The neuropsychological spectrum of anti-LGI1 antibody mediated autoimmune encephalitis

Griffith, Sarah; Malpas, Charles B; Alpitsis, Rubina; O’Brien, Terence J.; Monif, Mastura

doi:10.1016/j.jneuroim.2020.577271

Cited by 32 publications

(54 citation statements)

References 35 publications

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“…In the last few decades, the eld of autoimmune epilepsy has received increasing attention with the discovery of different subtypes of neural autoantibodies. 5,[16][17][18][19] In the latest 2017 epilepsy classi cation, autoimmune epilepsy has been recognized as a distinct entity by the International League Against Epilepsy. 20 Most patients with autoimmune epilepsy present with seizures, cognitive decline, and behavioral or psychiatric dysfunction.…”

Section: Discussionmentioning

confidence: 99%

“…A total of 117 patients, who were diagnosed with anti-LGI1 encephalitis according to the diagnostic criteria suggested by previous studies 6,8 , were retrospectively selected from the database of 5 , and γ-aminobutyric acid receptor-B (GABABR) from 49 patients were assessed by indirect immuno uorescence tests in serum or CSF. The protocol for indirect immuno uorescence was followed according to the instructions provided by the manufacturer (Euroimmun, Germany).…”

Section: Methodsmentioning

confidence: 99%

“…Leucine-rich glioma inactivated 1 (LGI1) is one of the antigenic targets of voltagegated potassium channel (VGKC) complex antibodies associated with AE. 4,5 Since its rst report in 2010, 6,7 increasing numbers of anti-LGI1 encephalitis cases have been identi ed and reported.…”

Section: Introductionmentioning

confidence: 99%

“…According to previous reports, there are differences between countries in clinical features and treatment strategies of anti-LGI1 encephalitis. 4,5,8,9 China proposed a consensus for the management of AE in 2017 to better identify and manage this disease in Chinese patients. 10 Due to the lack of reports with relatively large sample sizes and since an AE-related antibody analysis is not routinely performed, the data of clinical characteristics and long-term prognoses of Chinese patients with anti-LGI1 encephalitis is limited.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Long-term Outcomes of Patients with Anti–Leucine-Rich Glioma-Inactivated 1 Encephalitis

Qiao¹,

Wu²,

Liu³

et al. 2020

Preprint

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Background: This report aims to provide a detailed description of the clinical manifestation, immunotherapy, and long-term outcomes of 117 Chinese patients with anti-leucine-rich glioma-inactivated 1 (LGI1) encephalitis. Methods: We retrospectively selected 117 patients diagnosed with anti-LGI1 encephalitis from the databases of multiple clinical centers from September 2014 to December 2019. The clinical features, ancillary test results, and details of long-term outcomes were analyzed.Results: Among the 117 anti-LGI1 encephalitis patients, 81 (69%) were male and 36 (31%) were female; the median onset age was 51 years (range: 30-77 years). The median time from symptom onset until diagnosis was 8.7 weeks (range: 2-49 weeks). The main features evaluated in our cohort were seizures, cognitive impairment, and mental and behavioral abnormalities. One hundred and nine patients were treated with immunotherapy, After 3-5 days of treatment, the clinical symptoms were somewhat alleviated in all the patients, and their memory, mental ability, and behavior improved. The median follow-up time was 33 months (range: 6-59 months). A total of 19 (16%) patients experienced a relapse; the median duration from onset to the first relapse was 5 (0.3-27) months. There were no mortalities during the follow-up period.Conclusions: The outcome of patients with anti-LGI1 encephalitis is mostly favorable, although some patients continue to suffer from cognitive dysfunction. Early recognition is of great significance for the treatment of anti-LGI1 encephalitis. Prompt adequate immunotherapy has positive implications for the improvement of clinical symptoms of anti-LGI1 encephalitis. Long-term follow-up is important for the assessment of LGI1 antibody-mediated encephalitis.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Long-term Outcomes of Patients with Anti–Leucine-Rich Glioma-Inactivated 1 Encephalitis

Qiao¹,

Wu²,

Liu³

et al. 2020

Preprint

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“…His mental state improved greatly and EEG recovered to normal. [3][4] . Anti-GABA B R encephalitis mostly presents limbic encephalitis symptoms, with temporal lobe epilepsy as the core symptomatology, and most of them are accompanied by cognitive function decline, personality change and mental behavior abnormality.…”

Section: Case Presentationmentioning

confidence: 99%

Autoimmune encephalitis with antibodies against Leucinie-rich Glioma Inactivated 1 and γ-aminobutyric acid-beta-receptor: case report and literature review

Xie

Wen

Zhao

et al. 2020

Preprint

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A 60-year-old man presented with slow response and psychosis. Apart from hyponatremia, serum test also showed positive anti-Leucinie-rich Glioma Inactivated 1 (anti-LGI1) and anti-γ-aminobutyric acid-beta-receptor (anti-GABABR), and electroencephalogram exhibited moderate diffusion abnormality. The patient responded well to steroid treatment. Here we report the first autoimmune encephalitis(AE) characterized by positive anti-LGI1 and anti-GABABR, as well as summarizing AE with multiple auto-antibodies reported so far, hopefully to provide experience for clinical practice.

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Memory function in autoimmune encephalitis: a cross-sectional prospective study utilising multiple memory paradigms

Griffith,

Wesselingh,

Seery

et al. 2024

J Neurol

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Background and objective Autoimmune encephalitis (AE) is often associated with clinically significant memory impairment. This study aimed to evaluate memory in a cross-sectional prospective AE cohort using multiple memory paradigms. Methods 52 patients (50% seropositive) meeting Graus criteria for possible AE were prospectively recruited between October 2019 and August 202. A comprehensive examination of memory was performed, including tests of supraspan verbal memory (list learning), logicosemantic memory (story learning), figural memory (learning of geometric designs), and verbal associative learning (verbal paired associates). Memory scores were compared to demographically adjusted normative data. Pattern analysis was conducted to assist in the identification of patterns in memory performances. Results Mean memory scores were not significantly below the normative mean. At an individual patient level, over 20% of the cohort exhibited impaired delayed figural memory, supraspan verbal memory learning and recall. Observed performances were significantly below expected performance for story learning (p = 0.017) and recall (p = 0.003), figural recall (p < 0.0001), initial acquisition (p < 0.001) and final acquisition of a list (p < 0.001) and all delayed recall measures of the list (p < 0.00001). 54.76% of patients exhibited intact psychometrics, and 16 distinct patterns of impairment emerged, indicating variability in memory outcomes. Discussion While statistical evidence for memory impairment did not emerge at an aggregate level, a proportion of patients present with evidence of abnormal memory performance on psychometrics. Variability in impaired memory measures argues for an individualised patient-focused approach to clinical assessment in AE. Future research should validate these findings with a larger sample size and explore the relationships between memory profiles and other cognitive functions.

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The neuropsychological spectrum of anti-LGI1 antibody mediated autoimmune encephalitis

Cited by 32 publications

References 35 publications

Long-term Outcomes of Patients with Anti–Leucine-Rich Glioma-Inactivated 1 Encephalitis

Long-term Outcomes of Patients with Anti–Leucine-Rich Glioma-Inactivated 1 Encephalitis

Autoimmune encephalitis with antibodies against Leucinie-rich Glioma Inactivated 1 and γ-aminobutyric acid-beta-receptor: case report and literature review

Memory function in autoimmune encephalitis: a cross-sectional prospective study utilising multiple memory paradigms

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