| Title: |
Long-term clinical and biological prognostic factors of anti-NMDA receptor encephalitis in children |
| Authors: |
Mazowiecki, Maxime; Flet-Berliac, Lorraine; Roux, Julia; Lépine, Anne; Chretien, Pascale; Hacein-Bey-Abina, Salima; Giorgi, Laetitia; Villega, Frederic; Cheuret, Emmanuel; Benaiteau, Marie; Rogemond, Veronique; Picard, Geraldine; Baer, Sarah; Cleuziou, Pierre; Lametery, Elodie; Desguerre, Isabelle; Aubart, Mélodie; Chevignard, Mathilde; Grand, Roger Le; Horellou, Philippe; Leroy, Carole; Joubert, Bastien; Honnorat, Jerome; Deiva, Kumaran |
| Contributors: |
Unité de rééducation neurologique pédiatrique Bicêtre; Hôpital Bicêtre AP-HP, Le Kremlin-Bicêtre; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP); AP-HP. Université Paris Saclay; Assistance Publique - Hôpitaux de Marseille (APHM); Unité de Technologies Chimiques et Biologiques pour la Santé (UTCBS - UM 4 (UMR 8258 / U1267)); Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie - CNRS Chimie (INC-CNRS)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité); Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (MIRCEM); CIC Bordeaux; Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM); Interdisciplinary Institute for Neuroscience / Institut interdisciplinaire de neurosciences Bordeaux (IINS); Université de Bordeaux (UB)-Centre National de la Recherche Scientifique (CNRS); Service Neurologie Pédiatrique CHU Toulouse; Pôle Enfants CHU Toulouse; Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse); Mécanismes en sciences intégratives du vivant (MeLiS); Université Claude Bernard Lyon 1 (UCBL); Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS); Hôpitaux Universitaires de Strasbourg (HUS); Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC); Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS); Service de Neuro-pédiatrie Lille; Hôpital Jeanne de Flandre Lille -Centre Hospitalier Régional Universitaire CHU Lille (CHRU Lille); Hôpital Michallon; Service de Rééducation des pathologies neurologiques acquises de l'enfant Hôpitaux de Saint Maurice; Hôpitaux de Saint Maurice (HNSM); Laboratoire d'Imagerie Biomédicale Paris (LIB); Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS); Groupe de recherche clinique Handicap Moteur et Cognitif et Réadaptation (GRC 24 - HaMCRe); Sorbonne Université (SU); Immunologie des maladies virales, auto-immunes, hématologiques et bactériennes (IMVA-HB); Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay; Hospices Civils de Lyon (HCL); Institut universitaire de France (IUF); Ministère de l'Education nationale, de l’Enseignement supérieur et de la Recherche (M.E.N.E.S.R.); ANR-18-RHUS-0012,BETPSY,Biomarkers in autoimmune EncephaliTis and Paraneoplastic neurological SYndromes(2018) |
| Source: |
ISSN: 2332-7812 ; Neurology Neuroimmunology & Neuroinflammation ; https://hal.science/hal-05028880 ; Neurology Neuroimmunology & Neuroinflammation, 2025, 12 (2), pp.e200346. ⟨10.1212/nxi.0000000000200346⟩ ; https://www.neurology.org/doi/pdf/10.1212/NXI.0000000000200346. |
| Publisher Information: |
CCSD; American Academy of neurology |
| Publication Year: |
2025 |
| Collection: |
HAL Lyon 1 (University Claude Bernard Lyon 1) |
| Subject Terms: |
[SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC] |
| Description: |
International audience ; Background and ObjectivesAnti-NMDAR encephalitis (NMDARE) is a severe neurologic condition, and recently, the NMDAR Encephalitis One-Year Functional Status (NEOS) score has emerged as a 1-year prognostic tool. This study aimed to evaluate NEOS score and biomarker (neurofilament light chains [NfL], total-Tau protein, glial fibrillary acidic protein, and serum cytokines) correlation with modified Rankin Scale (mRS), cognitive impairment, and clinical recovery in pediatric NMDARE over 2 years. MethodsIn this French multicenter observational study, 104 pediatric patients with NMDARE were followed for a minimum of 2 years. Clinical data and serum/plasma samples were collected. Biomarker levels, measured using electroluminescence mesoscale discovery (MSD) S-PLEX, were compared between patients and controls and assessed for correlations with disease activity, mRS, cognitive/language impairment, and recovery status at 2 years.ResultsAt a median follow-up of 39.5 months, 68 percent of patients had unfavorable recovery and 54% had significant cognitive impairment. Both outcomes were strongly associated with younger age at diagnosis (OR 6.10 [1.91–27.3] p < 0.01 and 5.69 [1.46–27.7] p = 0.02, respectively). A higher NEOS score was significantly correlated with increased cognitive impairment (OR 2.53 [1.52–4.21], p < 0.001), higher mRS scores (OR 2.12 [1.34–3.57], p < 0.01), and unfavorable recovery at 2 years (OR 2.00 [1.30–3.06], p = 0.015). Elevated NfL levels were significantly associated with unfavorable recovery (OR 3.62 [1.29–10.9] p = 0.012) and severe cognitive impairment (OR 3.77 [1.38–10.9] p = 0.012) at 2 years. The combined area under the curve (AUC) for NfL and NEOS was significantly higher than the AUCs of NEOS and NfL alone (p = 0.01)DiscussionThe NEOS score strongly predicts long-term outcomes in NMDARE, with its predictive value extending beyond the first-year mR prediction. NfL levels at disease onset seem to improve accuracy in predicting poor outcomes, providing ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1212/nxi.0000000000200346 |
| Availability: |
https://hal.science/hal-05028880; https://hal.science/hal-05028880v1/document; https://hal.science/hal-05028880v1/file/mazowiecki-et-al-2024-long-term-clinical-and-biological-prognostic-factors-of-anti-nmda-receptor-encephalitis-in.pdf; https://doi.org/10.1212/nxi.0000000000200346 |
| Rights: |
https://creativecommons.org/licenses/by/4.0/ ; info:eu-repo/semantics/OpenAccess |
| Accession Number: |
edsbas.B7552DBA |
| Database: |
BASE |