2026-06-01T06:02:33Zhttps://riuma.uma.es/rest/oai/request

oai:riuma.uma.es:10630/371442026-02-03T11:06:37Zcom_10630_2254col_10630_37953

Prognostic Value of Persistent CSF Antibodies at 12 Months in Anti-NMDAR Encephalitis. Ciano-Petersen, Nicolas Lundahl Mélisse, Robert Muñiz-Castrillo, Sergio Wucher, Valentin Klich, Amna Alberto Vogrig, Alberto Villagrán García, Macarena Antonio Farina, Antonio David Goncalves, David Geraldine Picard, Geraldine Veronique Rogemond, Veronique Bastien Joubert, Bastien Oliver-Martos, Begoña Serrano-Castro, Pedro Jesús Maucort-Boulch, Delphine Honnorat, Jerome Encefalitis Background and objectives: Anti-NMDA receptor (NMDAR) encephalitis is defined by the presence of antibodies (Abs) targeting the NMDAR in the CSF. This study aimed to determine the prognostic value of persistent CSF NMDAR-Abs during follow-up. Methods: This retrospective observational study included patients diagnosed with anti-NMDAR encephalitis in the French Reference Center for Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis and for whom CSF samples were obtained at diagnosis and >4 months of follow-up to evaluate CSF NMDAR-Ab persistence. Because patients were tested for CSF NMDAR-Abs at different time points, samples were stratified into different periods of follow-up (i.e., 12 months was considered for the 9- to 16-month follow-up period). Results: Among the 501 patients diagnosed with anti-NMDAR encephalitis between January 2007 and June 2020, 89 (17%) were tested between 4 and 120 months for CSF NMDAR-Abs after clinical improvement and included in the study (75/89 women, 84%; median age 20 years, interquartile range [IQR] 16-26). During follow-up, 21 of 89 (23%) patients had a relapse after a median time of 29 months (IQR 18-47), and 20 of 89 (22%) had a poor outcome (mRS ≥3) after a median last follow-up of 36 months (IQR 19-64). Most patients (69/89, 77%) were tested at the 12-month follow-up period, and 42 of 69 (60%) of them had persistent CSF NMDAR-Abs. When comparing patients with persistent or absent CSF NMDAR-Abs at 12 months, poor outcome at the last follow-up was more frequent in the former (38% vs 8%, p = 0.01), who had relapses more often (23% vs 7%), which also appeared earlier in the course of the disease (90% during the following 4 years of follow-up vs 20%), although no significant difference was observed at long-term follow-up (p = 0.15). In addition, patients with persistent CSF NMDAR-Abs at 12 months had higher titers of CSF NMDAR-Abs at diagnosis 2025-01-28T09:17:31Z 2025-01-28T09:17:31Z 2023-05-05 journal article Ciano-Petersen NL, Robert M, Muñiz-Castrillo S, Wucher V, Klich A, Vogrig A, Villagrán García M, Farina A, Goncalves D, Picard G, Rogemond V, Joubert B, Oliver-Martos B, Serrano-Castro PJ, Maucort-Boulch D, Honnorat J. Prognostic Value of Persistent CSF Antibodies at 12 Months in Anti-NMDAR Encephalitis. Neurol Neuroimmunol Neuroinflamm. 2023 May 5;10(4):e200108. doi: 10.1212/NXI.0000000000200108. PMID: 37147137; PMCID: PMC10162705. https://hdl.handle.net/10630/37144 10.1212/NXI.0000000000200108 eng open access American Academy of Neurology