The Usage of Neuropsychological Tests and Multi-mode Magnetic Resonance Imaging in Patients With Autoimmune Encephalitis for Cognitive Neural Mechanism
Overview
- Phase
- N/A
- Intervention
- Steroids
- Conditions
- Cognitive Impairment
- Sponsor
- First Affiliated Hospital of Zhejiang University
- Enrollment
- 22
- Locations
- 1
- Primary Endpoint
- brain functional connectivity changes
- Status
- Completed
- Last Updated
- 7 years ago
Overview
Brief Summary
Most of patients with autoimmune encephalitis are left with permanent cognitive deficits of varying severity. The patients' life and career would be affected definitely by cognitive deficits. Recently, more and more clinical physician have begun to focus on cognitive impairment of patients with autoimmune encephalitis. Generally, the outcome was measured by the modified Rankin Scale (mRS). However, the mRS are commonly used to evaluate the degree of disability or dependence in the daily activities of the patients suffering from a stroke and cognition function were minimally evaluated in this scale. It is crucial to adopt detailed cognition tools to study the long-term cognitive outcomes and as an indicator of overall curative effect judgment in autoimmune encephalitis.
Currently, only early immunotherapy is uniformly and consistently considered to produce favorable cognitive outcomes. However, studies concerning the association of second-line immunotherapy with cognitive outcomes have been scarce and have shown conflicting results regarding autoimmune encephalitis.
Hence, the goal of this study was to explore cognitive neural mechanism of autoimmune encephalitis by using neuropsychological tests and multi-mode MRIs.
Detailed Description
The goal of this study was to explore cognitive neural mechanism of different types of autoimmune encephalitis by using neuropsychological tests and multi-mode MRIs. Neuropsychological tests involves the assessments of different cognitive domains. And multi-mode MRIs contains resting-fMRI, DTI and task-related fMRI.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Diagnosis was established in all patients based on characteristic clinical presentation and detection of immunoglobulin G (IgG) antibodies.
Exclusion Criteria
- •age \>60 years or \<16 years
- •notable lesions, such as tumors, scars, or vascular malformations, on brain MRI
- •a history of other neuropsychiatric disorders. -
Arms & Interventions
patients with first-line only
patients who received first-line immunotherapy (steroids, intravenous immunoglobulin, plasmapheresis)only
Intervention: Steroids
patients with first-line only
patients who received first-line immunotherapy (steroids, intravenous immunoglobulin, plasmapheresis)only
Intervention: Intravenous immunoglobulin
patient with first-line and second-line
patients who received intravenous second-line immunotherapy (steroids, intravenous immunoglobulin, plasmapheresis),in addition to first-line immunotherapy (rituximab, cyclophosphamide)
Intervention: rituximab
patient with first-line and second-line
patients who received intravenous second-line immunotherapy (steroids, intravenous immunoglobulin, plasmapheresis),in addition to first-line immunotherapy (rituximab, cyclophosphamide)
Intervention: cyclophosphamide
patient with first-line and second-line
patients who received intravenous second-line immunotherapy (steroids, intravenous immunoglobulin, plasmapheresis),in addition to first-line immunotherapy (rituximab, cyclophosphamide)
Intervention: Steroids
patient with first-line and second-line
patients who received intravenous second-line immunotherapy (steroids, intravenous immunoglobulin, plasmapheresis),in addition to first-line immunotherapy (rituximab, cyclophosphamide)
Intervention: Intravenous immunoglobulin
Outcomes
Primary Outcomes
brain functional connectivity changes
Time Frame: a minimum of 6 months following initial discharge from hospital
The study uses multi-model fMRI to measure changes of functional connectivity across regions during recovery
Secondary Outcomes
- emotion-depression(a minimum of 6 months following initial discharge from hospital)
- semantic fluency test(a minimum of 6 months following initial discharge from hospital)
- verbal episodic memory(a minimum of 6 months following initial discharge from hospital)
- information processing speed(a minimum of 6 months following initial discharge from hospital)
- emotion-anxiety(a minimum of 6 months following initial discharge from hospital)
- executive control(a minimum of 6 months following initial discharge from hospital)
- visual-spatial ability(a minimum of 6 months following initial discharge from hospital)
- non-verbal episodic memory(a minimum of 6 months following initial discharge from hospital)
- working memory(a minimum of 6 months following initial discharge from hospital)