Long-Term Cognitive, Functional, and Patient-Reported Outcomes in Patients With Anti-NMDAR Encephalitis
Juliëtte Brenner, Cinthia J. Ruhe, Ilse Kulderij, Anna E.M. Bastiaansen, Yvette S. Crijnen, Chelsey N. Kret, Julia C.P. Verkoelen, Anke A.G. Tolido, Brigit Thomassen, Laura P. Kersten, M. Bruijn, Sammy H.C. Olijslagers, Melissa R. Mandarakas, Jeroen Kerstens, Robin W. van Steenhoven, Juna M. de Vries, Sharon Veenbergen, Marco W.J. Schreurs, Rinze F. Neuteboom, Peter A. Sillevis Smitt, Esther van den Berg, Maarten J. Titulaer
Abstract
BACKGROUND AND OBJECTIVES: Anti-NMDA receptor (anti-NMDAR) encephalitis generally manifests in young adults. Although 80%-90% returns to independence, the majority experience persistent cognitive and psychosocial difficulties. Studies have demonstrated that cognitive recovery may continue for years; the temporal trajectory is largely unknown, as are factors influencing cognitive/psychosocial recovery. Objectives were to (1) describe the cognitive recovery trajectory, (2) assess self-reported outcomes, (3) identify factors relating to outcome, and (4) explore the relation between cognitive and self-reported outcomes, and participation. METHODS: -tests for normalized data and nonparametric tests for patient-reported data). Recovery was visualized by plotting outcomes against time-of-assessment. RESULTS: = 0.016). DISCUSSION: Recovery from anti-NMDAR encephalitis may continue for 3 years, with risk of persisting cognitive deficits, notably in memory and language, and sequelae in social functioning, energy levels, and well-being. The frequently applied outcome measure mRS does not fully capture outcomes. Almost half of patients struggled resuming school/work, associated with cognitive deficits and well-being.