Comparing clinical features, severity and prognosis of autoimmune encephalitis and with and without oligoclonal bands
ObjectiveThis study aimed to examine the clinical distinctions among patients diagnosed with autoimmune encephalitis (AE) based on the presence or absence of cerebrospinal fluid (CSF) oligoclonal bands (OCBs). Additionally, it sought to explore the relationship between OCBs and the severity and prog...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2024-01-01
|
| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1281276/full |
| _version_ | 1797365506634678272 |
|---|---|
| author | Hongfei Xue Xiaochan Guo Yushu Jiang Lingzhi Qin Xiaojuan Wang Jiajia Xu Shaomin Zuo Qiuyan Liu Wei Li |
| author_facet | Hongfei Xue Xiaochan Guo Yushu Jiang Lingzhi Qin Xiaojuan Wang Jiajia Xu Shaomin Zuo Qiuyan Liu Wei Li |
| author_sort | Hongfei Xue |
| collection | DOAJ |
| description | ObjectiveThis study aimed to examine the clinical distinctions among patients diagnosed with autoimmune encephalitis (AE) based on the presence or absence of cerebrospinal fluid (CSF) oligoclonal bands (OCBs). Additionally, it sought to explore the relationship between OCBs and the severity and prognosis of autoimmune encephalitis.MethodsA retrospective analysis was conducted on 94 patients diagnosed with AE at the People’s Hospital of Zhengzhou University between October 2016 and June 2022. The patients were divided into OCB-positive and OCB-negative groups based on CSF-OCBs. Patient severity at admission was assessed utilizing the Clinical Assessment Scale for Autoimmune Encephalitis (CASE) and the modified Rankin scale (mRS). Additionally, some oligoclonal-positive patients underwent dynamic longitudinal analysis of cerebrospinal fluid test indices. The mRS score was ultimately employed to evaluate patients’ short-term prognosis (6 months) and long-term prognosis (at least 12 months) following immunotherapy.ResultsOf the 94 patients, 34 (36.2%) belonged to the OCB-positive group, while 60 (63.8%) belonged to the OCB-negative group. The group with anti-n-methyl-d-aspartate receptor (anti-NMDAR) encephalitis exhibited the highest rate of oligoclonal positivity at 27 (49.1%), followed by anti-aminobutyric acid B receptor (GABABR) encephalitis with 4 cases (30.8%), anti-contactin-associated protein-like 2 (CASPR2) encephalitis with 2 cases (20%), and anti-leucine-rich glioma inactivating protein 1 (LGI1) encephalitis with 1 case (6.25%). No statistically significant differences were found between the two groups regarding gender, age, prodromal symptoms, psychiatric disorders, seizures, language disorders, motor dysfunction, cognitive dysfunction, tumor incidence, and magnetic resonance imaging (MRI) abnormalities (p > 0.05). The OCB-positive group exhibited higher rates of autonomic dysfunction, intensive care unit (ICU) admission, CSF leukocytes, and IgG index compared to the OCB-negative group (p < 0.05). Additionally, the OCB-positive group had significantly higher median CASE and mRS scores prior to immunotherapy than the OCB-negative group (p < 0.001 and p < 0.001). Furthermore, in both short-term follow-up and long-term follow-up, the OCB-positive group had a significantly lower proportion of patients with a favorable prognosis compared to the OCB-negative group (50% vs. 71.7, 61.8% vs. 83.3%; p = 0.036, p = 0.002).ConclusionAutonomic dysfunction, ICU admission, leukocytes in the cerebrospinal fluid, and elevated IgG index are more commonly observed in OCB-positive patients. OCB-positivity has also been linked to the severity and prognosis of AE, making it a potential biomarker. Initial OCB testing aids clinicians in identifying potentially critically ill patients early and monitoring disease progression, thereby optimizing clinical treatment decisions. |
| first_indexed | 2024-03-08T16:50:57Z |
| format | Article |
| id | doaj.art-52bc386b68304f23b5f07ca5b427bb44 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-03-08T16:50:57Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-52bc386b68304f23b5f07ca5b427bb442024-01-05T04:42:48ZengFrontiers Media S.A.Frontiers in Neurology1664-22952024-01-011410.3389/fneur.2023.12812761281276Comparing clinical features, severity and prognosis of autoimmune encephalitis and with and without oligoclonal bandsHongfei Xue0Xiaochan Guo1Yushu Jiang2Lingzhi Qin3Xiaojuan Wang4Jiajia Xu5Shaomin Zuo6Qiuyan Liu7Wei Li8Department of Neurology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou, ChinaDepartment of Neonatology, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Neurology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou, ChinaDepartment of Neurology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou, ChinaDepartment of Neurology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou, ChinaDepartment of Neurology, People’s Hospital of Henan University, Henan Provincial People’s Hospital, Zhengzhou, ChinaDepartment of Neurology, People’s Hospital of Henan University, Henan Provincial People’s Hospital, Zhengzhou, ChinaDepartment of Neurology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou, ChinaDepartment of Neurology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou, ChinaObjectiveThis study aimed to examine the clinical distinctions among patients diagnosed with autoimmune encephalitis (AE) based on the presence or absence of cerebrospinal fluid (CSF) oligoclonal bands (OCBs). Additionally, it sought to explore the relationship between OCBs and the severity and prognosis of autoimmune encephalitis.MethodsA retrospective analysis was conducted on 94 patients diagnosed with AE at the People’s Hospital of Zhengzhou University between October 2016 and June 2022. The patients were divided into OCB-positive and OCB-negative groups based on CSF-OCBs. Patient severity at admission was assessed utilizing the Clinical Assessment Scale for Autoimmune Encephalitis (CASE) and the modified Rankin scale (mRS). Additionally, some oligoclonal-positive patients underwent dynamic longitudinal analysis of cerebrospinal fluid test indices. The mRS score was ultimately employed to evaluate patients’ short-term prognosis (6 months) and long-term prognosis (at least 12 months) following immunotherapy.ResultsOf the 94 patients, 34 (36.2%) belonged to the OCB-positive group, while 60 (63.8%) belonged to the OCB-negative group. The group with anti-n-methyl-d-aspartate receptor (anti-NMDAR) encephalitis exhibited the highest rate of oligoclonal positivity at 27 (49.1%), followed by anti-aminobutyric acid B receptor (GABABR) encephalitis with 4 cases (30.8%), anti-contactin-associated protein-like 2 (CASPR2) encephalitis with 2 cases (20%), and anti-leucine-rich glioma inactivating protein 1 (LGI1) encephalitis with 1 case (6.25%). No statistically significant differences were found between the two groups regarding gender, age, prodromal symptoms, psychiatric disorders, seizures, language disorders, motor dysfunction, cognitive dysfunction, tumor incidence, and magnetic resonance imaging (MRI) abnormalities (p > 0.05). The OCB-positive group exhibited higher rates of autonomic dysfunction, intensive care unit (ICU) admission, CSF leukocytes, and IgG index compared to the OCB-negative group (p < 0.05). Additionally, the OCB-positive group had significantly higher median CASE and mRS scores prior to immunotherapy than the OCB-negative group (p < 0.001 and p < 0.001). Furthermore, in both short-term follow-up and long-term follow-up, the OCB-positive group had a significantly lower proportion of patients with a favorable prognosis compared to the OCB-negative group (50% vs. 71.7, 61.8% vs. 83.3%; p = 0.036, p = 0.002).ConclusionAutonomic dysfunction, ICU admission, leukocytes in the cerebrospinal fluid, and elevated IgG index are more commonly observed in OCB-positive patients. OCB-positivity has also been linked to the severity and prognosis of AE, making it a potential biomarker. Initial OCB testing aids clinicians in identifying potentially critically ill patients early and monitoring disease progression, thereby optimizing clinical treatment decisions.https://www.frontiersin.org/articles/10.3389/fneur.2023.1281276/fullautoimmune encephalitisoligoclonal bandsthe clinical assessment scale for autoimmune encephalitisthe modified Rankin scaleseverity |
| spellingShingle | Hongfei Xue Xiaochan Guo Yushu Jiang Lingzhi Qin Xiaojuan Wang Jiajia Xu Shaomin Zuo Qiuyan Liu Wei Li Comparing clinical features, severity and prognosis of autoimmune encephalitis and with and without oligoclonal bands Frontiers in Neurology autoimmune encephalitis oligoclonal bands the clinical assessment scale for autoimmune encephalitis the modified Rankin scale severity |
| title | Comparing clinical features, severity and prognosis of autoimmune encephalitis and with and without oligoclonal bands |
| title_full | Comparing clinical features, severity and prognosis of autoimmune encephalitis and with and without oligoclonal bands |
| title_fullStr | Comparing clinical features, severity and prognosis of autoimmune encephalitis and with and without oligoclonal bands |
| title_full_unstemmed | Comparing clinical features, severity and prognosis of autoimmune encephalitis and with and without oligoclonal bands |
| title_short | Comparing clinical features, severity and prognosis of autoimmune encephalitis and with and without oligoclonal bands |
| title_sort | comparing clinical features severity and prognosis of autoimmune encephalitis and with and without oligoclonal bands |
| topic | autoimmune encephalitis oligoclonal bands the clinical assessment scale for autoimmune encephalitis the modified Rankin scale severity |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1281276/full |
| work_keys_str_mv | AT hongfeixue comparingclinicalfeaturesseverityandprognosisofautoimmuneencephalitisandwithandwithoutoligoclonalbands AT xiaochanguo comparingclinicalfeaturesseverityandprognosisofautoimmuneencephalitisandwithandwithoutoligoclonalbands AT yushujiang comparingclinicalfeaturesseverityandprognosisofautoimmuneencephalitisandwithandwithoutoligoclonalbands AT lingzhiqin comparingclinicalfeaturesseverityandprognosisofautoimmuneencephalitisandwithandwithoutoligoclonalbands AT xiaojuanwang comparingclinicalfeaturesseverityandprognosisofautoimmuneencephalitisandwithandwithoutoligoclonalbands AT jiajiaxu comparingclinicalfeaturesseverityandprognosisofautoimmuneencephalitisandwithandwithoutoligoclonalbands AT shaominzuo comparingclinicalfeaturesseverityandprognosisofautoimmuneencephalitisandwithandwithoutoligoclonalbands AT qiuyanliu comparingclinicalfeaturesseverityandprognosisofautoimmuneencephalitisandwithandwithoutoligoclonalbands AT weili comparingclinicalfeaturesseverityandprognosisofautoimmuneencephalitisandwithandwithoutoligoclonalbands |