Assessment of care transitions and caregiver burden in anti-NMDA receptor encephalitis

Tomlinson, Amanda R.; Blum, Raia A.; Kwon, Churl‐Su; Easton, Ava; Yeshokumar, Anusha K.

doi:10.1016/j.yebeh.2020.107066

Cited by 18 publications

(20 citation statements)

References 32 publications

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“…Individuals with severe anti-NMDAR encephalitis generally need intensive care support, longer hospitalization periods, and more complex treatments (6). Furthermore, the population with anti-NMDAR encephalitis demonstrated poor longterm psychosocial function, high care transitions and caregiver burden, and heavy financial burden (7)(8)(9). The pathogenesis of this disease is awaited to clear, and potential biomarkers to indicate the disease development are needed to be explored.…”

Section: Introductionmentioning

confidence: 99%

Elevated ApoB/ApoA-I ratio is associated with acute anti-N-Methyl-D-aspartate receptor encephalitis, but not disease outcomes

Liu

et al. 2022

Front. Neurol.

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ObjectiveThe purpose of the present study is to clarify the relationship between the apolipoprotein B100/apolipoprotein A-I (ApoB/ApoA-I) ratio and anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis.MethodsA total of 71 patients with anti-NMDAR encephalitis were included in this study, and their ApoB/ApoA-I ratios in baseline and follow-up were retrospectively analyzed.ResultsThe ApoB/ApoA-I ratio was closely correlated with the baseline-modified Rankin scale (mRS) score of >3 in patients with anti-NMDAR encephalitis. A subgroup analysis showed obvious differences between the high and low ApoB/ApoA-I ratio groups. The ApoB/ApoA-I ratio was positively correlated with intensive care unit (ICU) treatment, length of hospital stay, baseline mRS score, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). The ratios of the high and low ApoB/ApoA-I groups both improved in the follow-up.ConclusionThe increased ApoB/ApoA-I ratio is associated with acute anti-NMDAR encephalitis, but not disease outcomes. Serum ApoB/ApoA-I ratio was related to inflammation and immunity in peripheral blood. The findings might provide a new idea for further exploration of the pathogenesis and treatment of anti-NMDAR encephalitis.

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Section: Introductionmentioning

confidence: 99%

Elevated ApoB/ApoA-I ratio is associated with acute anti-N-Methyl-D-aspartate receptor encephalitis, but not disease outcomes

Liu

et al. 2022

Front. Neurol.

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“…The involvement of the physical but also psychological and emotional sphere is indeed crucial to understand the burden that this disease can have on the families of both adult and pediatric affected patients. There is evidence that, in adult patients, an inappropriate treatment path could significantly influence the caregiver’s burden [ 57 ]. In a recent study, concerns on at least one measure of neuropsychological (executive functioning), adaptive and emotional behavior were reported in almost 90% of caregivers [ 54 ].…”

Section: Resultsmentioning

confidence: 99%

Neuropsychological Sequelae, Quality of Life and Adaptive Behavior in Children and Adolescents with Anti-NMDAR Encephalitis: A Narrative Review

et al. 2021

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Anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis is a rare autoimmune illness characterized by a constellation of often severe, but treatable, psychiatric and neurological symptoms. Whereas symptoms such as psychosis and bizarre and abnormal motor behavior are common in adults, pediatric patients typically present with behavioral changes, irritability and sleep dysfunction. The recovery phase is usually slow and may be associated with longstanding adaptive, behavioral and neuropsychological problems. Very few studies explored the cognitive and adaptive sequelae in children with anti-NMDAR encephalitis. The present review article suggests that, although most children and adolescents return to their daily life and previous activities, they may have a low quality of life and show neuropsychological sequelae involving language, memory, especially verbal memory, and attentional resources, even after several months from the hospital discharge. In particular, the available results reveal difficulties in cognitive skills involving executive functions. This impairment is considered the “core” of the cognitive profile of young patients with anti-NMDAR encephalitis. On the other hand, some cognitive skills, such as general intelligence, show good overall recovery over time. Additional neuropsychological research evaluating larger samples, more homogenous methods and longitudinal studies is required.

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“…These individuals are integral players in patients' recovery but also have their own physical and psychological needs. 23 A national survey through the Encephalitis Society and the Autoimmune Encephalitis Alliance found communication and expectations for caregivers to be lacking—a finding that was associated with higher levels of caregiver burden. In particular, poor transition from the inpatient to outpatient setting was a strong factor for higher levels of burden and highlighted the need for a comprehensive follow-up in a neurology clinic.…”

Section: Care Coordination and Discharge Planningmentioning

confidence: 99%

“…In particular, poor transition from the inpatient to outpatient setting was a strong factor for higher levels of burden and highlighted the need for a comprehensive follow-up in a neurology clinic. 23 …”

Section: Care Coordination and Discharge Planningmentioning

confidence: 99%

Autoimmune Neurology

Abbatemarco

Day

Titulaer

et al. 2021

Neurol Neuroimmunol Neuroinflamm

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Autoimmune neurology is a rapidly developing specialty driven by an increasing recognition of autoimmunity as the cause for a broad set of neurologic disorders and ongoing discovery of new neural autoantibodies associated with recognizable clinical syndromes. The diversity of clinical presentations, unique pathophysiology, and the complexity of available treatments requires a dedicated multidisciplinary team to diagnose and manage patients. In this article, we focus on antibody-associated autoimmune encephalitis (AE) to illustrate broader themes applicable to the specialty. We discuss common diagnostic challenges including the utilization of clinical assessment tools along with the determination of the prognostic significance of certain autoantibodies, with a focus on implications for long-term management. A growing body of literature demonstrates the long-term cognitive, behavioral, and physical sequelae of AE. Dedicated resources are needed to effectively manage these patients. These resources may be best provided by experienced neurology clinics in partnership with other neurologic subspecialists, as well as psychiatrists, neuropsychologists, and physical medicine and rehabilitation providers.

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Assessment of care transitions and caregiver burden in anti-NMDA receptor encephalitis

Cited by 18 publications

References 32 publications

Elevated ApoB/ApoA-I ratio is associated with acute anti-N-Methyl-D-aspartate receptor encephalitis, but not disease outcomes

Elevated ApoB/ApoA-I ratio is associated with acute anti-N-Methyl-D-aspartate receptor encephalitis, but not disease outcomes

Neuropsychological Sequelae, Quality of Life and Adaptive Behavior in Children and Adolescents with Anti-NMDAR Encephalitis: A Narrative Review

Autoimmune Neurology

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