id,collection,dc.contributor.author,dc.date.accessioned,dc.date.available,dc.date.issued,dc.description.abstract[en],dc.identifier.uri,dc.language,dc.rights.uri,dc.subject.ddc,dc.subject[en],dc.title,dc.type,dcterms.accessRights.openaire,dcterms.bibliographicCitation.doi,dcterms.bibliographicCitation.journaltitle,dcterms.bibliographicCitation.number,dcterms.bibliographicCitation.originalpublishername,dcterms.bibliographicCitation.pageend,dcterms.bibliographicCitation.pagestart,dcterms.bibliographicCitation.pmid,dcterms.bibliographicCitation.volume,dcterms.isPartOf.eissn,dcterms.isPartOf.issn,refubium.affiliation,refubium.funding,refubium.resourceType.isindependentpub "39a53dad-16c9-4964-9750-d8ef106b2958","fub188/15","Bartels, Frederik||Krohn, Stephan||Nikolaus, Marc||Johannsen, Jessika||Wickström, Ronny||Schimmel, Mareike||Häusler, Martin||Berger, Andrea||Breu, Markus||Blankenburg, Markus||Stoffels, Johannes||Hendricks, Oliver||Bernert, Günther||Kurlemann, Gerd||Knierim, Ellen||Kaindl, Angela||Rostásy, Kevin||Finke, Carsten","2022-01-14T10:09:56Z","2022-01-14T10:09:56Z","2020","Objective: To evaluate disease symptoms, and clinical and magnetic resonance imaging (MRI) findings and to perform longitudinal volumetric MRI analyses in a European multicenter cohort of pediatric anti-N-methyl-D-aspartate receptor encephalitis (NMDARE) patients. Methods: We studied 38 children with NMDARE (median age = 12.9 years, range =1-18) and a total of 82 MRI scans for volumetric MRI analyses compared to matched healthy controls. Mixed-effect models and brain volume z scores were applied to estimate longitudinal brain volume development. Ordinal logistic regression and ordinal mixed models were used to predict disease outcome and severity. Results: Initial MRI scans showed abnormal findings in 15 of 38 (39.5%) patients, mostly white matter T2/fluid-attenuated inversion recovery hyperintensities. Volumetric MRI analyses revealed reductions of whole brain and gray matter as well as hippocampal and basal ganglia volumes in NMDARE children. Longitudinal mixed-effect models and z score transformation showed failure of age-expected brain growth in patients. Importantly, patients with abnormal MRI findings at onset were more likely to have poor outcome (Pediatric Cerebral Performance Category score > 1, incidence rate ratio = 3.50, 95% confidence interval [CI] = 1.31-9.31, p = 0.012) compared to patients with normal MRI. Ordinal logistic regression models corrected for time from onset confirmed abnormal MRI at onset (odds ratio [OR] = 9.90, 95% CI = 2.51-17.28, p = 0.009), a presentation with sensorimotor deficits (OR = 13.71, 95% CI = 2.68-24.73, p = 0.015), and a treatment delay > 4 weeks (OR = 5.15, 95% CI = 0.47-9.82, p = 0.031) as independent predictors of poor clinical outcome. Interpretation: Children with NMDARE exhibit significant brain volume loss and failure of age-expected brain growth. Abnormal MRI findings, a clinical presentation with sensorimotor deficits, and a treatment delay > 4 weeks are associated with worse clinical outcome. These characteristics represent promising prognostic biomarkers in pediatric NMDARE. ANN NEUROL 2020","https://refubium.fu-berlin.de/handle/fub188/33528||http://dx.doi.org/10.17169/refubium-33249","eng","https://creativecommons.org/licenses/by-nc/4.0/","600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit","Anti-N-Methyl-D-Aspartate Receptor Encephalitis||Child||Magnetic Resonance Imaging||Brain","Clinical and Magnetic Resonance Imaging Outcome Predictors in Pediatric Anti–N‐Methyl‐D‐Aspartate Receptor Encephalitis","Wissenschaftlicher Artikel","open access","10.1002/ana.25754","Annals of Neurology","1","Wiley","159","148","32314416","88","1531-8249","0364-5134","Charité - Universitätsmedizin Berlin","DEAL Wiley","no"