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J Neurol Neurosurg Psychiatry. 2012 Feb;83(2):195-8. doi: 10.1136/jnnp-2011-300411. Epub 2011 Sep 20.

Cognitive deficits following anti-NMDA receptor encephalitis.

Author information

1
Department of Neurology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany. carsten.finke@charite.de

Abstract

BACKGROUND:

Anti-NMDA receptor (NMDAR) encephalitis is a recently characterised autoimmune disorder mainly affecting young women. Although the clinical features of the acute disease are well characterised, cognitive long-term outcome has not been examined in detail.

METHODS:

The authors investigated cognitive performance in nine patients with proven anti-NMDAR encephalitis after recovery from the acute disease period (median 43 months after disease onset, range 23 to 69). Patients underwent a comprehensive neuropsychological assessment, including memory tasks that have previously been shown to be sensitive for hippocampal dysfunction.

RESULTS:

Substantial persistent cognitive impairments were observed in eight out of nine patients that mainly consisted of deficits in executive functions and memory. The severity of these deficits varied inter-individually. Patients with early immunotherapy performed significantly better. The most severe deficits were observed with inefficient or delayed initial treatment.

CONCLUSION:

Our results suggest that cognitive deficits constitute a major long-term morbidity of anti-NMDAR encephalitis. These deficits relate to the distribution of NMDARs in the human brain and their functional role in normal cognition. Good cognitive long-term outcome may depend on early and aggressive treatment.

PMID:
21933952
PMCID:
PMC3718487
DOI:
10.1136/jnnp-2011-300411
[Indexed for MEDLINE]
Free PMC Article

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