and/or immunoglobulin, the clinical symptoms of the patients improved obviously. Total MMSE and MoCA-B scores of patients were significant increased after 1 year (21.19 ± 3.54 vs. 26.10 ± 3.02, P < 0.001; and 19.00 ± 4.38 vs. 25.19 ± 4.25, P < 0.001, respectively). Recall scores and orientation scores of MoCA-B were significantly improved after 1 year (0.76 ± 1.34 vs. 3.24 ± 1.48, P < 0.001; and 3.10 ± 1.26 vs. 5.00 ± 1.22, P < 0.001, respectively). However, 3/21 (14.29%) patients still have obvious short-term memory impairment (recall scores ≤ 1). Conclusion: Cognitive impairment is one of the most common manifestations of anti-LGI1 encephalitis, with the main prominent being acute or subacute short-term memory loss. Although most patients with anti-LGI1 encephalitis respond well to immunotherapy, a small number of patients still have cognitive disorders, mainly recent memory impairment, after 1 year.

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BackgroundThe present association between socioeconomic status (SES) and stroke is positive in developing communities, but it is negative in developed countries where a positive SES-stroke relationship was recorded several decades ago. We hypothesized that the SES-stroke relationship in developing societies mirrors the trajectory of the Western countries at some stage of economic development. This study aimed to examine whether this inflexion is approaching in China.MethodsThis study comprises of two cross-sectional surveys conducted in the same urban areas of Nanjing, China in 2000 (S2000) and 2011 (S2011) using the same selection criteria (i.e., aged≥35 years) and sampling approach. Physician-diagnosed stroke was the outcome event, while family average income (FAI) was the explanatory variable and tertiled in our anlaysis. Mixed-effects models were used to examine the FAI-stroke association.ResultsOverall, 19,861 (response rate = 90.1%) and 7824 (response rate = 82.8%) participants participated in the S2000 and S2011, respectively. The prevalence of stroke increased by 2.5-folds (95%CI = 2.2, 2.9) from 2000 (2.1%, 95%CI = 1.9%, 2.3%) to 2011 (5.1%, 95%CI = 4.6%, 5.6%) (p < 0.01). Compared with the lower FAI category, the positive association between stroke prevalence and the higher FAI group decreased from 1.99 (95%CI = 1.55, 2.56) in 2000 to 1.49 (95%CI = 1.09, 2.03) in 2011 after control for potential confounders. A similar pattern was also observed for the middle FAI group (1.60, 95% CI = 1.23, 2.08 in 2000 vs. 1.37, 95%CI = 1.01, 1.88 in 2011).ConclusionsThis study revealed that socioeconomic inequalities in stroke were diminishing in regional China during the recent 11-year period, although the SES-stroke association was still positive. Tailored intervention against stroke should currently target on SES-vulnerable people.