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Autoimmune encephalitis: Early and late findings on serial MR imaging and correlation to treatment timepoints

Abunada, Mahmoud; Nierobisch, Nathalie; Ludovichetti, Riccardo; Simmen, Cyril; Terziev, Robert; Togni, Claudio; Michels, Lars; Kulcsar, Zsolt; Hainc, Nicolin (2024). Autoimmune encephalitis: Early and late findings on serial MR imaging and correlation to treatment timepoints. European Journal of Radiology Open, 12:100552.

Abstract

INTRODUCTION

MRI is negative in a large percentage of autoimmune encephalitis cases or lacks findings specific to an antibody. Even rarer is literature correlating the evolution of imaging findings with treatment timepoints. We aim to characterize imaging findings in autoimmune encephalitis at presentation and on follow up correlated with treatment timepoints for this rare disease.

METHODS

A full-text radiological information system search was performed for "autoimmune encephalitis" between January 2012 and June 2022. Patients with laboratory-identified autoantibodies were included. MRI findings were assessed in correlation to treatment timepoints by two readers in consensus. For statistical analysis, cell-surface vs intracellular antibody groups were assessed for the presence of early limbic, early extralimbic, late limbic, and late extralimbic findings using the χ$^{2}$ test.

RESULTS

Thirty-seven patients (female n = 18, median age 58.8 years; range 25.7 to 82.7 years) with 15 different autoantibodies were included in the study. Twenty-three (62%) patients were MRI-negative at time of presentation; 5 of these developed MRI findings on short-term follow up. Of the 19 patients with early MRI findings, 9 (47%) demonstrated improvement upon treatment initiation (7/9 cell-surface group). There was a significant difference (p = 0.046) between the MRI spectrum of cell-surface vs intracellular antibody syndromes as cell-surface antibody syndromes demonstrated more early classic findings of limbic encephalitis and intracellular antibody syndromes demonstrated more late extralimbic abnormalities.

CONCLUSION

MRI can be used to help narrow the differential diagnosis in autoimmune encephalitis and can be used as a monitoring tool for certain subtypes of this rare disease.

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Neuroradiology
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Radiology, Nuclear Medicine and Imaging
Language:English
Date:June 2024
Deposited On:17 Jan 2025 14:24
Last Modified:18 Jan 2025 21:00
Publisher:Elsevier
ISSN:2352-0477
OA Status:Gold
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1016/j.ejro.2024.100552
PubMed ID:38327544
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  • Licence: Creative Commons: Attribution 4.0 International (CC BY 4.0)

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