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The alterations of spontaneous neural activities and white matter microstructures in anti-N-methyl-D-aspartate receptor encephalitis: a resting-state fMRI and DTI study

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Abstract

Background and purpose

Limited studies had jointly excavated the structural and functional changes in cognitive deficit in anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis patients. We aimed to explore these changes in anti-NMDAR patients and their effect on cognitive function.

Methods

Twenty-three patients and 25 healthy controls (HCs) underwent resting-state functional magnetic resonance imaging, diffusion tensor imaging scanning, and neuroethology tests. The significantly differentiated brain regions via the fractional amplitude of low-frequency fluctuation (fALFF) were defined as regions of interest (ROIs). Granger causal, functional connectivity, and tract-based spatial statistical analyses were applied to explore the functional changes in ROIs and assess the structural changes.

Results

HCs outperformed patients in Montreal Cognitive Assessment. The fALFF values of right gyrus rectus (RGR) in patients were significantly reduced. The fractional anisotropy (FA) values of WM in the genu of corpus callosum and right superior corona radiata were significantly decreased and positively associated with neuroethology testing scores. The Granger causal connectivity (GCC) from the left inferior parietal lobule to RGR was significantly decreased and positively associated with inherent vigilance. Indicated by the multiple linear regression result, decreased FA value of the right superior corona radiata might be a reliable marker that reflects the cognitive impairment.

Conclusions

Significant changes in spontaneous neural activities, GCC, and WM structures in anti-NMDAR encephalitis were reported. These findings promote the understanding of underlying relationships between cerebral function, structural network alterations, and cognitive dysfunction.

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Data availability

Available upon request.

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Acknowledgements

We are sincerely grateful to all the participants. Moreover, we are very grateful to Wei Ye, the radiology technician, for his help and support in the MRI data acquisition.

Funding

This study was supported by the grant from the National Natural Science Foundation of China (Number: 81560223).

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Authors and Affiliations

  1. Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China

    Minda Wei, Zexiang Chen, Caitiao Lv, Weining Cen & Jinou Zheng

Authors
  1. Minda Wei
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  2. Zexiang Chen
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  3. Caitiao Lv
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  4. Weining Cen
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  5. Jinou Zheng
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Contributions

Minda Wei: study design, analyzing the data, writing original manuscript. Zexiang Chen: methodology and statistical analysis. Caitiao Lv and Weining Cen: investigation and data acquisition. Jinou Zheng: providing funding, study design, and revision of the manuscript. All the authors contributed to this research and read and approved the final manuscript.

Corresponding author

Correspondence to Jinou Zheng.

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The protocol was approved by the First Affiliated Hospital of Guangxi Medical University Ethics Committee.

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All the subjects (or kinsfolk) signed a written informed consent about the study.

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The authors declare no competing interests.

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Wei, M., Chen, Z., Lv, C. et al. The alterations of spontaneous neural activities and white matter microstructures in anti-N-methyl-D-aspartate receptor encephalitis: a resting-state fMRI and DTI study. Neurol Sci 44, 1341–1350 (2023). https://doi.org/10.1007/s10072-022-06574-y

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