Aberrant multimodal brain networks in patients with anti‐NMDA receptor encephalitis

• Published in: CNS neuroscience & therapeutics Vol. 27; no. 6; pp. 652 - 663
• Main Authors: Wang, Jinhui, Duan, Yunyun, Zhang, Tian, Huang, Jing, Ren, Zhuoqiong, Ye, Jing, Wang, Ningkai, Li, Yinzhi, Chen, Xiaoya, Gao, Peiyi, Li, Kuncheng, Liu, Yaou
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Inc 01.06.2021; John Wiley and Sons Inc
• Subjects: Adult; Anti-N-Methyl-D-Aspartate Receptor Encephalitis - diagnostic imaging; Anti-N-Methyl-D-Aspartate Receptor Encephalitis - pathology; Anti-N-Methyl-D-Aspartate Receptor Encephalitis - psychology; anti‐NMDAR encephalitis; Brain; Brain - physiopathology; brain network; Cognitive ability; Cognitive Dysfunction - etiology; Cognitive Dysfunction - psychology; cognitive impairment; Diffusion Tensor Imaging; Efficiency; Encephalitis; Female; Glutamic acid receptors; Glutamic acid receptors (ionotropic); Humans; lateral orbital gyrus; Magnetic Resonance Imaging; Male; Memory; Morphology; Multimodal Imaging; multimodal magnetic resonance imaging; N-Methyl-D-aspartic acid receptors; Nerve Net - diagnostic imaging; Nerve Net - pathology; Neuropsychological Tests; Neuropsychology; Original; Prefrontal Cortex - diagnostic imaging; Prefrontal Cortex - pathology; Prefrontal Cortex - physiopathology; Software; Structure-function relationships; Therapeutic targets; Time series; Young Adult; cognitive impairment; brain network; lateral orbital gyrus; anti-NMDAR encephalitis; multimodal magnetic resonance imaging
• ISSN: 1755-5930; 1755-5949
• DOI: 10.1111/cns.13632

Aims To explore large‐scale brain network alterations and examine their clinical and neuropsychological relevance in patients with anti‐N‐methyl‐D‐aspartate receptor (NMDAR) encephalitis. Methods Twenty‐four patients with anti‐NMDAR encephalitis and 26 matched healthy controls (HCs) were enrolled in our study. Based on the multimodal MRI dataset, individual morphological, structural, and functional brain networks were constructed and compared between the two groups at multiple levels. The associations with clinical/neuropsychological variables and the discriminant ability of significant alterations were further studied. Results Multimodal network analysis revealed that anti‐NMDAR encephalitis mainly affected morphological and structural networks, but subtle alterations were observed in functional networks. Intriguingly, decreased network local efficiency was observed for both morphological and structural networks and increased nodal centrality in the lateral orbital gyrus was convergently observed among the three types of networks in the patients. Moreover, the alterations, particularly those from structural networks, accounted largely for cognitive deficits of the patients and could distinguish the diseased individuals from the HCs with excellent performance (area under the curve =0.933). Conclusions The current study provides a comprehensive view of characteristic multimodal network dysfunction in anti‐NMDAR encephalitis, which is crucial to establish new diagnostic biomarkers and promising therapeutic targets for the disease. The current study provides a comprehensive view of characteristic multimodal network dysfunction in anti‐N‐methyl‐D‐aspartate receptor encephalitis, which is crucial to establish new diagnostic biomarkers and promising therapeutic targets for the disease.