Leypoldt, Frank and Buchert, Ralph and Kleiter, Ingo and Marienhagen, Joerg and Gelderblom, Mathias and Magnus, Tim and Dalmau, Josep and Gerloff, Christian and Lewerenz, Jan (2012) Fluorodeoxyglucose positron emission tomography in anti-N-methyl-D-aspartate receptor encephalitis: distinct pattern of disease. JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 83 (7). pp. 681-686. ISSN 0022-3050, 1468-330X
Full text not available from this repository. (Request a copy)Abstract
Background Patients with encephalitis associated with antibodies against N-methyl-D-aspartate-receptor antibody (NMDAR-ab) encephalitis frequently show psychotic symptoms, amnesia, seizures and movement disorders. While brain MRI in NMDAR-ab encephalitis is often normal, abnormalities of cerebral glucose metabolism have been demonstrated by positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) in a few usually isolated case reports. However, a common pattern of FDG-PET abnormalities has not been reported. Methods The authors retrospectively identified six patients with NMDAR-ab encephalitis in two large German centres who underwent at least one whole-body FDG-PET for tumour screening between January 2007 and July 2010. They analysed the pattern of cerebral uptake derived from whole-body PET data for characteristic changes of glucose metabolism compared with controls, and the changes of this pattern during the course of the disease. Results Groupwise analysis revealed that patients with NMDAR-ab encephalitis showed relative frontal and temporal glucose hypermetabolism associated with occipital hypometabolism. Cross-sectional analysis of the group demonstrated that the extent of these changes is positively associated with clinical disease severity. Longitudinal analysis of two cases showed normalisation of the pattern of cerebral glucose metabolism with recovery. Conclusions A characteristic change in cerebral glucose metabolism during NMDAR-ab encephalitis is an increased frontotemporal-to-occipital gradient. This pattern correlates with disease severity. Similar changes have been observed in psychosis induced by NMDAR antagonists. Thus, this pattern might be a consequence of impaired NMDAR function.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | PARANEOPLASTIC LIMBIC ENCEPHALITIS; FDG-PET; NMDAR ENCEPHALITIS; KETAMINE; BRAIN; MRI; PSYCHOPATHOLOGY; MECHANISMS; SYMPTOMS; TERATOMA; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Abteilung für Nuklearmedizin |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 12 May 2020 09:58 |
| Last Modified: | 12 May 2020 09:58 |
| URI: | https://pred.uni-regensburg.de/id/eprint/18549 |
Actions (login required)
 |
View Item |
