Fixel-based analysis links white matter characteristics, serostatus and clinical features in limbic encephalitis

Structural network topology in limbic encephalitis is associated with amygdala enlargement, memory performance and serostatus

“…18 Altogether, our findings underline the concept that GAD-LE is a disease entity involving a variety of anatomical structures across the entire brain and beyond the mesial temporal lobe. 3,5 With regard to LGI1-LE and as previously hypothesized, in contrast, our results point toward a less widespread pathology with a clear focus on mesiotemporal structures. 5,6 The absence of significant alterations of network topology in CASPR2-LE may be grounded in insufficient statistical power due to the small sample size on the one hand, and on the other hand, previous literature has reported only subtle MRI findings in CASPR2-LE.…”

“…9 As it remains unclear whether LE is a predominantly unihemispheric process, we defined either one hemisphere as the predominantly affected hemisphere or both hemispheres as affected hemispheres according to a two-step classification scheme based on electroencephalographic data and mesiotemporal volumetry described elsewhere. 2,3,10 Twenty-six healthy control subjects from a preexisting in-house database were individually age-and gender-matched to the LE patients. Moreover, presurgical scans of 20 epilepsy patients with histologically confirmed HS who underwent selective amygdalohippocampectomy were included.…”

“…1 Growing evidence suggests that the clinical picture of LE patients including their magnetic resonance imaging (MRI) signature largely depends on the associated antibody. 2,3 Antibodies against glutamic acid decarboxylase 65 (GAD), leucine-rich glioma-inactivated 1 (LGI1), and contactin-associated protein-like 2 (CASPR2) are most commonly found in LE patients. 1 Previous imaging research in the field of LE has mostly focused on identifying structural alterations of either mesiotemporal gray matter regions or white matter tracts.…”

“…1 Previous imaging research in the field of LE has mostly focused on identifying structural alterations of either mesiotemporal gray matter regions or white matter tracts. 2,3 Nevertheless, these approaches are limited in their ability to gain insights into pathological processes at a larger scale. To integrate previous findings into a global and functionally relevant framework, we chose to apply a structural connectivity network model.…”

“…Limbic encephalitis (LE) comprises a spectrum of autoimmune brain diseases characterized by temporal lobe epilepsy and memory impairment 1 . Growing evidence suggests that the clinical picture of LE patients including their magnetic resonance imaging (MRI) signature largely depends on the associated antibody 2,3 . Antibodies against glutamic acid decarboxylase 65 (GAD), leucine‐rich glioma‐inactivated 1 (LGI1), and contactin‐associated protein‐like 2 (CASPR2) are most commonly found in LE patients 1 .…”