Autoimmune Encephalitis, Cognitive Impairment
Conditions
Keywords
episodic memory, executive control, fMRI
Brief summary
Most of patients with autoimmune encephalitis are left with permanent cognitive deficits of varying severity. The patients' life and career would be affected definitely by cognitive deficits. Recently, more and more clinical physician have begun to focus on cognitive impairment of patients with autoimmune encephalitis. Generally, the outcome was measured by the modified Rankin Scale (mRS). However, the mRS are commonly used to evaluate the degree of disability or dependence in the daily activities of the patients suffering from a stroke and cognition function were minimally evaluated in this scale. It is crucial to adopt detailed cognition tools to study the long-term cognitive outcomes and as an indicator of overall curative effect judgment in autoimmune encephalitis. Currently, only early immunotherapy is uniformly and consistently considered to produce favorable cognitive outcomes. However, studies concerning the association of second-line immunotherapy with cognitive outcomes have been scarce and have shown conflicting results regarding autoimmune encephalitis. Hence, the goal of this study was to explore cognitive neural mechanism of autoimmune encephalitis by using neuropsychological tests and multi-mode MRIs.
Detailed description
The goal of this study was to explore cognitive neural mechanism of different types of autoimmune encephalitis by using neuropsychological tests and multi-mode MRIs. Neuropsychological tests involves the assessments of different cognitive domains. And multi-mode MRIs contains resting-fMRI, DTI and task-related fMRI.
Interventions
DRUGrituximab
375 mg/m2 weekly for 4 weeks
DRUGcyclophosphamide
750 mg/m2 monthly for 4-6 cycles depending on the response
DRUGSteroids
500-1000 mg of methylprednisolone daily for 3 days, then tapered doses
DRUGIntravenous immunoglobulin
intravenous immunoglobulin (IVIG) with or without plasmapheresis
Sponsors
First Affiliated Hospital of Zhejiang University
Study design
Observational model
CASE_CONTROL
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
16 Years to 60 Years
Healthy volunteers
Yes
Inclusion criteria
Diagnosis was established in all patients based on characteristic clinical presentation and detection of immunoglobulin G (IgG) antibodies. \-
Exclusion criteria
1. age \>60 years or \<16 years 2. notable lesions, such as tumors, scars, or vascular malformations, on brain MRI 3. a history of other neuropsychiatric disorders. -
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| brain functional connectivity changes | a minimum of 6 months following initial discharge from hospital | The study uses multi-model fMRI to measure changes of functional connectivity across regions during recovery |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| non-verbal episodic memory | a minimum of 6 months following initial discharge from hospital | Aggie Figures Learning Test (AFLT) |
| working memory | a minimum of 6 months following initial discharge from hospital | working memory test |
| emotion-anxiety | a minimum of 6 months following initial discharge from hospital | self-rating anxiety scale (SAS),the \*total\* range (20-80 scores), anxiety state (the total score is equal or above 41) |
| emotion-depression | a minimum of 6 months following initial discharge from hospital | self-rating depression scale (SDS), the \*total\* range (20-80 scores), depression state (the total score is equal or above 41) |
| verbal episodic memory | a minimum of 6 months following initial discharge from hospital | Chinese auditory verbal learning test (CAVLT) |
| information processing speed | a minimum of 6 months following initial discharge from hospital | symbol-digit modalities test (SDMT) |
| visual-spatial ability | a minimum of 6 months following initial discharge from hospital | block design test |
| semantic fluency test | a minimum of 6 months following initial discharge from hospital | vegetable and fruit, animal |
| executive control | a minimum of 6 months following initial discharge from hospital | Stroop test |
Countries
China
Outcome results
None listed