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Cognitive outcomes in anti-LGI-1 encephalitis

Published online by Cambridge University Press:  05 September 2022

Rachel Galioto Open the ORCID record for Rachel Galioto [Opens in a new window] ,
Albert Aboseif ,
Kamini Krishnan ,
John Lace Open the ORCID record for John Lace [Opens in a new window]  and
Amy Kunchok
Rachel Galioto*
Affiliation:
Mellen Center for Multiple Sclerosis, Cleveland Clinic, Cleveland, OH, USA Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
Albert Aboseif
Affiliation:
Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
Kamini Krishnan
Affiliation:
Neurological Institute, Cleveland Clinic, Cleveland, OH, USA Lou Rouvo Center for Brain Health, Cleveland Clinic, Cleveland, OH, USA
John Lace
Affiliation:
Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
Amy Kunchok
Affiliation:
Mellen Center for Multiple Sclerosis, Cleveland Clinic, Cleveland, OH, USA Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
*
Corresponding author: Rachel Galioto, email: galiotr@ccf.rog
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Abstract

Objective:

Cognitive impairment is one of the most common symptoms of anti-leucine rich glioma inactivated 1 (anti-LGI-1) encephalitis, but little is known about the cognitive profile of these patients. This study characterized the cognitive profile of patients with anti-LGI-1 encephalitis and compared patterns of impairment to healthy controls and other patient groups with known temporal lobe/limbic involvement.

Methods:

A retrospective analysis of adult patients with anti-LGI-1 encephalitis who underwent neuropsychological assessment was conducted. Performance patterns of anti-LGI-1 patients were compared to patients deemed cognitively healthy (HC), as well as patients with amnestic mild cognitive impairment (aMCI) and temporal lobe epilepsy (TLE).

Results:

Among 10 anti-LGI encephalitis patients (60% male, median age 67.5 years) who underwent neuropsychological testing (median = 38.5 months from symptom onset), cognitive deficits were common, with 100% of patients showing impairment (≤1.5 SD below mean) on 1+ measures and 80% on 2+ measures. Patients with anti-LGI-1 encephalitis performed worse than controls on measures of basic attention, vigilance, psychomotor speed, complex figure copy, and aspects of learning/memory. Of measures which differed from controls, there were no differences between the anti-LGI-1 and TLE patients, while the anti-LGI-1 patients exhibited higher rates of impairment in basic attention and lower rates of delayed verbal memory impairment compared to the aMCI patients.

Conclusions:

Long-term cognitive deficits are common in patients with anti-LGI-1 encephalitis and involve multiple domains. Future research in larger samples is needed to confirm these findings.

Keywords

leucine-rich glioma inactived 1autoimmune encephalitisneuropsychological profilecognitive assessmentcognitive outcomesmild cognitive impairmenttemporal lobe epilepsy
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 29 , Issue 6 , July 2023 , pp. 541 - 550
Copyright
Copyright © INS. Published by Cambridge University Press, 2022

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