Brain Metabolic Alterations in Seropositive Autoimmune Encephalitis: An <sup>18</sup>F-FDG PET Study
Introduction: Autoimmune encephalitis (AE) diagnosis and follow-up remain challenging. Brain <sup>18</sup>F-fluoro-deoxy-glucose positron emission tomography (FDG PET) has shown promising results in AE. Our aim was to investigate FDG PET alterations in AE, according to antibody subtype....
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MDPI AG
2023-02-01
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| Online Access: | https://www.mdpi.com/2227-9059/11/2/506 |
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| author | Sébastien Bergeret Cristina Birzu Pierre Meneret Alain Giron Sophie Demeret Clemence Marois Louis Cousyn Laura Rozenblum Alice Laurenge Agusti Alentorn Vincent Navarro Dimitri Psimaras Aurélie Kas |
| author_facet | Sébastien Bergeret Cristina Birzu Pierre Meneret Alain Giron Sophie Demeret Clemence Marois Louis Cousyn Laura Rozenblum Alice Laurenge Agusti Alentorn Vincent Navarro Dimitri Psimaras Aurélie Kas |
| author_sort | Sébastien Bergeret |
| collection | DOAJ |
| description | Introduction: Autoimmune encephalitis (AE) diagnosis and follow-up remain challenging. Brain <sup>18</sup>F-fluoro-deoxy-glucose positron emission tomography (FDG PET) has shown promising results in AE. Our aim was to investigate FDG PET alterations in AE, according to antibody subtype. Methods: We retrospectively included patients with available FDG PET and seropositive AE diagnosed in our center between 2015 and 2020. Brain PET Z-score maps (relative to age matched controls) were analyzed, considering metabolic changes significant if |Z-score| ≥ 2. Results: Forty-six patients were included (49.4 yrs [18; 81]): 13 with GAD autoantibodies, 11 with anti-LGI1, 9 with NMDAR, 5 with CASPR2, and 8 with other antibodies. Brain PET was abnormal in 98% of patients versus 53% for MRI. The most frequent abnormalities were medial temporal lobe (MTL) and/or striatum hypermetabolism (52% and 43% respectively), cortical hypometabolism (78%), and cerebellum abnormalities (70%). LGI1 AE tended to have more frequent MTL hypermetabolism. NMDAR AE was prone to widespread cortical hypometabolism. Fewer abnormalities were observed in GAD AE. Striatum hypermetabolism was more frequent in patients treated for less than 1 month (<i>p</i> = 0.014), suggesting a relation to disease activity. Conclusion: FDG PET could serve as an imaging biomarker for early diagnosis and follow-up in AE. |
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| last_indexed | 2024-03-11T09:07:24Z |
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| spelling | doaj.art-d90b1b691e5c45298aa8160eec3385f12023-11-16T19:19:14ZengMDPI AGBiomedicines2227-90592023-02-0111250610.3390/biomedicines11020506Brain Metabolic Alterations in Seropositive Autoimmune Encephalitis: An <sup>18</sup>F-FDG PET StudySébastien Bergeret0Cristina Birzu1Pierre Meneret2Alain Giron3Sophie Demeret4Clemence Marois5Louis Cousyn6Laura Rozenblum7Alice Laurenge8Agusti Alentorn9Vincent Navarro10Dimitri Psimaras11Aurélie Kas12Sorbonne University, AP-HP, Pitié Salpêtrière-Charles Foix Hospital Group, Nuclear Medicine Department, 75013 Paris, FranceParis Brain Institute, ICM, Sorbonne University, AP-HP, UMR S 1127, INSERM, Pitié Salpêtrière-Charles Foix Hospital Group, Service de Neurologie 2-Mazarin, 75013 Paris, FranceNuclear Medicine Department, Eugène Marquis Centre, INSERM, LTSI-UMR 1099, 35000 Rennes, FranceLaboratoire d’Imagerie Biomédicale, LIB, Sorbonne Université, CNRS, INSERM, 75006 Paris, FranceSorbonne University, AP-HP, Pitié Salpêtrière-Charles Foix Hospital Group, Neurology Department, Neurological Intensive Care Unit, 75013 Paris, FranceSorbonne University, AP-HP, Pitié Salpêtrière-Charles Foix Hospital Group, Neurology Department, Neurological Intensive Care Unit, 75013 Paris, FranceSorbonne University, AP-HP, Pitié-Salpêtrière-Charles Foix Hospital Group, Epilepsy Unit, Paris Brain Institute, ICM, Reference Center for Rare Epilepsies, 75013 Paris, FranceSorbonne University, AP-HP, Pitié Salpêtrière-Charles Foix Hospital Group, Nuclear Medicine Department, 75013 Paris, FranceParis Brain Institute, ICM, Sorbonne University, AP-HP, UMR S 1127, INSERM, Pitié Salpêtrière-Charles Foix Hospital Group, Service de Neurologie 2-Mazarin, 75013 Paris, FranceParis Brain Institute, ICM, Sorbonne University, AP-HP, UMR S 1127, INSERM, Pitié Salpêtrière-Charles Foix Hospital Group, Service de Neurologie 2-Mazarin, 75013 Paris, FranceSorbonne University, AP-HP, Pitié-Salpêtrière-Charles Foix Hospital Group, Epilepsy Unit, Paris Brain Institute, ICM, Reference Center for Rare Epilepsies, 75013 Paris, FranceParis Brain Institute, ICM, Sorbonne University, AP-HP, UMR S 1127, INSERM, Pitié Salpêtrière-Charles Foix Hospital Group, Service de Neurologie 2-Mazarin, 75013 Paris, FranceSorbonne University, Laboratoire d’Imagerie Biomédicale, LIB, CNRS, INSERM, AP-HP, Pitié Salpêtrière-Charles Foix Hospital Group, Nuclear Medicine Department, 75013 Paris, FranceIntroduction: Autoimmune encephalitis (AE) diagnosis and follow-up remain challenging. Brain <sup>18</sup>F-fluoro-deoxy-glucose positron emission tomography (FDG PET) has shown promising results in AE. Our aim was to investigate FDG PET alterations in AE, according to antibody subtype. Methods: We retrospectively included patients with available FDG PET and seropositive AE diagnosed in our center between 2015 and 2020. Brain PET Z-score maps (relative to age matched controls) were analyzed, considering metabolic changes significant if |Z-score| ≥ 2. Results: Forty-six patients were included (49.4 yrs [18; 81]): 13 with GAD autoantibodies, 11 with anti-LGI1, 9 with NMDAR, 5 with CASPR2, and 8 with other antibodies. Brain PET was abnormal in 98% of patients versus 53% for MRI. The most frequent abnormalities were medial temporal lobe (MTL) and/or striatum hypermetabolism (52% and 43% respectively), cortical hypometabolism (78%), and cerebellum abnormalities (70%). LGI1 AE tended to have more frequent MTL hypermetabolism. NMDAR AE was prone to widespread cortical hypometabolism. Fewer abnormalities were observed in GAD AE. Striatum hypermetabolism was more frequent in patients treated for less than 1 month (<i>p</i> = 0.014), suggesting a relation to disease activity. Conclusion: FDG PET could serve as an imaging biomarker for early diagnosis and follow-up in AE.https://www.mdpi.com/2227-9059/11/2/506positron emission tomographyautoimmune encephalitisdiagnostic imagingimaging biomarkersmetabolism |
| spellingShingle | Sébastien Bergeret Cristina Birzu Pierre Meneret Alain Giron Sophie Demeret Clemence Marois Louis Cousyn Laura Rozenblum Alice Laurenge Agusti Alentorn Vincent Navarro Dimitri Psimaras Aurélie Kas Brain Metabolic Alterations in Seropositive Autoimmune Encephalitis: An <sup>18</sup>F-FDG PET Study Biomedicines positron emission tomography autoimmune encephalitis diagnostic imaging imaging biomarkers metabolism |
| title | Brain Metabolic Alterations in Seropositive Autoimmune Encephalitis: An <sup>18</sup>F-FDG PET Study |
| title_full | Brain Metabolic Alterations in Seropositive Autoimmune Encephalitis: An <sup>18</sup>F-FDG PET Study |
| title_fullStr | Brain Metabolic Alterations in Seropositive Autoimmune Encephalitis: An <sup>18</sup>F-FDG PET Study |
| title_full_unstemmed | Brain Metabolic Alterations in Seropositive Autoimmune Encephalitis: An <sup>18</sup>F-FDG PET Study |
| title_short | Brain Metabolic Alterations in Seropositive Autoimmune Encephalitis: An <sup>18</sup>F-FDG PET Study |
| title_sort | brain metabolic alterations in seropositive autoimmune encephalitis an sup 18 sup f fdg pet study |
| topic | positron emission tomography autoimmune encephalitis diagnostic imaging imaging biomarkers metabolism |
| url | https://www.mdpi.com/2227-9059/11/2/506 |
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