Long-Term Clinical and Biological Prognostic Factors of Anti-NMDA Receptor Encephalitis in Children
Maxime Mazowiecki, Lorraine Flet‐Berliac, Julia Roux, Anne Lépine, Pascale Chrétien, Salima Hacein‐Bey‐Abina, Laetitia Giorgi, Frédéric Villega, Emmanuel Cheuret, Marie Bénaiteau, Véronique Rogemond, Géraldine Picard, Sarah Baer, Pierre Cleuziou, Elodie Lametery, Isabelle Desguerre, Mélodie Aubart, Mathilde Chevignard, Roger Le Grand, Philippe Horellou, Carole Leroy, Bastien Joubert, Jérôme Honnorat, Kumaran Deiva
Abstract
BACKGROUND AND OBJECTIVES: Anti-NMDAR encephalitis (NMDARE) is a severe neurologic condition, and recently, the NMDAR Encephalitis One-Year Functional Status (NEOS) score has emerged as a 1-year prognostic tool. This study aimed to evaluate NEOS score and biomarker (neurofilament light chains [NfL], total-Tau protein, glial fibrillary acidic protein, and serum cytokines) correlation with modified Rankin Scale (mRS), cognitive impairment, and clinical recovery in pediatric NMDARE over 2 years. METHODS: In this French multicenter observational study, 104 pediatric patients with NMDARE were followed for a minimum of 2 years. Clinical data and serum/plasma samples were collected. Biomarker levels, measured using electroluminescence mesoscale discovery (MSD) S-PLEX, were compared between patients and controls and assessed for correlations with disease activity, mRS, cognitive/language impairment, and recovery status at 2 years. RESULTS: = 0.01). DISCUSSION: The NEOS score strongly predicts long-term outcomes in NMDARE, with its predictive value extending beyond the first-year mR prediction. NfL levels at disease onset seem to improve accuracy in predicting poor outcomes, providing valuable information for treatment decisions and future clinical trials.