Cognitive function recovery pattern in adult patients with severe anti-N-methyl-D-aspartate receptor encephalitis: A longitudinal study

Abstract

Objective: To observe the dynamic characteristics of cognitive function following early application of immunotherapy in adult patients with severe anti N-methyl D-aspartate receptor (anti-NMDAR) encephalitis. Methods: Serial neuropsychological assessments were performed at three sequential time points in five adult patients with severe anti-NMDAR encephalitis following early-initiated immunotherapy. The three sequential points were 1-2, 6, and 11-12 months after treatment. Five normal subjects without psychological or neurological diseases were assessed as a control group. Results: Following early-initiated immunotherapy, all five patients demonstrated a gradual improvement of overall cognitive function over the 1-year follow-up period. All patients had suffered from a comprehensive cognitive function disorder from the early stages of the illness. Six months after the immunotherapy, the treatment group showed no significant differences in verbal episodic memory function compared with the control group. One year after the immunotherapy, non-verbal episodic memory function in the treatment group had normalized. The results of other tests related to frontoparietal cognitive function revealed damage of varying degrees during these three phases. Conclusion: The results of this sequential observation study indicated a three-phase recovery pattern of cognitive function in adult patients with severe anti-NMDAR encephalitis following early initiated immunotherapy. These findings extend current understanding of the recovery mechanisms of cognitive function impairment in this disease.