N-methyl-D-aspartate receptor- antibody encephalitis impairs maintenance of attention to items in working memory

NMDA receptors (NMDAR) may be crucial to working memory (WM). Computational models predict that they sustain neural firing and produce associative memory, which may underpin maintaining and binding information respectively. We test this in patients with antibodies to NMDAR (n=10, female) and compare...

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Autors principals: Dor, A, Harrison, C, Irani, SR, Al-Diwani, A, Grogan, J, Manohar, S
Format: Journal article
Idioma:English
Publicat: Society for Neuroscience 2024
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author Dor, A
Harrison, C
Irani, SR
Al-Diwani, A
Grogan, J
Manohar, S
author_facet Dor, A
Harrison, C
Irani, SR
Al-Diwani, A
Grogan, J
Manohar, S
author_sort Dor, A
collection OXFORD
description NMDA receptors (NMDAR) may be crucial to working memory (WM). Computational models predict that they sustain neural firing and produce associative memory, which may underpin maintaining and binding information respectively. We test this in patients with antibodies to NMDAR (n=10, female) and compare them with healthy control participants (n=55, 20 male, 35 female). Patients were tested after recovery with a task that separates two aspects of WM: sustaining attention and feature binding. Participants had to remember two colored arrows. Then attention was directed to one of them. After a variable delay, they reported the direction of either the same arrow (congruent cue), or of the other arrow (incongruent cue). We asked how congruency affected recall precision and measured types of error. Patients had difficulty in both sustaining attention to an item over time and feature binding. Controls were less precise after longer delays and incongruent cues. In contrast, patients did not benefit from congruent cues at longer delays (Group x Congruency [long condition], p=0.041), indicating they could not sustain attention. Additionally, patients reported the wrong item (misbinding errors) more than controls after congruent cues (Group x Delay [congruent condition], main effect of group, p=<0.001). Our results suggest NMDARs are critical for both maintaining attention and feature binding.<b>Significance Statement</b> Computational theories suggest NMDA receptors (NMDARs) are critical for actively maintaining information, while other theories propose they allow us to associate or "bind" objects features together. This is the first causal test in humans of the role of NMDARs in actively maintaining attention in working memory and feature binding. We find patients have difficulty with both these processes in support of computational models. Notably, we demonstrate that patients with NMDA receptor-antibody encephalitis are an ideal model condition to study roles of receptors in human cognition. Secondly, few studies follow these patients long after treatment. Our findings demonstrate a specific long-term neuropsychological deficit, previously unreported to our knowledge, that highlights the need for greater focus on neurocognitive rehabilitation with these patients.
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spelling oxford-uuid:a9acd7fa-427d-4915-b2e8-db7fcaf842e42024-12-17T11:47:05ZN-methyl-D-aspartate receptor- antibody encephalitis impairs maintenance of attention to items in working memoryJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:a9acd7fa-427d-4915-b2e8-db7fcaf842e4EnglishSymplectic ElementsSociety for Neuroscience2024Dor, AHarrison, CIrani, SRAl-Diwani, AGrogan, JManohar, SNMDA receptors (NMDAR) may be crucial to working memory (WM). Computational models predict that they sustain neural firing and produce associative memory, which may underpin maintaining and binding information respectively. We test this in patients with antibodies to NMDAR (n=10, female) and compare them with healthy control participants (n=55, 20 male, 35 female). Patients were tested after recovery with a task that separates two aspects of WM: sustaining attention and feature binding. Participants had to remember two colored arrows. Then attention was directed to one of them. After a variable delay, they reported the direction of either the same arrow (congruent cue), or of the other arrow (incongruent cue). We asked how congruency affected recall precision and measured types of error. Patients had difficulty in both sustaining attention to an item over time and feature binding. Controls were less precise after longer delays and incongruent cues. In contrast, patients did not benefit from congruent cues at longer delays (Group x Congruency [long condition], p=0.041), indicating they could not sustain attention. Additionally, patients reported the wrong item (misbinding errors) more than controls after congruent cues (Group x Delay [congruent condition], main effect of group, p=<0.001). Our results suggest NMDARs are critical for both maintaining attention and feature binding.<b>Significance Statement</b> Computational theories suggest NMDA receptors (NMDARs) are critical for actively maintaining information, while other theories propose they allow us to associate or "bind" objects features together. This is the first causal test in humans of the role of NMDARs in actively maintaining attention in working memory and feature binding. We find patients have difficulty with both these processes in support of computational models. Notably, we demonstrate that patients with NMDA receptor-antibody encephalitis are an ideal model condition to study roles of receptors in human cognition. Secondly, few studies follow these patients long after treatment. Our findings demonstrate a specific long-term neuropsychological deficit, previously unreported to our knowledge, that highlights the need for greater focus on neurocognitive rehabilitation with these patients.
spellingShingle Dor, A
Harrison, C
Irani, SR
Al-Diwani, A
Grogan, J
Manohar, S
N-methyl-D-aspartate receptor- antibody encephalitis impairs maintenance of attention to items in working memory
title N-methyl-D-aspartate receptor- antibody encephalitis impairs maintenance of attention to items in working memory
title_full N-methyl-D-aspartate receptor- antibody encephalitis impairs maintenance of attention to items in working memory
title_fullStr N-methyl-D-aspartate receptor- antibody encephalitis impairs maintenance of attention to items in working memory
title_full_unstemmed N-methyl-D-aspartate receptor- antibody encephalitis impairs maintenance of attention to items in working memory
title_short N-methyl-D-aspartate receptor- antibody encephalitis impairs maintenance of attention to items in working memory
title_sort n methyl d aspartate receptor antibody encephalitis impairs maintenance of attention to items in working memory
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