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[18F]FDG brain PET and clinical symptoms in different autoantibodies of autoimmune encephalitis: a systematic review

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Abstract

Introduction

Autoimmune encephalitis (AE) is caused by the antibodies that target receptors and intracellular or surface proteins. To achieve the appropriate therapeutic results, early and proper diagnosis is still the most important issue. In this review, we provide an overview of FDG-PET imaging findings in AE patients and possible relation to different subtypes and clinical features.

Methods

PubMed, Web of Science, and Scopus were searched in August 2021 using a predefined search strategy.

Results

After two-step reviewing, 22 studies with a total of 332 participants were entered into our qualitative synthesis. In anti-NMDAR encephalitis, decreased activity in the occipital lobe was present, in addition, to an increase in frontal, parietal, and specifically medial temporal activity. Anti-VGKC patients showed altered metabolism in cortical and subcortical regions such as striata and cerebellum. Abnormal metabolism in patients with anti-LGI1 has been reported in diverse areas of the brain including medial temporal, hippocampus, cerebellum, and basal ganglia all of which had hypermetabolism. Hypometabolism in parietal, frontal, occipital lobes, temporal, frontal, and hippocampus was observed in AE patients with anti-GAD antibodies.

Conclusion

Our results indicate huge diversity in metabolic patterns among different AE subtypes and it is hard to draw a firm conclusion. Moreover, the timing of imaging, seizures, and acute treatments can alter the PET patterns strongly. Further prospective investigations with specific inclusion and exclusion criteria should be carried out to identify the metabolic defect in different AE subtypes.

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Authors and Affiliations

  1. Neuroscience Research Group (NRG), Universal Scientific Education and Research Network (USERN), Tehran, Iran

    Fardin Nabizadeh

  2. School of Medicine, Iran University of Medical Sciences, Tehran, Iran

    Fardin Nabizadeh

  3. Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran

    Fardin Nabizadeh, Alireza Sardaripour, Nasim Rezaeimanesh & Abdorreza Naser Moghadasi

  4. School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

    Elham Ramezannezhad

  5. Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran

    Alireza Sardaripour

  6. School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

    Seyed Ali Seyedi

  7. School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran

    Negin Salehi

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  1. Fardin Nabizadeh
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Correspondence to Abdorreza Naser Moghadasi.

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Nabizadeh, F., Ramezannezhad, E., Sardaripour, A. et al. [18F]FDG brain PET and clinical symptoms in different autoantibodies of autoimmune encephalitis: a systematic review. Neurol Sci 43, 4701–4718 (2022). https://doi.org/10.1007/s10072-022-06094-9

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