The T1-weighted/T2-weighted ratio as a biomarker of anti-NMDA receptor encephalitis.

Autor:	Hartung TJ; Department of Neurology and Experimental Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany., Cooper G; Department of Neurology and Experimental Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany., Jünger V; Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Berlin, Germany.; Neuroscience Clinical Research Center (NCRC), Charité - Universitätsmedizin Berlin, Berlin, Germany.; Department of Neuroradiology, Charité - Universitätsmedizin Berlin, Berlin, Germany., Komnenić D; Department of Neurology and Experimental Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.; Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany., Ryan L; Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany.; Einstein Center for Neurosciences Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany., Heine J; Department of Neurology and Experimental Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany., Chien C; Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Berlin, Germany.; Neuroscience Clinical Research Center (NCRC), Charité - Universitätsmedizin Berlin, Berlin, Germany.; Medizinische Klinik m.S. Psychosomatik, Charité - Universitätsmedizin Berlin, Berlin, Germany., Paul F; Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Berlin, Germany., Prüss H; Department of Neurology and Experimental Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.; German Center for Neurodegenerative Diseases (DZNE) Berlin, Berlin, Germany., Finke C; Department of Neurology and Experimental Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany carsten.finke@charite.de.
Jazyk:	angličtina
Zdroj:	Journal of neurology, neurosurgery, and psychiatry [J Neurol Neurosurg Psychiatry] 2024 Mar 13; Vol. 95 (4), pp. 366-373. Date of Electronic Publication: 2024 Mar 13.
DOI:	10.1136/jnnp-2023-332069
Abstrakt:	Background: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis rarely causes visible lesions in conventional MRI, yet advanced imaging detects extensive white matter damage. To improve prognostic capabilities, we evaluate the T1-weighted/T2-weighted (T1w/T2w) ratio, a measure of white matter integrity computable from clinical MRI sequences, in NMDAR encephalitis and examine its associations with cognitive impairment. Methods: T1-weighted and T2-weighted MRI were acquired cross-sectionally at 3 Tesla in 53 patients with NMDAR encephalitis (81% women, mean age 29 years) and 53 matched healthy controls. Quantitative and voxel-wise group differences in T1w/T2w ratios and associations with clinical and neuropsychological outcomes were assessed. P-values were false discovery rate (FDR) adjusted where multiple tests were conducted. Results: Patients with NMDAR encephalitis had significantly lower T1w/T2w ratios across normal appearing white matter (p=0.009, Hedges' g=-0.51), which was associated with worse verbal episodic memory performance (r=0.39, p=0.005, p(FDR)=0.026). White matter integrity loss was observed in the corticospinal tract, superior longitudinal fascicle, optic radiation and callosal body with medium to large effects (Cohen's d=[0.42-1.17]). In addition, patients showed decreased T1w/T2w ratios in the hippocampus (p=0.002, p(FDR)=0.005, Hedges' g=-0.62), amygdala (p=0.002, p(FDR)=0.005, Hedges' g=-0.63) and thalamus (p=0.010, p(FDR)=0.019, Hedges' g=-0.51). Conclusions: The T1w/T2w ratio detects microstructural changes in grey and white matter of patients with NMDAR encephalitis that correlate with cognitive performance. Computable from conventional clinical MRI sequences, this measure shows promise in bridging the clinico-radiological dissociation in NMDAR encephalitis and could serve as an imaging outcome measure in clinical trials. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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