Neurology Neuroimmunology & Neuroinflammation, Journal Year: 2025, Volume and Issue: 12(2)

Published: Jan. 29, 2025

Cognitive deficits represent a major long-term complication of anti-leucine-rich, glioma-inactivated 1 encephalitis (LGI1-E). Although severely affecting patient outcomes, the structural brain changes underlying these remain poorly understood. In this study, we hypothesized link between white matter (WM) networks and cognitive outcomes in LGI1-E. cross-sectional combined clinical assessments, comprehensive neuropsychological testing, diffusion tensor MRI, probabilistic WM tractography, computational network analysis patients with LGI1-E referred to Charité-Universitätsmedizin Berlin. Healthy individuals were recruited as control participants matched for age sex logistic regression propensity scores. Twenty-five (mean = 63 ± 12 years, 76% male) 25 healthy controls enrolled. Eighty-eight percent presented persistent symptoms at postacute follow-up (median: months from onset, interquartile range: 6-23 months)-despite treatment immunotherapy good overall recovery (modified Rankin Scale [mRS] score peak illness vs postacute: z -4.1, p < 0.001, median mRS visit: 1). Neuroimaging revealed that are characterized by (1) systematic reduction whole-brain connectivity (t -2.16, 0.036, d -0.61), (2) cortico-subcortical hypoconnectivity cluster both limbic extralimbic systems, (3) "topological reorganization" marked bidirectional shift relative importance individual regions network. The extent reorganization was strongly associated verbal memory (r -0.56), attention -0.55), executive functions -0.60, all pFDR 0.017). traditionally viewed form encephalitis, our study characterizes "network disorder" affects whole brain. Structural linked multidomain impairment, which not prevented immunotherapy. These findings highlight need closer monitoring improved strategies mitigate impairment

Language: Английский