Global brain atrophy and metabolic dysfunction in LGI1 encephalitis: A prospective multimodal MRI study
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Global brain atrophy and metabolic dysfunction in LGI1 encephalitis : A prospective multimodal MRI study. / Szots, Monika; Blaabjerg, Morten; Orsi, Gergely; Iversen, Pernille; Kondziella, Daniel; Madsen, Camilla G.; Garde, Ellen; Magnusson, Peter O.; Barsi, Peter; Nagy, Ferenc; Siebner, Hartwig R.; Illes, Zsolt.
In: Journal of the Neurological Sciences, Vol. 376, 2017, p. 159-165.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Global brain atrophy and metabolic dysfunction in LGI1 encephalitis
T2 - A prospective multimodal MRI study
AU - Szots, Monika
AU - Blaabjerg, Morten
AU - Orsi, Gergely
AU - Iversen, Pernille
AU - Kondziella, Daniel
AU - Madsen, Camilla G.
AU - Garde, Ellen
AU - Magnusson, Peter O.
AU - Barsi, Peter
AU - Nagy, Ferenc
AU - Siebner, Hartwig R.
AU - Illes, Zsolt
PY - 2017
Y1 - 2017
N2 - Background: Chronic cognitive deficits are frequent in leucin-rich glioma-inactivated 1 protein (LGI1) encephalitis. We examined structural and metabolic brain abnormalities following LGI1 encephalitis and correlated findings with acute and follow-up clinical outcomes. Methods: Nine patients underwent prospective multimodal 3 Tesla MRI 33.1 ± 18 months after disease onset, including automated volumetry, diffusion tensor imaging (DTI) and magnetic resonance spectroscopy (MRS). Data were compared to 9 age- and sex-matched healthy controls. Results: Although extratemporal lesions were not present on MRI in the acute stage, tract-based spatial statistics analyses of DTI during follow-up showed widespread changes in the cerebral and cerebellar white matter (WM), most prominent in the anterior parts of the corona radiata, capsula interna and corpus callosum. MRS revealed lower glutamine/glutamate WM levels compared to controls. Higher cerebellar gray matter volume was associated with better function at disease onset (measured by the modified Rankin Scale), and higher putaminal volume was associated with better cognition by Addenbrooke's Cognitive Examination test at 23.4 ± 7.6 months. Conclusions: Poor clinical outcome following LGI1 encephalitis is associated with global brain atrophy and disintegration of white matter tracts. The pathological changes affect not only temporomesial structures but also frontal lobes and the cerebellum.
AB - Background: Chronic cognitive deficits are frequent in leucin-rich glioma-inactivated 1 protein (LGI1) encephalitis. We examined structural and metabolic brain abnormalities following LGI1 encephalitis and correlated findings with acute and follow-up clinical outcomes. Methods: Nine patients underwent prospective multimodal 3 Tesla MRI 33.1 ± 18 months after disease onset, including automated volumetry, diffusion tensor imaging (DTI) and magnetic resonance spectroscopy (MRS). Data were compared to 9 age- and sex-matched healthy controls. Results: Although extratemporal lesions were not present on MRI in the acute stage, tract-based spatial statistics analyses of DTI during follow-up showed widespread changes in the cerebral and cerebellar white matter (WM), most prominent in the anterior parts of the corona radiata, capsula interna and corpus callosum. MRS revealed lower glutamine/glutamate WM levels compared to controls. Higher cerebellar gray matter volume was associated with better function at disease onset (measured by the modified Rankin Scale), and higher putaminal volume was associated with better cognition by Addenbrooke's Cognitive Examination test at 23.4 ± 7.6 months. Conclusions: Poor clinical outcome following LGI1 encephalitis is associated with global brain atrophy and disintegration of white matter tracts. The pathological changes affect not only temporomesial structures but also frontal lobes and the cerebellum.
KW - Anti-LGI1 antibody
KW - Cognition
KW - Diffusion tensor imaging
KW - Limbic encephalitis
KW - MR-spectroscopy
KW - Volumetry
U2 - 10.1016/j.jns.2017.03.020
DO - 10.1016/j.jns.2017.03.020
M3 - Journal article
C2 - 28431605
AN - SCOPUS:85016081100
VL - 376
SP - 159
EP - 165
JO - Journal of the Neurological Sciences
JF - Journal of the Neurological Sciences
SN - 0022-510X
ER -
ID: 188755906