| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 5630121 | Journal of Neuroimmunology | 2017 | 7 Pages |
â¢Patients with autoimmune encephalitis may have persistent neurocognitive symptoms and impairments in adaptive behavior.â¢These impairments may not be adequately captured by routine neurologic assessments alone.â¢Comprehensively elucidating persistent impairments and predicting patients at high risk will allow for care optimization.
This study evaluates long-term neurobehavioral function in patients with clinically diagnosed autoimmune encephalitis (AE) of various etiologies through retrospective chart review and a cross-sectional structured telephone interview. Of 77 patients meeting clinical diagnostic criteria for AE over a ten year period, 39/77 (51%) patients had known AE-associated antibodies, and 38/77 (49%) had no detected antibody. 9/77 (12%) died, and 26/77 (34%) had “poor” neurologic disability score (mRS 3-5) at the last documented follow-up. 44 participants enrolled in the telephone interview, of whom 38/44 (86%) endorsed ongoing difficulties with fatigue, emotional lability, short-term memory, and/or concentration. On standardized assessment of adaptive behavior (ABAS-3), 23/44 (52%) scored “below average” (general adaptive composite: mean 86.95, standard deviation 18.45). Of the participants with “good” neurologic disability outcome (mRS 0-2), 12/30 (40%) scored “below average” in adaptive behavior. In summary, patients with AE frequently have persistent impairments in neurologic disability, neurocognitive symptomatology, and adaptive behavior, which may not be adequately captured by routine neurologic assessments. Comprehensively elucidating these persistent neurobehavioral impairments and predicting which patients are at highest risk will allow for optimal care of patients and their families.
Graphical abstractAdaptive behavior (General Adaptive Composite Standard Score) worsens with worsening neurologic disability (mRS), however, a proportion of patients who score well on neurologic disability measures still score below average on adaptive behavior.Download high-res image (38KB)Download full-size image
