Nicolle Della C M, Moses Jennifer L
Cardiff University, Tower Building, 70 Park Place, Cardiff CF10 3AT, UK.
Arch Clin Neuropsychol. 2018 Dec 1;33(8):964-983. doi: 10.1093/arclin/acy005.
A systematic review was conducted to investigate the emerging cognitive profile for people diagnosed with anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis.
Ten papers met the review criteria including five neuropsychological case studies and five case series; three of the 10 studies used matched controls. The cognitive functioning of 54 participants (46 female: eight male) was studied. Paper quality assessment was undertaken and outcomes summarized. Neuropsychological results during the acute phase (≤12 months) and chronic phase (>12 months) were extracted and a narrative review of the papers' findings undertaken.
A range of neuropsychological test batteries were used across the studies, administered between one and four times. The review revealed difficulties with memory, particularly delayed verbal memory, and executive functioning. This may be consistent with the role of NMDA receptors in the limbic system, specifically the hippocampus, which are thought to be essential to aspects of learning and memory.
To date, there is a paucity of high quality neuropsychological and psychological research concerning the impact of anti-NMDAR encephalitis on cognitive function and psychosocial wellbeing, both of adults and particularly of those under 18 years. Significant limitations of the literature reviewed include lack of attention to pre-morbid functioning, insufficient rationale for neuropsychological battery choice, use of samples of convenience, and limited translation of neuropsychological findings into rehabilitation. Limitations of this review include exclusive focus on an adult population and the necessity of a narrative review given the methodological diversity in studies making up the evidence base.
进行一项系统综述，以研究被诊断为抗N-甲基-D-天冬氨酸受体（抗NMDAR）脑炎患者新出现的认知特征。
十篇论文符合综述标准，包括五篇神经心理学病例研究和五篇病例系列；十项研究中有三项使用了匹配对照。对54名参与者（46名女性：8名男性）的认知功能进行了研究。进行了论文质量评估并总结了结果。提取了急性期（≤12个月）和慢性期（>12个月）的神经心理学结果，并对论文的研究结果进行了叙述性综述。
各项研究使用了一系列神经心理学测试组，测试进行了一至四次。综述发现存在记忆困难，尤其是延迟言语记忆和执行功能方面的困难。这可能与NMDA受体在边缘系统，特别是海马体中的作用一致，海马体被认为对学习和记忆的各个方面至关重要。
迄今为止，关于抗NMDAR脑炎对成人尤其是18岁以下人群认知功能和心理社会福祉影响的高质量神经心理学和心理学研究匮乏。所综述文献的显著局限性包括未关注病前功能、神经心理学测试组选择的理论依据不足、使用便利样本以及神经心理学研究结果在康复方面的转化有限。本综述的局限性包括仅关注成年人群体，以及鉴于构成证据基础的研究方法多样，有必要进行叙述性综述。
