NMDAcogBR - Evaluation of cognition, functional outcomes, and neuroimaging in anti-NMDAR autoimmune encephalitis

• Grant number: 23/07264-5
• Support Opportunities: Regular Research Grants
• Start date: October 01, 2025
• End date: September 30, 2028
• Field of knowledge: Health Sciences - Medicine
• Principal Investigator: Livia Almeida Dutra
• Grantee: Livia Almeida Dutra
• Host Institution: Instituto Israelita de Ensino e Pesquisa Albert Einstein (IIEPAE). Sociedade Beneficente Israelita Brasileira Albert Einstein (SBIBAE). São Paulo , SP, Brazil
• Associated researchers: Helena Alessi ; João Henrique Fregadolli Ferreira ; Shirley Silva Lacerda

Abstract

Autoimmune encephalitis with antibodies against N-methyl-D-Aspartate receptor (NMDARE) is a rare inflammatory brain disorder characterized by acute or subacute onset of a decreased level of consciousness, cognitive and behavioral changes, seizures, abnormal movements and dysautonomia. The disease affects mainly young adults and children, and its treatment requires costly medications such as IVIG and rituximab. Previously published data indicated that nearly 80% of patients have a good treatment response, with motor and cognitive improvement. However, despite the good outcome initially reported, case series described persistent cognitive, behavioral, psychiatric, and psychosocial impairment in the post-acute phase of the disease (12 months after first symptoms). Brain Magnetic Resonance Imaging (MRI) is often normal in those patients. Therefore, the reasons for persistent cognitive decline and low functional outcomes in NMDARE are not fully understood, and studies evaluating the association of those outcomes with advanced MRI sequences are scarce. Objective: To prospectively evaluate cognition, functional outcomes, and advanced MRI sequences (resting state imaging, diffusion tensor imaging and volumetry) of adult Brazilian patients in the post-acute phase of NMDARE, and to compare results to healthy controls. NMDARE patients and controls will be evaluated using functional outcomes questionnaires, neuropsychological tests, and advanced MRI sequences in two appointments 12 months apart. Results will be compared, and variables associated with cognitive and functional prognosis will be studied. (AU)