Hippocampal Functional Dynamics Are Clinically Implicated in Autoimmune Encephalitis With Faciobrachial Dystonic Seizures

Frontiers in Neurology

Jonathan G. Best¹  Sarosh R. Irani¹  Julia C. Nantes²  Charlotte J. Stagg³  Adam Al-Diwani⁴  Clive R. Rosenthal⁵  Natalie L. Voets⁶  Adam G. Thomas⁷ 

[1] Autoimmune Neurology Group, Nuffield Department of Clinical Neurosciences, Oxford, United Kingdom;Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada;Department of Psychiatry, Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, United Kingdom;Department of Psychiatry, University of Oxford, Oxford, United Kingdom;Division of Clinical Neurology, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom;Physiological Neuroimaging Group, Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom;Section on Functional Imaging Methods, Department of Health and Human Services, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States;

关键词: seizures;    hippocampus;    fMRI;    LGI1;    cognitive impairment;   

DOI  :  10.3389/fneur.2018.00736

来源: DOAJ

【 摘 要 】

This is the first study to investigate functional brain activity in patients affected by autoimmune encephalitis with faciobrancial dystonic seizures (FBDS). Multimodal 3T MRI scans, including structural neuroimaging (T1-weighted, diffusion weighted) and functional neuroimaging (scene-encoding task known to activate hippocampal regions), were performed. This case series analysis included eight patients treated for autoimmune encephalitis with FBDS, scanned during the convalescent phase of their condition (median 1.1 years post-onset), and eight healthy volunteers. Compared to controls, 50% of patients showed abnormal hippocampal activity during scene-encoding relative to familiar scene-viewing. Higher peak FBDS frequency was significantly related to lower hippocampal activity during scene-encoding (p = 0.02), though not to markers of hippocampal microstructure (mean diffusivity, p = 0.3) or atrophy (normalized volume, p = 0.4). During scene-encoding, stronger within-medial temporal lobe (MTL) functional connectivity correlated with poorer Addenbrooke's Cognitive Examination-Revised memory score (p = 0.03). These findings suggest that in autoimmune encephalitis, frequent seizures may have a long-term impact on hippocampal activity, beyond that of structural damage. These observations also suggest a potential approach to determine on-going MTL performance in this condition to guide long-term management and future clinical trials.

【 授权许可】

Unknown