Novel qEEG Biomarker to Distinguish Anti-NMDAR Encephalitis From Other Types of Autoimmune Encephalitis.
Novel qEEG Biomarker to Distinguish Anti-NMDAR Encephalitis From Other Types of Autoimmune Encephalitis.
复制标题
DOI：
10.3389/fimmu.2022.845272
复制
发表时间：
2022
影响因子：
7.3
通讯作者：
Nakajima H
中科院分区：
文献类型：
--
作者：
Mizoguchi T;Hara M;Hirose S;Nakajima H
建立脑电图 (EEG) 诊断生物标志物，以区分抗 N-甲基-d-天冬氨酸受体脑炎 (NMDARE) 和其他类型的自身免疫性脑炎（其他 AE）。我们回顾了 2014 年 1 月至 2020 年 10 月期间在我们机构接受治疗的 90 名急性脑炎患者的临床记录。我们纳入了符合 Graus 等人定义的可能 AE (pAE) 诊断标准的患者。 （pAE 标准），然后分为明确的 NMDARE 和其他 AE。我们调查了主要症状并使用脑电图功率值（PV）分析了所有入院脑电图。使用 Mann-Whitney U 检验或 Fisher 精确检验检验统计显着性。 25 名患者符合 pAE 标准，分为 9 名患有明确 NMDARE 的患者（中位年龄：21 岁；8 名女性）和 12 名患有其他 AE 的患者（中位年龄：37.5 岁；6 名女性）。最终有四人被排除在外。与其他 AE 相比，NMDARE 中言语功能障碍（9/9 vs. 4/12，p = 0.005）和运动障碍（6/9 vs. 1/12，p = 0.016）更常见。 PV 分析揭示了新的定量脑电图 (qEEG) 指数，即快慢比 (FSR)（总 β 的 PV/总 θ + δ 的 PV）。 NMDARE 的 FSR 中位数（0.139 vs. 0.029，p = 0.004）高于其他 AE，FSR 的受试者工作特征曲线面积为 0.86（95% CI 0.70-1.00）。截止值为 0.047，特异性为 0.75，敏感性为 1.00。重点关注不符合 Graus 2016 年“可能的 NMDARE 标准”（proNMDARE 标准）（n = 10）的患者，NMDAR 抗体检测的预测概率为 0.30 (3/10)，在 FSR 大于截止值 (n = 5) 的患者中，该概率增加至 0.60 (3/5)。 NMDARE 组强调言语功能障碍和运动障碍，新型 qEEG 指数 FSR 准确区分 NMDARE 患者和其他 AE。 FSR 是一种很有前途的 NMDARE 诊断标志物，与 proNMDARE 标准相结合表明 AE 患者的 NMDAR 抗体呈阳性结果。
To establish the diagnostic biomarker of electroencephalogram (EEG) to distinguish between anti-N-methyl-d-aspartate receptor encephalitis (NMDARE) and other types of autoimmune encephalitis (other AEs). We reviewed the clinical records of 90 patients with acute encephalitis who were treated in our institution between January 2014 and October 2020. We enrolled the patients who fulfilled the diagnostic criteria for possible AE (pAE) defined by Graus et al. (pAE criteria) and then classified into definite NMDARE and other AEs. We investigated the main syndrome and analyzed all admission EEGs using EEG power value (PV). Statistical significance was tested using the Mann–Whitney U test or Fisher’s exact test. Twenty-five patients fulfilled the pAE criteria and were classified into 9 with definite NMDARE (median age: 21 years; 8 women) and 12 with other AEs (median age: 37.5 years; 6 women). Four were eventually excluded. Speech dysfunction (9/9 vs. 4/12, p = 0.005) and movement disorders (6/9 vs. 1/12, p = 0.016) were more frequent in NMDARE than in other AEs. The PV analyses revealed the novel quantitative EEG (qEEG) index, namely, fast slow ratio (FSR) (PV of total beta/PV of total theta + delta). The median FSR (0.139 vs. 0.029, p = 0.004) was higher for NMDARE than other AEs, and the receiver operating characteristic curve area of FSR was 0.86 (95% CI 0.70–1.00). A cutoff value of 0.047 yielded a specificity of 0.75 and a sensitivity of 1.00. Focusing on patients who did not meet the “probable NMDARE criteria” in Graus 2016 (proNMDARE criteria) (n = 10), the pretest probability of NMDAR antibody test was 0.30 (3/10), which increased in patients with an FSR greater than the cutoff (n = 5) to 0.60 (3/5). The NMDARE group highlighted speech dysfunction and movement disorders, and a novel qEEG index FSR accurately distinguished the NMDARE patients from other AEs. The FSR is a promising diagnostic marker for NMDARE that indicates the positive results of NMDAR antibodies in patients with AE when combined with the proNMDARE criteria.
登录
查看更多内容
影响因子：
2
作者：
Baysal-Kirac, Leyla;Tuzun, Erdem;Baykan, Betul
通讯作者：
Baykan, Betul
影响因子：
6
作者：
Giordano, Antonino;Fazio, Raffaella;Martinelli, Vittorio
通讯作者：
Martinelli, Vittorio
影响因子：
2.4
作者：
Moise, Anna-Marieta;Karakis, Ioannis;Rodriguez, Andres
通讯作者：
Rodriguez, Andres
影响因子：
56.3
作者：
Granerod, Julia;Ambrose, Helen E.;Crowcroft, Natasha S.
通讯作者：
Crowcroft, Natasha S.
影响因子：
3.3
作者：
Raja, Pritam;Shamick, Biswas;Netravathi, M.
通讯作者：
Netravathi, M.