RT Journal Article
SR Electronic
T1 MRI Features and Their Association With Outcomes in Children With Anti-NMDA Receptor Encephalitis
JF Neurology - Neuroimmunology Neuroinflammation
JO Neurol Neuroimmunol Neuroinflamm
FD Lippincott Williams & Wilkins
SP e200130
DO 10.1212/NXI.0000000000200130
VO 10
IS 4
A1 Grace Gombolay
A1 J. Nicholas Brenton
A1 Jennifer H. Yang
A1 Coral M. Stredny
A1 Ryan Kammeyer
A1 Catherine E. Otten
A1 NgocHanh Vu
A1 Jonathan D. Santoro
A1 Karla Robles-Lopez
A1 Andrew Christiana
A1 Claude Steriade
A1 Morgan Morris
A1 Mark Gorman
A1 Manikum Moodley
A1 Duriel Hardy
A1 Alexandra B. Kornbluh
A1 Ilana Kahn
A1 Leigh N. Sepeta
A1 Anusha Yeshokumar
A1 and the Conquering Neuroinflammation and Epilepsies Consortium (CONNECT)
YR 2023
UL http://nn.neurology.org/content/10/4/e200130.abstract
AB Objectives How brain MRI lesions associate with outcomes in pediatric anti-NMDA receptor encephalitis (pNMDARE) is unknown. In this study, we correlate T2-hyperintense MRI brain lesions with clinical outcomes in pNMDARE.Methods This was a multicenter retrospective cohort study from 11 institutions. Children younger than 18 years with pNMDARE were included. One-year outcomes were assessed by the modified Rankin Score (mRS) with good (mRS ≤2) and poor (mRS ≥3) outcomes.Results A total of 175 pNMDARE subjects were included, with 1-year mRS available in 142/175 (81%) and 60/175 (34%) had abnormal brain MRIs. The most common T2-hyperintense lesion locations were frontal, temporal, and parietal. MRI features that predicted poor 1-year outcomes included abnormal MRI, particularly T2 lesions in the frontal and occipital lobes. After adjusting for treatment within 4 weeks of onset, improvement within 4 weeks, and intensive care unit admission, MRI features were no longer associated with poor outcomes, but after multiple imputation for missing data, T2 frontal and occipital lesions associated with poor outcomes.Discussion Abnormal frontal and occipital lesions on MRI may associate with 1-year mRS in pNMDARE. MRI of the brain may be a helpful prognostication tool that should be examined in future studies.