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Fluorodeoxyglucose positron emission tomography in anti-N-methyl-D-aspartate receptor encephalitis: distinct pattern of disease

Leypoldt, Frank ; Buchert, Ralph ; Kleiter, Ingo ; Marienhagen, Jörg ; Gelderblom, Mathias ; Magnus, Tim ; Dalmau, Josep ; Gerloff, Christian ; Lewerenz, Jan

Journal of neurology, neurosurgery and psychiatry, 2012-07, Vol.83 (7), p.681-686 [Periódico revisado por pares]

London: BMJ Publishing Group Ltd

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Fluorodeoxyglucose positron emission tomography in anti-N-methyl-D-aspartate receptor encephalitis: distinct pattern of disease
Autor: Leypoldt, Frank ; Buchert, Ralph ; Kleiter, Ingo ; Marienhagen, Jörg ; Gelderblom, Mathias ; Magnus, Tim ; Dalmau, Josep ; Gerloff, Christian ; Lewerenz, Jan
Assuntos: Adult ; Anti-N-Methyl-D-Aspartate Receptor Encephalitis - pathology ; Biological and medical sciences ; Brain - metabolism ; Brain - pathology ; brain glucose metabolism ; Cerebrospinal fluid ; Convulsions & seizures ; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases ; Encephalitis ; Epilepsy ; FDG-PET ; Female ; Fluorodeoxyglucose F18 ; Frontal Lobe - pathology ; Glucose ; Glucose - metabolism ; Humans ; immunology ; limbic encephalitis ; Male ; Medical sciences ; multiple sclerosis ; neurobiology ; neurochemistry ; neurogenetics ; Neuroimaging ; Neuroimaging - methods ; neuroimmunology ; Neurology ; neurooncology ; NMDA ; paraneoplastic syndrome ; Patients ; Positron-Emission Tomography - methods ; Radiopharmaceuticals ; Retrospective Studies ; Software packages ; Temporal Lobe - metabolism ; Temporal Lobe - pathology ; Tomography ; Tumors ; Young Adult
É parte de: Journal of neurology, neurosurgery and psychiatry, 2012-07, Vol.83 (7), p.681-686
Notas: FL and RB contributed equally to the manuscript.
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Descrição: BackgroundPatients 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.MethodsThe 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.ResultsGroupwise 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.ConclusionsA 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.
Editor: London: BMJ Publishing Group Ltd
Idioma: Inglês

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Fluorodeoxyglucose positron emission tomography in anti-N-methyl-D-aspartate receptor encephalitis: distinct pattern of disease

Leypoldt, Frank ; Buchert, Ralph ; Kleiter, Ingo ; Marienhagen, Jörg ; Gelderblom, Mathias ; Magnus, Tim ; Dalmau, Josep ; Gerloff, Christian ; Lewerenz, Jan

London: BMJ Publishing Group Ltd

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