Department of Epileptology, University Hospital Bonn, Germany.
Department of Neuropathology, University Hospital Bonn, Bonn, Germany.
Epilepsia. 2020 Oct;61(10):e140-e145. doi: 10.1111/epi.16691. Epub 2020 Sep 17.
Limbic encephalitis (LE) forms a spectrum of autoimmune diseases involving temporal lobe epilepsy and memory impairment. Imaging features of LE are known to depend on the associated antibody and to occur on the brain network level. However, first studies investigating brain networks in LE have either focused on one distinct antibody subgroup or on distinct anatomical regions. In this study, brain graphs of 17 LE patients with autoantibodies against glutamic acid decarboxylase 65 (GAD-LE), four LE patients with autoantibodies against leucine-rich glioma-inactivated 1, five LE patients with autoantibodies against contactin-associated protein-like 2, 26 age- and gender-matched healthy control subjects, and 20 epilepsy control patients with hippocampal sclerosis were constructed based on T1-weighted structural magnetic resonance imaging scans and diffusion tensor imaging. GAD-LE showed significantly altered global network topology in terms of integration and segregation as compared to healthy controls and patients with hippocampal sclerosis (P < .01, analysis of variance with Tukey-Kramer post hoc tests). Linear regression linked global network measures with amygdala volume and verbal memory performance (P < .05). Alterations of local network topology show serotype dependence in hippocampus, amygdala, insula, and various cortical regions. Our findings reveal serotype-dependent patterns of structural connectivity and prove the relevance of in silico network measures on clinical grounds.
边缘性脑炎（LE）是一种自身免疫性疾病谱，涉及颞叶癫痫和记忆障碍。LE 的影像学特征已知取决于相关抗体，并发生在脑网络水平。然而，首次研究 LE 中脑网络的研究要么集中在一个独特的抗体亚群上，要么集中在不同的解剖区域。在这项研究中，基于 T1 加权结构磁共振成像扫描和弥散张量成像，构建了 17 例谷氨酸脱羧酶 65 自身抗体阳性的 LE 患者（GAD-LE）、4 例富亮氨酸胶质瘤失活 1 自身抗体阳性的 LE 患者、5 例接触蛋白相关蛋白样 2 自身抗体阳性的 LE 患者、26 名年龄和性别匹配的健康对照者和 20 名海马硬化性癫痫对照患者的脑图。与健康对照组和海马硬化性癫痫对照组相比，GAD-LE 的全局网络拓扑在整合和分离方面存在显著改变（P <.01，方差分析，Tukey-Kramer 事后检验）。线性回归将全局网络测量与杏仁核体积和言语记忆表现相关联（P <.05）。局部网络拓扑的改变在海马体、杏仁核、岛叶和各种皮质区域显示出血清型依赖性。我们的发现揭示了结构连接的血清型依赖性模式，并证明了基于计算的网络测量在临床基础上的相关性。
