Abstract:
OBJECTIVE:To describe the clinical features and outcome of anti-NMDA receptor (NMDAR) encephalitis in patients ≥45 years old. METHOD:Observational cohort study. RESULTS:In a cohort of 661 patients with anti-NMDAR encephalitis, we identified 31 patients ≥45 years old. Compared with younger adults (18-44 years), older patients were more often male (45% vs. 12%, p < 0.0001), had lower frequency of tumors (23% vs. 51%, p = 0.002; rarely teratomas), had longer median time to diagnosis (8 vs 4 weeks, p = 0.009) and treatment (7 vs. 4 weeks, p = 0.039), and had less favorable outcome (modified Rankin Scale score 0-2 at 2 years, 60% vs. 80%, p < 0.026). In multivariable analysis, younger age (odds ratio [OR] 0.15, confidence interval [CI] 0.05-0.39, p = 0.0001), early treatment (OR 0.60, CI 0.47-0.78, p < 0.0001), no need for intensive care (OR 0.09, CI 0.04-0.22, p < 0.0001), and longer follow-up (p < 0.0001) were associated with good outcome. Rituximab and cyclophosphamide were effective when first-line immunotherapies failed (OR 2.93, CI 1.10-7.76, p = 0.031). Overall, 60% of patients older than 45 years had full or substantial recovery at 24 months follow-up. CONCLUSIONS:Anti-NMDAR encephalitis is less severe in patients ≥45 years old than in young adults, but the outcome is poorer in older patients. In this age group, delays in diagnosis and treatment are more frequent than in younger patients. The frequency of underlying tumors is low, but if present they are usually carcinomas instead of teratomas in younger patients. Early and aggressive immunotherapy will likely improve the clinical outcome.
journal_name
Neurologyjournal_title
Neurologyauthors
Titulaer MJ,McCracken L,Gabilondo I,Iizuka T,Kawachi I,Bataller L,Torrents A,Rosenfeld MR,Balice-Gordon R,Graus F,Dalmau Jdoi
10.1212/WNL.0b013e3182a4a49csubject
Has Abstractpub_date
2013-09-17 00:00:00pages
1058-63issue
12eissn
0028-3878issn
1526-632Xpii
WNL.0b013e3182a4a49cjournal_volume
81pub_type
杂志文章相关文献
NEUROLOGY文献大全abstract:OBJECTIVE:To improve clinical recognition and provide research diagnostic criteria for three clinical syndromes associated with frontotemporal lobar degeneration. METHODS:Consensus criteria for the three prototypic syndromes-frontotemporal dementia, progressive nonfluent aphasia, and semantic dementia-were developed b...
journal_title:Neurology
pub_type: 共识发展会议,杂志文章,评审
doi:10.1212/wnl.51.6.1546
更新日期:1998-12-01 00:00:00
abstract::Idiopathic trigeminal sensory neuropathy is a benign disorder. We report two patients with transient MRI abnormalities, suggesting transient inflammation of the trigeminal nerve caused temporary facial sensory symptoms. ...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.46.5.1455
更新日期:1996-05-01 00:00:00
abstract:OBJECTIVE:To investigate whether quantitative MR techniques can be used to distinguish between mesial temporal sclerosis in patients with a history of prolonged febrile convulsion and in patients without such a history. METHODS:Quantitative hippocampal T2 relaxometry, hippocampal volumetry, and single voxel (1)H-MRS d...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.56.12.1659
更新日期:2001-06-26 00:00:00
abstract:OBJECTIVE:To investigate whether admission hyperglycemia predicts poststroke infections and, if so, whether poststroke infections modify the effect of admission hyperglycemia on functional outcome in ischemic stroke. METHODS:We used data from acute ischemic stroke patients in the Preventive Antibiotics in Stroke Study...
journal_title:Neurology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1212/WNL.0000000000003811
更新日期:2017-04-11 00:00:00
abstract::We used proton magnetic resonance spectroscopy (1H MRS) to investigate the temporal lobes of 25 patients with temporal lobe epilepsy. Spectra were obtained from 2 x 2 x 2 cm cubes in the medial region of the temporal lobe, and were analyzed on the basis of signals from N-acetylaspartate (NAA), creatine + phosphocreati...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.44.8.1411
更新日期:1994-08-01 00:00:00
abstract:OBJECTIVE:To report the CNS syndromes of patients ≥60 years of age with antibodies against neuronal surface antigens but no evidence of brain MRI and CSF inflammatory changes. METHODS:This was a retrospective clinical analysis of patients with antibodies against neuronal surface antigens who fulfilled 3 criteria: age ...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000004541
更新日期:2017-10-03 00:00:00
abstract:OBJECTIVES:Deep brain stimulation of the internal pallidum (GPi-DBS) is an established therapeutic option in treatment-refractory dystonia, and the identification of factors predicting surgical outcome is needed to optimize patient selection. METHODS:In this retrospective multicenter study, GPi-DBS outcome of 8 patien...
journal_title:Neurology
pub_type: 杂志文章,多中心研究
doi:10.1212/WNL.0000000000001312
更新日期:2015-03-03 00:00:00
abstract::We found an antinuclear antibody highly restricted to nuclei of neurons in two patients with subacute sensory neuronopathy complicating oat cell carcinoma of the lung. Serum was tested by indirect immunofluorescence and immunoperoxidase staining. At low concentrations of antibody, only the nuclei of the neurons were s...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.35.4.538
更新日期:1985-04-01 00:00:00
abstract:OBJECTIVE:To perform whole-brain morphometry in patients with frontal lobe epilepsy and evaluate the utility of group-level patterns for individualized diagnosis and prognosis. METHODS:We compared MRI-based cortical thickness and folding complexity between 2 frontal lobe epilepsy cohorts with histologically verified f...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000002374
更新日期:2016-02-16 00:00:00
abstract:BACKGROUND:Cerebral infarctions are common in older persons but their relationship with dementia and cognitive function remains controversial. METHODS:Participants were 164 older Catholic nuns, priests, and brothers who underwent annual clinical evaluation and brain autopsy at death. The authors quantified number and ...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000055863.87435.b2
更新日期:2003-04-08 00:00:00
abstract::A 59-year-old woman with levodopa-responsive parkinsonism complicated by motor fluctuations and generalized levodopa dyskinesia underwent bilateral subthalamic deep brain stimulation (STN DBS) 7 years after symptom onset. DBS improved levodopa-responsive upper extremity bradykinesia but aggravated speech, swallowing, ...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000073986.74883.36
更新日期:2003-07-22 00:00:00
abstract:BACKGROUND:The APOE epsilon4 allele has emerged as a major genetic factor for Alzheimer disease (AD), and its presence has been associated with an increase in beta-amyloid senile plaques (SPs) and neuritic plaques (NPs). Whether it affects neurofibrillary tangle (NFT) accumulation or cholinergic losses in AD remains co...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000128091.92139.0f
更新日期:2004-06-08 00:00:00
abstract:BACKGROUND AND PURPOSE:Resistance to insulin-mediated glucose uptake by peripheral tissues is a cardinal defect in type 2 diabetes mellitus. Insulin resistance is also common among nondiabetic individuals, and may be an important risk factor for stroke in both populations. The authors review the definition, epidemiolog...
journal_title:Neurology
pub_type: 杂志文章,评审
doi:10.1212/wnl.59.6.809
更新日期:2002-09-24 00:00:00
abstract::In muscles with sustained voluntary contraction, EMG activity is transiently inhibited after transcranial magnetic stimulation. We recorded this postexcitatory silent period (SP) at 1.5 times individual stimulus threshold level from the first dorsal interosseus muscle in 65 neurologic patients aged 11 to 80 years. Whe...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.44.5.936
更新日期:1994-05-01 00:00:00
abstract::We retrospectively examined the clinical courses of 20 children with severe near-drowning and divided their outcomes into 3 groups: normal (4), persistent vegetative state (9), and dead (7). We reviewed serial blood glucose levels and cerebral blood flow measured by stable xenon computed tomography within the 1st 48 h...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.40.5.820
更新日期:1990-05-01 00:00:00
abstract:OBJECTIVES:Compensatory processes involving the recruitment of additional cerebral areas can limit cognitive impairment caused by brain damage as revealed by fMRI. Multiple sclerosis (MS) is characterized by frequent cognitive deficiencies and diffuse brain damage. Understanding the missing or disturbed processes resul...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0b013e3181f612e3
更新日期:2010-10-05 00:00:00
abstract:OBJECTIVE:To empirically validate the expanded concept of mild cognitive impairment (MCI), which differentiates between four clinical subtypes-amnestic MCI-single domain, amnestic MCI-multiple domains, nonamnestic MCI-single domain, and nonamnestic MCI-multiple domains-and to examine the prevalence, course, and outcome...
journal_title:Neurology
pub_type: 杂志文章,随机对照试验
doi:10.1212/01.wnl.0000249117.23318.e1
更新日期:2006-12-26 00:00:00
abstract::T, B, and "null" lymphocytes were determined in peripheral blood obtained from 24 control subjects and 15 multiple sclerosis patients. The total number of lymphocytes and T lymphocytes were reduced significantly in multiple sclerosis patients as compared with those of controls. Although the percentage of B lymphocytes...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.26.10.997
更新日期:1976-10-01 00:00:00
abstract::Twenty-nine untreated patients diagnosed with probable AD and 15 control patients underwent two or more clinical and volumetric MRI assessments with intervals ranging from 5 months to 6 years. The change in global cerebral volume for an individual was calculated by a novel method of registration and subtraction of ser...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.52.8.1687
更新日期:1999-05-12 00:00:00
abstract:OBJECTIVE:To determine the diagnostic value of high-resolution ultrasound (HRUS) for detection of chronic inflammatory demyelinating polyneuropathy (CIDP), Lewis-Sumner syndrome (LSS), and multifocal motor neuropathy (MMN). METHODS:Between January 2013 and January 2015, we enrolled 75 consecutive treatment-naive patie...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000003483
更新日期:2017-01-10 00:00:00
abstract::We observed that patients with amnesia after cardiac arrest had preserved recognition memory despite profound loss of recall memory. In the present study, rate of forgetting was measured in six amnesic subjects for both recall and recognition memory of verbal material. The data show that recall decayed significantly f...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.36.3.408
更新日期:1986-03-01 00:00:00
abstract:OBJECTIVE:To determine whether patients with Alzheimer disease (AD) compensate for neuropathologic changes when performing a mnemonic task by recruiting 1) the same brain regions as age-matched, healthy controls, but to a greater extent; 2) additional brain regions not activated by controls; or 3) both. METHODS:Twelve...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000237534.31734.1b
更新日期:2006-09-26 00:00:00
abstract:OBJECTIVE:To characterize prospectively the cognitive profile in ALS. METHODS:Clinically definite ALS patients (11 men, 2 women), age 39.9 to 74.0 years (mean age, 54.2 +/- 9.6 years; mean disease duration, 21.1 +/- 10.5 months) underwent neuropsychologic, language, and speech testing followed by MR 1H spectroscopy (4...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.53.8.1665
更新日期:1999-11-10 00:00:00
abstract::We investigated the modulatory effects of human interferon beta (IFN-beta) and gamma (IFN-gamma) on expression of class I and II major histocompatibility complex (MHC) antigens and intercellular adhesion molecule-1 (ICAM-1) in fetal human astrocytes in culture using flow cytometry and immunocytochemistry. Under the ba...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.45.2.367
更新日期:1995-02-01 00:00:00
abstract::The goal of pharmacologic therapy for patients with epilepsy is to suppress seizures without side effects. There is growing interest in developing antiepileptogenic drugs capable of preventing the onset of seizures in patients at high risk and inducing a permanent remission of seizures in patients with epilepsy, i.e.,...
journal_title:Neurology
pub_type: 杂志文章,评审
doi:10.1212/wnl.59.9_suppl_5.s34
更新日期:2002-11-12 00:00:00
abstract::Inclusion-body myositis (IBM) is an inflammatory muscle disease that has proven resistant to treatment. Tumor necrosis factor molecules have been detected in muscle biopsies from patients with IBM. Etanercept is a TNFalpha receptor fusion protein that binds and inactivates tumor necrosis factor. Nine patients were tre...
journal_title:Neurology
pub_type: 临床试验,杂志文章
doi:10.1212/01.wnl.0000192258.32408.54
更新日期:2006-01-24 00:00:00
abstract:OBJECTIVE:To examine associations of average and change in late-life blood pressure (BP) with cerebrovascular and Alzheimer disease (AD) neuropathology in a large group of decedents followed longitudinally in vivo. METHODS:This clinical-pathologic study was derived from prospective, community-based cohort studies of a...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000005951
更新日期:2018-08-07 00:00:00
abstract::The authors sought to determine in a retrospective analysis whether carotid plaque soft TD on CT is associated with recent ischemic neurologic events. Among 141 patients (99 asymptomatic), 106 plaques with more than 50% stenosis were selected for density measurements. They found an odds ratio for neurologic events ass...
journal_title:Neurology
pub_type: 杂志文章,多中心研究
doi:10.1212/01.wnl.0000191391.71614.51
更新日期:2006-01-10 00:00:00
abstract:OBJECTIVE:We prospectively investigated the role of depressive symptoms (DS) on all-cause dementia in a population with small vessel disease (SVD), considering onset age of DS and cognitive performance. METHODS:The RUN DMC study (Radboud University Nijmegen Diffusion Tensor and Magnetic Resonance Cohort) is a prospect...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000003089
更新日期:2016-09-13 00:00:00
abstract:OBJECTIVE:To test the hypothesis that concussion-related brain alterations seen at symptomatic injury and medical clearance to return to play (RTP) will have dissipated by 1 year after RTP. METHODS:For this observational study, 24 athletes with concussion were scanned longitudinally within 1 week after injury, at RTP,...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000008523
更新日期:2019-11-19 00:00:00